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14365 (AR)Building Owner 53-260 Ave. Velasco Double D Construction P.O. BOX 1504 78-495 CALLE TAMPICO LA OUINTA, CALIFORNIA 92253 man.ny 51-060 Ave. Herrera AAddress -Tip. sd#ap�e 253 TA1-4 771--156.1 Contractor SameSame Address City lZip Tel.: State Lic. City & Classif.. B 681012 Lic. # 323 Arch., Engr., Sam 'Designer Address Tel. City ( Zip ( State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm th I am licensed under provisions of Chapter 9 (commencing with. Section 7000) off Division 3 f the B=In�ests and Piofessllosns. Code,ytand my license is in full force and effect. l itV� �C 111I'f,�.1 ref i"'� / w�i f't1 SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor•s'License Law for the following reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance.also requires the applicant for such permit -to rile a signed statement that he* is licensed pursuant to the provisions of the Contractor's_ License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or that: he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by :any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). - ❑ I,as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure isnot Intended or offered for sale. (Sec. 7044, Buisness and Professions 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, provided that such Improvements arenotIntended or offered.for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale.) . O 1, as owner of the property, am exclusively contracting with licensed contractors to con- 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 such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) O 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION 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 ❑ Copy is filed with the city, . ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed If the permit is for one hundred dollars ($100) valuation or less.)" I certify that in the performance of thg work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers'�Ompensation LawsiCali rnia. 1a /11 F� Date fff NOTICE. fT0 APPLICANT: If, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions -of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND' SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL'FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO T.HE.COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. ' 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. • I certify that I have read this application and state that the above information it correct. 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-. mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip No. 14355 11LDING: TYPE CONST. 'OCC: GRP. R. Number 779-085 025 Lots I & 2 Block 227 (gal Description oject Description Guest -House Sq. Ft. No. No. Dw. Size 392 Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ . -Demolition ❑ Permit does not include block walls or pool. Estimated Valuation $21r,286.00 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. • Electrical Plumbing S.M.I.-:— Grading Driveway Enc. Infrastructure 77 2 V8 TOTAL REMARKS 7 75 • Permit tees reelect lot merger incentive. ZONE: BY: Minimum Setback Distances.. ., Front Setback from Center.Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Prop' ine FINAL DATE INSPE R Issued by:: Date Permi Validated by: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBIW FEES IST FL. SO. FT. ® $ UNITS SLAB GRADE QLD 2ND FL. SO. FT. YARD SPKLR SYSTEM ' STORAGE TANK MOBILEHOME SVC. BAR SINK POR. SO. FT. ® 'DUCT WORK ROCK STORAGE GAR. SO. FT. ® POWER OUTLET ROOF DRAINS HEATING (FINAL) OTHER APPJEOUIP. DRAINAGE PIPING CAR P. SO. FT. WALL SO. FT. GROUT DRINKING FOUNTAIN SO. FT. ® FINAL INSP. URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER SYSTEM WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES FRAMING / �'� ; WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY 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 ® 11/. c SEWAGE DISPOSAL SO.FT.GAR ® 3/ac HOUSE SEWER FINISH GRADING GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEEMECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING �Q DERGROUND A.C. UNIT COLL. AREA SLAB GRADE QLD ROUGH PLUMP. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER G -SANK ROUGH WIRING 'DUCT WORK ROCK STORAGE FOUND. REINF. a� J GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. 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. D / FRAMING / �'� ; FINAL INSP. ROOFING t/ VENTILATION Ole 7 0 ��5&4A%-1r� / r mloyml? / � /�/.--50 •TJ�/��%�� G� ��%a� 12-gcT� �/� 3 8 // G0+2/LoCr%GK1 trb' — 77 / REMARKS: / / J M) % C' s / Ev FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION ' / l CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL