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003658 (MISC)I P.O. BOX 1504 No. .003658 Building 47-125 Temecula 78-105 CALLE ESTADO Address LA QUINTA, CALIFORNIA 92253 Owner Jack Barth Mailing _ BUILDING: TYPE CONST. OCC: GRP., Address same A.P. Number 774-26l�-042 City Zip Tel. La- .0u, int 25;�jbe-36$ j Legal Description Contractor Project Description fist ��� ` .Q, S8£e Ite Disk . Address -City.... .. ". _ - .... Zip Tel.. , State Lic. City & Classif. Lic. # Sq. Ft. No. No. Dw. Size Stories Units Arch., Engr:; ' Designer New ❑ Add [XX Alter ❑" Repair ❑ Demolition ❑ I' Address Tel. City Zip State Lic. # _— LICENSED CONTRACTOR'S, DECLARATION •r I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section C. 7000) of Division 3 of the Business and Professions 'Code, and my license is in full force and effect. SIGNATURE DATE - - " ' OWNER -BUILDER DECLARATIONEstlmB ed Valuation hereby affirm that I am exempt from the. Contractor's License Law for the following reason: (Sec. 7031,5,Bus1ness 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 •.n requires the applicant for such permit to file a signed'statement that he is licensed pursuant to PERMIT AMOUNT - 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. lie is exempt therefrom, andthe basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit Plan Chk. Dep. subjects the applicant to a civil penalty of not more than'live hundred dollars ($500): Plan Chk. Bal. ❑ 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 A� r.� t+a Professions Code: The Contractor's License Law does not apply -to an owner of property...who Const.. $20.00 builds or improves thereon and who does such work .himself or through his own employees, Mebh. 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 Electrical 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- Plumbing - - slruct 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 S.M.L. --. - - such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading O I am exempt under. Sec. B. 8 P.C.- for this reason Driveway Enc. Date ' 4 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: Company O.Copy is filed with the city. O Certified copy is hereby furnished. TOTAL CERTIFICATE OF EXEMPTION FROM " ` .REMARKS" WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less:) ... . .. .. r_fj} �i 2V I certify that in the performance of thg work for which this permit is issued, I. shall not a a i i' -� w 1"1 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 -ZONE:' BY: " subject to the Woikers' Compensation provisions of the 'Labor Code; you must forthwith' - comply with such provisions or this permit shall be deemed revoked. Minimum Setback Distances: Front.Setback from Center Line Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY. Side Street Setback'from Center Line 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.) • .. Side -Setback from Property Line ' Lender's Name Lender's Address FINAL DATE INSPECTOR This is a building permit when properly filled out, signed and *validated, and is subject to expiration if work thereunder is suspended for 180 days: - •• I- A / ©r] certify that I have read this application and state that the above information correct. Issued by: Date-21i2't OPermlt 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. Validated by - Signature of applicant Date Mailing Address Validation: City, State, Zip HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES'` 1ST FL. SO. FT. ® $ 2ND FL. SO. FT. FOR. SO.. FT. ® GAR. SO. FT. ® CARP. SO. FT. WALL SO. FT. SO. FT. ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING NOTE: Not to be used as property tax valuation BONDING FLOOR DRAIN MECHANICAL FEES FORMS WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APP.IEOUIP. LAUNDRY TRAY AIR HANDLING UNIT CFM TEMP. POLE 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 WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 C SEWAGE DISPOSAL SO.FT.GAR ® 3/ac HOUSE SEWER REMARKS: 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 GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IEOUIP. 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. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS. GARDEN WALL FINAL