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002890 (SFD)Building 555-210 MMI Crwk Address Owner 3iut Mailing P.O. BOX 1504 No 002I89n 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Address 7r 00500=trY ClUbDr. City Zip Tel. Faun t - '92264 5-2328 Contractor 'Vatij6va morb= .. and land . Address ..-. Sam City Zip Tela BUILDING: TYPE CONST. OCG: GRP. A.P. Number Legal Description Project Description TIM Im, PM%WP 14 A PUW 3 .-M State Lic. CityY 1627 & Classif. 2881 Lic. # 328 Sq. Ft. 424 Size No. No. Dw. Stories Units Arch., Engr., .. ... .. .. ' Designer New liL Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address 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 Division13 of the Business and Professions Code, and my license is.in fullllfforce and effect. _SIGNATURE - " - i' DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt.froom the Contractor's License Law for the following Estimated ValUatlOn �•g ryr� q� d F 1�r Ll'r Ci .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 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 -thealleged 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 PERMIT - - AMOUNT Plan Chk. Dep. Plan Chk..BaI. 98l� �!,' 0 J4W Const. �.g 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 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.) ❑ 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 reascn Mech. �/�t .7�t Electrical%� 41 Plumbing $7.50 S.M;I..�Q Q Grading Driveway Enc. Date owner Infrastructure 11705.91 WORKERS' COMPENSATION DECLARATION 1 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 Q Copy is filed with the city. Q Certified copy is hereby furnished. TOTAL CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATIONINSURANCE REMARKS ` (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, l 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. - " - ZONE: BY: Mlnlrrium Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line Ihereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) - Side Setback from Property Line ' Lender's Name Lender's Address FINAL DATE Issued by: .Validated by: Validation: A1269 INSPECTOR o,g Date — Permit Z 6 7 1,21 Ck This is -a building permit when properly filled out, signed and validated, ard'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- i mentioned property for inspection purposes. • .` '4�` r % Signature of applicant"I _ - ^� = Date r J Mailing Address " t f City, State, Zip I i' HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL F NO. PLUMBING FEES 1ST FL. SQ. FT. @ UNITS COLL. AREA 2ND FL. SO. FT. OUGH PLUMB. q-/6 ��` , YARD SPKLR SYSTEM POR. SO. FT. @ MOBILEHOME SVC. BAR SINK GAR. SO. FT. @ POWER OUTLET ROOF DRAINS CARP. SQ. FT. @ DUCT WORK DRAINAGE PIPING WALL SO. FT. @ GAS (ROUGH) DRINKING FOUNTAIN SQ FT @ HEATING (FINAL) URINAL ESTIMATED CONSTRUCTION VALUATION $ (FINAL) t� 7 WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER HEATER WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER WATER SYSTEM GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED GRADING cu. yd. plus x$ _ $ LAUNDRYTRAY AIR HANDLING UNIT CFM FINAL INSP. rp��_ �? KITCHEN SINK ABSORPTION SYSTEM. B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE, TEM/PERM 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. SQ. FT. RESID @ 1+/a c SEWAGE DISPOSAL e6 LATHING d SO.FT.GAR @ 3/ac HOUSE SEWER 'I,INSULATIONISOUNDG-g/-'Fj 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 ali/GSETBACK�� O ROUND PLUMB -/F UNDERGROUND A.C. UNIT COLL. AREA %(,e,SLAB GRADE ��.. OUGH PLUMB. q-/6 ��` , BONDING HEATING (ROUGH) STORAGE TANK /�r FORMS a lQ � EWER OR SEPTsL T�I�( CC II UGH WIRING L��f/(o-.g DUCT WORK ROCK STORAGE I6I60UND. REIN%- 6V _ iIkASd.AS GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP./EQUIP. 964 REINF. STEEL.S s (FINAL) t� 7 TEMP. POLE GROUT WATER HEATER SERVICE OeINAL INSP. 6 �� 1 BOND BEAM WATER SYSTEM $ GRADING cu. yd. plus x$ _ $ GR. FINAL INSP. rp��_ �? ' �rLUMBER 2c//RAMING �� GG 6�41NAL INSP. -1,-r? ROOFING�r.c� y �r % ✓7 -}� 6 /G ?p W /L /�� l0 - D l i N Y✓Q w� iL�� IL G( "�3�� aG(r REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL e6 LATHING d MESH 'I,INSULATIONISOUNDG-g/-'Fj FINISH GRADING N_/FINAL INSPECTION��-�`� CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL