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05310 (CRES)P.O. BOX 1504 Building78-105 CALLE ESTADO Address 54 V 0 =SCO LA QUINTA, CALIFORNIA 92253 Owner JIM& MC DON= No. 05.310, Mailing BUILDING: TYPE CONST. OCC: GRP. Address Ste, A.P. Number 774-284-011-012 City Q Tg Zip Tel. 92253 364-4908 Legal Description Contractor ]Project Description CA YRT WESSM6' I? Address City ' State Lia City & Classif. Lic. # Sq. Ft. No. No. Dw. Size - - Stories Units Arch., Engr., Designer . New ❑ Add. ❑ Alter ❑ Repair ❑ Demolition ❑ Address' Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION k )h- ereby 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 ` z - SIGNATURE DATE OWNER -BUILDER DECLARATION' Estimated Valuation I hereby affirm that I am exempt from the Contractors License Law for the following 1 reason: (Sec. 7031.5,Susiness 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 tie a signed statement that hes 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 Code, or that. he is exempt therelmm, and the basis for the •alleged exemption. Any Section 7031.5 by 'any for • Plan Chk. Dep. ' violation of applicant a permit. subjects the applicant to a civil penalty of not more than five hundred dollars ($500). - I, Plan Chk. Bal. 24.25 ❑ 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 CiOrISt. S �� Professions Code: The Contractor's License Law does not apply to an owner of property who •0 ' builds or improves thereon and who does such work himself or through his own employees, Mech. Provided that such improvements are not intended or offered for sale. lf, however, the building - or improvement is sold within one year of completion, the owner-bufider will have the burden Electrical 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 coir Plumbing _ strut( 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. f j 14 ' such projects with a contiactor(s) licensed pursuant to the Contractor's License Law.) Grading 11I am exempt under Sec B. 8 P.C. for this reason Driveway Enc. Date t1 'S �� ti ' :� `.{.:�✓ Infrastructure ' Owner _. WORKERS' COMPENSATION DECLARATION t I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Workers Compensation Insurance, ora certified copy thereof. (Sec. 3800, Labor Code.) Policy No Company -� ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. TOTAL CERTIFICATE OF EXEMPTION FROM REMARKS "r WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation ee��[ r� ay 66��rrDQ ��SS ttss" �a. t� .�..3a] A4a+ ?_ r t~i3—P1 y .,A0 - or ' less:) - I certify that in the performance of the -work for which this permit is issued, l shall not - employ any person in any manner soasst become subject to the Workers' Compensation Laws of California r ' �%` Date Owner NOTICE TO APPLICANT: tt, after making this CeitiBcate 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 Nis permit shall bedeenedrewked. - - Minimum Setback Distances: ' 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, ChdCode.) Side Setback from Property Line Lenders Name Lenders 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. I certity that I have read this 211/89 application and state that the above information is correct. I Issued by: Date Permit 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. Validated by: Signature of applicant Date . Mailing Address Validation: City,. State, Zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS SLAB GRADE ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL SQ. FT. FORMS SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SQ. FT. Q GAS (ROUGH) METER LOOP HEATING (FINAL) POWER OUTLET ROOF DRAINS GAR. SQ. FT. ® TEMP. POLE GROUT DRAINAGE PIPING CAR P. SO. FT. @ FINAL INSP. WALL SQ. FT. WATER SYSTEM DRINKING FOUNTAIN. GRADING cu. yd. $ plus x$ _$ URINAL SO FT ® FINAL INSP. FRAMING/�/�Q / ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL 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. SQ. FT. ® c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT: RESID ® 11/. c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER FINAL INSPECTION Ag —� 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) STORAGE 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/�/�Q / FINAL INSP. ROOFING O�/ y //�ii1p,_/J !'G��!`'il REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION Ag —� CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL I