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07279 (SFD)Tiht 4 4 Q" Buildin Addr ess 43-690 Skward Way Owner Starlight Dunes Partnershi Mailing Address P.O. ¢©x 329 CityZip Tel. La Quinti 92253 Contractor kick Johnsen Canstructio'n Address. Same City lZip Tel.: P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 564.222$ State Lic. City & Classif. 339269 B Lic. # 2.02 Arch., Engr., Designer 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 70pp) 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 Contractors License Law for the following reason: (Sec. 7031.5,Buseress and Professions Code: Any city or county which requires a Permit to construct, after, irprove, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to fie a signed statement that he is licensed pursuant to the provisions of the Contractors 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 exerWtfbn. Any violation of Section 7031.5 by 'any applicant for a permit subjects the applicant to a civ0 penally of not more than rive 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 suchrrprovements are not intended or offered for sale. If, however, the building Of improvement is sold within one year of completion, the owner -builder will have the burden of proving that he dud 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 combactorrs) 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 IN 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 If the permit is for one hundred dollars (8100) 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., 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 abuilding permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certitythat I have read this application and state that the above information is correct. 1 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 Dale" Mailing Address City, State, Zip - No. 07279 LDING: TYPE CONST. OCC. GRP. P. Number Legal Description Lot 27 Project Description_ _Fmntiath find,.l Sq. Ft. 2687 No. No. Dw. Size - Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ (Estimated Valuation $141.266 R PERMIT Plan Chk. Dep. Plan Chk. Bal: Const. Mech. Electrical ' Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL AMOUNT REMARKS ��?vr.Jx1>fR7'l3 .[�5��4-ca4l df�Q3• ��'i. 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 2/28/ Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ UNITS SLAB GRADE QQ ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL. SQ. FT. FORMS L4�WER OR SEPTIC TA K712 !reOUGH WIRING MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® GAS (ROUGH)// --;70 /U METER LOOP HEATING (FINAL) POWER OUTLET ROOF DRAINS GAR. SQ. FT. ® TEMP. POLE GROUT DRAINAGE PIPING CAR P. SQ. FT. ® FINAL INSP. BOND BEAM WATER SYSTEM DRINKING FOUNTAIN. WALL SQ. FT. LUMBER GR. FINAL INSP. 3l 011 FRAMING URINAL SQ. FT. @ ft�23 �a / � ESTIMATED CONSTRUCTION VALUATION $ REMARKS:- EMARKS:VENTILATION WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES I WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTONDISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED SPARK ARRESTOR LAUNDRYTRAY AIR HANDLING UNIT CFM GAR. FIREWALL 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. SQ. FT. ® c BATH TUB FINISH GRADING SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® IV4 c SEWAGE DISPOSAL SQ.FT.GAR ® Vic 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 I ELECTRICAL HEATING & AIR GOND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE QQ ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS L4�WER OR SEPTIC TA K712 !reOUGH WIRING DUCT WORK ROCKSTORAGE FOUND. REINF. S/� �d _ GAS (ROUGH)// --;70 /U 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. 3l 011 FRAMING FINAL INSP. G I ROOFING a� Q� ft�23 �a / � REMARKS:- EMARKS:VENTILATION VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL IRTH NG MESH INSULATIONISOUND Of �1 d FINISH GRADING FINAL INSPECTION pkS� CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL