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07282 (SFD)P.O. BOX 1504 No. 07282 Building S� aiCt� 7&105 CALLE ESTADO Address ay LA QUINTA, CALIFORNIA 92253 Sta Address P. Box 329 City Zip Tel. LA 0,08ta 192253 564-2228 Contractor Address Zip State Lic. City & Classif:397 169 8 Lic. # 202 Arch., Engr., Designer Address Tel. City 11 Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I• herebbyy affirm that I am�licensed under provisions of Chapter 9 (commencing with Section 7000) -f b,ive^itsio+�n 3 of the Business and Professions Code, and my license is in full force and effect. t th 4��1 ��c q i _SIGNATURE ' DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,8rsiress and Professions Code: Any city or county which requires a permit to construct, after. kprove, demolish, or. repair any structure,prior to its issuance also requires the applicard for such permit to Me 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 or the Business and Professions Code, or that. he is exempt therefrom, and the basis for the alleged exemption. Any viotation of Section 7031.5 by 'any applicant for a permit subjects the applicant to a civilpenalty 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, Suisness 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 krprovements are not intended' or offered for sale. 1f, however, the building orimprovement is sold withn one year of completion, the owner -builder will have the burden of proving that he did not buil or krprove for the purpose of safe.) ❑ 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 w, S P.C. for this reason Date - Owner WORKERS' COMPENSATION DECLARATION Thereby 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 oorpleted 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, 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: f, after making this Certificate of Exemption you should become subject to the Workers' C.onpensation provisions of the Labor Code, you must forthwith comply with such provisions or thS 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.) Lenders Name _ Lenders Address 'This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 100 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 BUILDING: TYPE -CONST. OCC: GRP. Number Legal Description Lot 34 Project Description. Frontier Model Sq. Ft. 2687 No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition PERMIT AMOUNT Plan Chk,Dep. Plan Chk. Bal. 645.90 Const. 786.50 Mech. 60.00 Electrical 136.96 Plumbing 144.50 S.M.I. 9.38 Grading Driveway Enc. Infrastructure 3.,178.$5 TOTAL *4961.73 /'% ✓rl! t' �✓ REMARKS3i.t;e,;t 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: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS COLL. AREA SLAB GRADE ROUGH PLUMB. YARD SPKLR SYSTEM 2ND FL. SO. FT. HEATING (ROUGH) STORAGE TANK FORMS MOBILEHOME SVC. BAR SINK POR. Sp. FT. ® DUCT WORK ROCK STORAGE FOUND. REINF. 7/ %©� ( POWER OUTLET ROOF DRAINS GAR. SO. FT. ® HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) DRAINAGE PIPING CARP. SO. FT. ® GROUT WATER HEATER DRINKING FOUNTAIN. WALL Sp. FT. FINAL INSP. BOND BEAM WATER SYSTEM URINAL SO. FT. @ GRADING cu. yd. $ plus x$ =$ ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP. O ® WATER PIPING NOTE: Not to be used as property tax valuation ROOFING,4/j4& FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM 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. SO. FT. ® c BATH TUB SO. FT. ®c I WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR ® V/ic 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 9 ELECTRICAL HEATING & AIR COND. SOLAR T Tom. SETBACK GROUND PLUMBING ' UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS GnEWER OR SEPTIC TANK Z .41 geROUGH WIRING cC DUCT WORK ROCK STORAGE FOUND. REINF. 7/ %©� ( GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. 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. O ® FRAMING LA FINAL INSP.Igp ROOFING,4/j4& S] n W/`q O+ ' ^ �.V REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LA HING D L MESH INSULATIONISOUND Z� FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL \