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11204 (AR)Building 53_41.5 Velasco Address Owner Joe 6livera Mailing �� Address City. La Quinta zip 92253 P.O. BOX 1504 !\ % ,N O . 78-105 CALLE ESTADOf LA QUINTA, CALIFORNIA 92253 ff"" d 564 -4454 Contractor I owner/BUiider. lZip Tel.: State Lic. City & Classif. I Lic. # Arcn., tngr., Designer Address Tel. CityI Zip I State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's Lirense Law for the following reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a permit to construct, atter, 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 o/ the Business and Professions Code, or that. he Is exempt therefrom, and the basis for the alleged exemption. Any violation o/ Section 7031.5 by any applicant for a permit su bjects the applicant to a civil penalty of not more than rive hundred dollars (E500). 06, 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 Professions Code: The Contractor's License Law does not apply to an owner o/ property who builds or improves thereon and who does such work himself or through his own employees, provided that' such _improvements are not intended or offered ./or safe. ff. however, the building or improvement is sold .within one year o/ completion, the owner -builder will have the burden o/ proving that he did not build or improve /or the purpose o/ sale.) - ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner or 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, tabor. 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 (5100) valuation or less.) 1 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' Compensation Laws of California. Date Owner NOTICE TO 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. CONSTRUCTION LENDING AGENCY 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.) Lender's Name Lender's Address 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 is 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 11244 BUILDING: TYPE CONST. OCC: GRP. - A.P. Number Legal Description Project Description Room Addition Sq. Ft. �$ Size No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation 10,355.40 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. 81.90 Const. 126.00 Mech. 19.50 Electrical 21.3.3 Plumbing S.M.I. .77 Grading Driveway Enc. Infrastructure TOTAL 250.10 REMARKS ftflt ?? 5� 3 42iiIfT,49-i 1—'if2mc'r. in, tit 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 Property Line FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. @ $ UNITS SLAB GRADE 2ND FL. SQ. FT. @ BONDING YARD SPKLR SYSTEM POR. SQ. FT. @ MOBILEHOME SVC. BAR SINK GAR. SQ, FT, ® POWER OUTLET ROOF DRAINS CAR P. SO. FT. ® FOUND. REINF. DRAINAGE PIPING WALL SQ. FT. HEATING (FINAL) DRINKING FOUNTAIN. SQ FT ® GAS (FINAL) URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation SERVICE FLOOR DRAIN MECHANICAL FEES BOND BEAM WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FINAL INSP.D a4 q � LAUNDRYTRAY AIR HANDLING UNIT CFM W D �/.� „_ IrQC /Q/ q�� !C I G 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. SQ. FT. ® c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11% c SEWAGE DISPOSAL GAR. FIREWALL SQ.FT.GAR ® 3/ac HOUSE SEWER LAT G GAS PIPING PERMIT 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 & AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) SYORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING. DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. 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.D a4 q � ROOFING W D �/.� „_ IrQC /Q/ q�� !C I G REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LAT G MESH INSULATION/SOUND r FINISH GRADING FINAL INSPECTION Q CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/IN]TIALS GARDEN WALL FINAL