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002898 (SFD); City Zip Tel.* _ State Lic. & Classif. 28$1" City Lic. # 3 P.O. BOX 1504 NQ. UUZ15tits Building Address 5-5-293 Shmi. CkWk LA QUINTA CALIFORNIA 92253 Alter ❑ Repair ❑ Demolition ❑ - Owner Tel. . City - ' Mailing ' swwim Side Setback from Property Line BUILDING: TYPE CONST. OCC: GRP. INSPECTOR Address 7 .aoootimmv camb)ve Validated by: A.P. Number City Tel. Estimated Valuation ' 1011,545.00 -' PERMIT STA JZip � . 92ND sra—2na - Legal Description 7 Contractor ..- Mech. Project Description PCS 6�' PEM 15 As . fttiM-al Mntaagle and Land 87.5 S.M.I. 7,e.i7V ..Address. Driveway Enc. PlAn 2 CR ; City Zip Tel.* _ State Lic. & Classif. 28$1" City Lic. # 3 MqG Sq. Ft.W. Size. 44 No. No. Dw. Stories Units Arch., Engr.; Designer New C1 Add ❑ Alter ❑ Repair ❑ Demolition ❑ - Address Tel. Rear Setback from Rear Prop.. Line City - Zip State Lic: # . Side Setback from Property Line FINAL DATE INSPECTOR LICENSED CONTRACTOR'S. DECLARATION I hereby affirm that l am licensed under provisions of'Chapter 9 (commencing with.Section 7000) of Divis�iong3`.gf`the,Business and Professions,Coda, and my license'is iin4ull force and I effect. 4 `-r � ,#�` �' _ .; , i ! - a+ Date "� ' Permit Validated by: SIGNATURE DATE OWNER -BUILDER DECLARATION % I hereby affirm that 1 ani 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• after, 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 - DiWsion 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 permit subjects the applicant to a civil'penalty of not more than five hundred'dollars ($500). 0.1, 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. r7044. 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 wig 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 tocon- 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.) - ❑ I am exempt under Sec. • B. 8 P.C. for this reason Estimated Valuation ' 1011,545.00 -' PERMIT AMOUNT' Plan Chk. Dep. - Plan Chk. BBI.. 7 Const.. asr?J� Mech. 3Qe 011) Electrical - i,; �t f 65.44 Plumbing 87.5 S.M.I. 7,e.i7V Grading Driveway Enc. Date Owner Infrastructure 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. I.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 ($100) valuation TOTAL REMARKS or less.) - I certify that in the performance of tho 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 subjecUto 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 relatirig to building construction, and hereby authorize representativesr , of city to enter the above mentioned property for inssppection purposes._ Signature.of applicant 0; ; Date Mailing Address J.,0, City, State, Zip r nwnv a,vrT 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: _A 7 l 9 8 Z .1 0 6.4. 8. 8 G 0, - CONSTRUCTION ESTIMATE NO. ELECTRICAL EFMI Nk NO. PLUMBING FEES IST FL. SQ. FT. ® $ UNITS 4GROUND 4SLAB GRADE ��OUGH 2ND FL. SQ. FT. BONDING YARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS CAR P. SO. FT. S (ROUGH) f r O q ^) DRAINAGE PIPING WALL SO. FT. OTHER APPJEOUIP. DRINKING FOUNTAIN SQ FT ® TEMP. POLE URINAL ESTIMATED CONSTRUCTION VALUATION $ GROUT WATER PIPING NOTE: Not to be used as property tax valuation &<MAL INSPf_ �y—C t!/ 0 FLOOR DRAIN MECHANICAL FEES WATER SYSTEM WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER — l7' GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM REMARKS: 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 SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER MESH 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 &ETBACK . (�� PLUM gUNDERGROUND A.C. UNIT COLL. AREA 4GROUND 4SLAB GRADE ��OUGH PLUM BONDING HEATING (ROUGH) STORAGE TANK FORMS �2 �cEWER OR SIC1KI�-? 144UGH WIRINC��/..,?j DUCT WORK ROCK STORAGE FOUND. REIN F;2 f L�,eGREINF. S (ROUGH) f r O q ^) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE &<MAL INSPf_ �y—C t!/ 0 BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ _$ LUMBER GR.NALINSP.6'—,QL — l7' RAMING —%G_ 1 INAL INSP. /, -T 0 j��p /J�� AA r"_ OOF�yCy_ C l��X (� / (V� �! �/� [ ��1 ��G +n�✓� /�L` �� .,/ REMARKS: VENTILATTII*ON FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL /pLlejLATHING v— MESH mi INSULATION/SOUND f /1 FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL