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13632 (AC)T4hf 4 4 a" P.O. BOX 1504 Building 54-162 Shoal Creek 78-105 CALLE ESTADO Address LA QUINTA, CALIFORNIA 92253 Owner PGA hest Residential Association Of Mailing Address 55^-940 PGA Blvd. City Zip Tel. La Quinta, CA $2253 1 771--2234 co2trasctok Yiestern Construction Addy ss I t X99 Jackal ]Drive, Ste. B CityTel. Bermuda DunesZip CA 92203 345-4537 State Lic.B .75573 City 329 & Classif. Lic. # Arch., Engr., Designer Address CityI Zip I State I Lic. # LICENSED CONTRACTOR'S DECLARATION I liereby affirm that 1 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 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 is not 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 are not intended or offered for sale. If, however, the building or:irriprovement 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.) ❑ 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.) ❑ 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION ke1 hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worr's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Polic No.i Company O�y 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 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. f C y 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 No. 13632 BUILDING: TYPE CONST. OCC.,GRP. A.P. Number Legal Description Project Description Restroom Sq. Ft. 35 No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $1t000.00 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. b.:3 Const. 15. U Mech. Electrical 21. 0U Plumbing .S.M.I. . {i Grading Driveway Enc. Infrastructure TOTAL b • 15 REMARKS _ I ,­� /n\ M - I ill L_/--1 ZONE: BY: I " "" - - — 11 1" I Minimum Setback Distances: U Front Setback from Cenkyr Line t 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 Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. g $ UNITS BONDING C r STORAGE TANK YARD SPKLR SYSTEM 2ND FL. SQ. FT. DUCT WORK ROCK STORAGE GAS (ROUGH) MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® GAS (FINAL) TEMP. POLE GAR. SO. FT. ® POWER OUTLET ROOF DRAINS SERVICE FINAL INSP. DRAINAGE PIPING CAR P. SO. FT. ® GRADING cu. yd. $ -Plus-X$-=$ WALL SQ. FT. DRINKING FOUNTAIN. FINAL INSP. URINAL SQ FT ® REMARKS: 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 IKITCHEN 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 INSPECTOR'S SIGNATURESIINITIALS SQ. FT. ®c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER GAS PIPING PERMIT FEE PERMIT�FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE JPL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK SLAB GRADE FORMS FOUND. REINF. REINF. STEEL GROUT BOND BEAM LUMBER GR. FRAMING ROOFING VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL I GARDEN WALL FINAL GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. GAS (FINAL) TEMP. POLE WATER HEATER SERVICE FINAL INSP. WATER SYSTEM GRADING cu. yd. $ -Plus-X$-=$ FINAL INSP. FINAL INSP. REMARKS: INSPECTOR'S SIGNATURESIINITIALS