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04357 (SATT)r. TA P.O. BOX 1504 Buildin �— 78-105 CALLE ESTADO Address 53369 Ta ng'lewo ,•, .... LA.QUINTA, CALIFORNIA 92253 Owner su=ise company _ Mailing, Address_ 75-005 Country alub Dr. _ City - Zip Tel. q�y Valor Desert 9226P..-568"�2Q2Qi Contractor . National Mortgage r - 7I �A3357 '.i BUILDING: TYPE CONST. OCC. GRP. A.P. Number - .. kISA West — 'The Greens Legal Description Project Description ` Phase 7G City Zip Tel. w ! r�h State Lic.rA r $ City & Classif. Lic. it - Sq. Ft. 1700 No. No. Dw.'. Size Stories Units' Arch., Engr., Designer New'❑ Add ❑ Alter ❑ Repair ❑. Demolition ❑ Address Tel. " City • ' Zip State _ , Lia q LICENSED CONTRACTOR'S DECLARATION Ihereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7n, of Division 3 of the Business and Professions Code, and my license is in full force and effect_ SIGNATURE - DATE 1OWNER-BUILDER DECLARATION Estimated Valuation I -I•hereby affirm that I am exempt from the Contractor's License Law for the following 1120 769 . reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a • d 7 permit to , construct, after, Improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to rife a signed statement that he is licensed pursuant to PERMIT - •AMOUNT the provisions of the Contractor's License law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cade, or that. he Is exempt therefrom, and the basis Any Section 7031.5 by 'any for Chk. Dep. - i - �, 1 for the alleged exemption. violation of applicant a permitPlan subjects the applicant to a civil penalty of not more than five hundred dollars ($500). Plan Chk. Bal. ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and .401.27 Const. '495.50Professions • Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees, Mech. A.111 •"1f /i.0 339 provided that such improvements are not intended or offered for sale. If, however, the building V r or improvement is sold within one year of completion, the owner -builder will have the burden Electrical ` 72.50 of proving that he did not build or improve for the purpose of sale.) ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 105,00 struct,the project. (Sec.' 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for S.M.I. 0.44 such projects with a contractor(s) licensed pursuant tothe Contractor's License Law.) Grading O 1 am exempt under Sec. B. & P.C. for this reason " Driveway Enc. Date "'Owner Infrastructure 1 �. r tv�l3ri`.�I r. WORKERS' COMPENSATION DECLARATION Ix trasa'X€ Ct'rur2 Waw y 4 00 ' I hereby•affirm-that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No.' Company .O Copy is filed with the city. ❑ Certified copy is hereby furnished. - - TOTAL +� - Y 4F,Y • as i Yf-i 1, IF�. , ij CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE +(This seefion-need not.be completed if the permit Is for oris hundred dollars ($100) valuation r ft'��-" "3t. e.t111 Illi R`-�.-f =,3r!. '�•-ir " or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. r Date _*Owner NOTICE -TO APPLICANT: g, alter making this Certificate of Exemption you should become ZONE: BY: - subject to the Workers' Compensation provisions of the Labor. Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Minimum Setback Distances: -' d Front Setback from Center Line Rear Setback from Rear Prop. Line ' CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line ,. I hereby affirm that there is a construction lending agency for the performance of the ' work for which this permit is issued. (Sec. 3097, Civil Code.) Side Setback from Property Line Lender's Name Lender's; Address FINAL DATE INSPECTOR ` ' This is a building permit when properly filled out, signed and validated, and is subject to . expiration if work thereunder is suspended for 180 days./ 2 6 13 8 I certify that I have read this application and state that the above Information is correct. Issued by: Date Permit- " I agree to comply with all city and county ordinances and state laws relating to building , construction, and hereby authorize representatives -of this city to enter the above- bove Mentioned mentioned property for inspection purposes. . - Validated by: 3: i Signature of•applicant • Date ' Mailing Address Validation: City,. State, Zip .O.< � WHITE -FINANCE, PINK APPLICANT, GREEN -BUILDING,' GOLDENROD - ASSESSORS OFFICE, HARD COPY.- FILE J., I'•�S �. ��is?!R-.e'�Jl..'.-�1��t 1.'a`�.S�P .,. "i,!_ v w _, ..flu,:.tf.f.-�.,5:•.. J-TIiN,,.r.)' Rn...1�k .....'�:. u.n .. r.a.. -• .... _.-: v.J, �.. ...- u,:!-..�r...�-_u<'w.•1.t?...a. -. r: �'t...:�J+Y'.3 •-i ('.�.� fti ... CONSTRUCTION ESTIMATL NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL SO FT (a S UNITS SLAB GRADE ROUGH PLUMB BONDING YARD SPKLR SYSTEM 2ND FL SO FT. a FORMS SEWER OR SEPT"C TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR SO FTat GAS (ROUGH) METER LOOP HEATING (FINAL) OUTLET ROOF DRAINS GAR SO. FT. aPOWER TEMP. POLE GROUT DRAINAGE PIPING CARP. SO FT. 6 FINAL INSP. WALL SO. FT. (d WATER SYSTEM DRINKING FOUNTAIN GRADING cu. yd. $ plus x$ _$ URINAL SO. FT. (d FINAL INSP. FRAMING ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASH ER(AUTONDISH) APPLIANCE DRYER FIRE ZONE ROOFING GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FIREPLACE ILAUNDRYTRAY AIR HANDLING UNIT CFM KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP POLE, TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. ® c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID g I'A c SEWAGE DISPOSAL SO.FT.GAR (g 3/.c HOUSE SEWER J �61I CTION/ / GAS PIPING PERM17 FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB FEE STRUCTURE PLUMBING ELECTRICAL HEATING 8 AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPT"C TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ _$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR - GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING J �61I CTION/ / " CE 7. OCC. FENCE FINAL 1 INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL