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07035 (SFD)T,i"�t 4 4 Q" Address �� Shoal Creek Sunri se Address 42-600 Cook St. Suite 200 P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 City Palm 0esertlzip 922b0 ITeI. _ 2828 Contractor National Hortgage & Land ress Sim Zip I Tela State Lic. City & Classif.288130 I Lic. # 323 Arcn., tngr., Designer Address I Tel. City Zip 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 affirin that 1 am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Buskoess and Professions Code: Any city or county which requires a permit to construct, after, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to file 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 civilpenally 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 Contractors 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 kmprovements are not intended or offered for sale. If, however, the building orimprovement is sok/ within one year of completion, the owner -builder will have the burden of proving that he did not build or krprove for the purpose of 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 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 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 it 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. Date Owner NOTICE TO APPLICANT: 8, 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 1130 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 ateMailing Address City, State, Zip No. 07035 BUILDING: TYPE CONST. OCC: GRP, A.P. Number PGA IIEST — Phase 25A Legal Description Tract 24317-2 Project Description Plan 9C VWCA M9 Sq. Ft. GQ 420 Size - - No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $171,743 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. . Mech. 4 0. ov Electrical 17 0.26 Plumbing IOU. bu S.M.I. U Grading Driveway Enc. Infrastructure $3.901. Mess rtr x,Vs .%JV Intra Due TOTAL + /. ,s./ REMARKS fi"+_ AIA"W) �t; .# WA .1.� Y.•rii.>fi .l r °J r'.:i.,. x •.i •.,. .:.c.: y 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 2/12/9OPermit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL SQ. FT. ® $ UNITS COLL AREA SLAB GRADE ROUGH PLUMB. YARD SPKLR SYSTEM 2ND FL SQ. FT. ® HEATING (ROUGH) STORAGE TANK FORMS MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® DUCTWORK ROCK STORAGE /J FOUND. REINF. POWER OUTLET ROOF DRAINS GAR. SO. FT. ® HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL GAS (FINAL) DRAINAGE PIPING CAR P. SQ. FT. ® GROUT WATER HEATER DRINKING FOUNTAIN. WALL SQ. FT. FINAL INSP. BOND BEAM WATER SYSTEM URINAL SQ. FT. @ GRADING cu. yd. plus x$ =$ ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES D// To � �� 3� �LG� cC_ /, WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER VENTILATION GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FIRE ZONE ROOFING: LAUNDRY TRAY AIR HANDLING UNIT CFM FIREPLACE 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 SQ. FT. ® c WATER HEATER MAX HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1Y. c SEWAGE DISPOSAL SQ.FT.GAR ® 314c HOUSE SEWER 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 10�ROUND PLUQbW G UNDERGROUND A.C. UNIT COLL AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS WR EGiEROn) ROUGH WIRING. DUCTWORK ROCK STORAGE /J FOUND. REINF. S (ROUGHY • PP ! � C/P 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. / -1 NAL INSP. �lGC% `\ MING ,�V FINAL INSP. ROOFINGL/ ►�VVVV_ 1 (J D// To � �� 3� �LG� cC_ /, REMARKS VENTILATION FIRE ZONE ROOFING: FIREPLACE SPARK ARRESTOR GAR. FIREWALL THING MESH INSULATIOWSOUNDS FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL 1