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04930 (SFD)44 P.O. BOX 1504 Building 78-105 CALLE ESTADO Address 49-040 Tango Curt LA QUINTA, CALIFORNIA 92253 Owner Sar C4 a Development Mailing City lZip Contractor Address .. State Lic. City & Classif. 337077 Lic. # 12199 Arch., Engr., Designer, Address Tel- CityI Zip I State I Lic- # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed' under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.: r SIGNATURE= DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractors 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 lifea 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 I mtessions Code, or that. he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by "any applicant for a permit subjects the applicant to a civilpenalty of not more than five hundred dollars ($500). 0 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 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. d, 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.) ❑ [,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 or property who buftds or improves thereon, and who contracts for such projects with a contractors) 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 Workers 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 ff the permit is for one hundred dollars ($100) 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 aliforniaDateOwner NOTICE TO APPLICANT: ff, alter making this Certificate or Exemption you should become subject to the Workers' Compensation provisions or the Labor Code, you must forthwith comply with such provisions or this pemut shall be deemed revoked. CONSTRUCTION LENDING AGENCY 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.) 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 180 days. I certity that 1 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 No. a4s3-0 WING: TYPE CONST. • OCC: GRP.- A.P. Number_ Legal Description Project Description g3azs 1804 - Lot 11 REMARKS — I- , '" ��r'i'��+ ..'t'J If% 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: Dates 2 % 19 / 8 Permit Validated by: Validation: Sq. Ft. 1884 Size No.. Stories • No. DIN. Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $93,604 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal.347.2-4 Const. I S n0 Mech.11 Electricals -> G Plumbing %A , A S.M.I. Grading Driveway Enc. Infrastructure _. . TOTAL $3,076.92 REMARKS — I- , '" ��r'i'��+ ..'t'J If% 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: Dates 2 % 19 / 8 Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS A.C. UNIT COLL. AREA SLAB GRADEROU YARD SPKLR SYSTEM 2ND FL. SQ. FT. BONDING MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® OR SF K ROUGH WIRING POWER OUTLET ROOF DRAINS GAR. SQ. FT. ® FOUND. REINF, k GAS (ROUGH) —740 /,me ETER LOOP DRAINAGE PIPING CAR P. SQ. FT. ® HEATING (FINAL) OTHER APP./EQUIP. WALL SQ. FT. DRINKING FOUNTAIN, . POLE URINAL SQ. FT. @ GROUT ESTIMATED CONSTRUCTION VALUATION $ WATER HEATER 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(AUTO)(DISH) APPLIANCE DRYER GRADING Cu. yd. plus x$ GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FINAL INSP. 2 LAUNDRY TRAY AIR HANDLING UNIT CFM 44 ROOFING J /"J �� VENTILATION �T 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 FIREPLACE SQ. 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 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 PLUMBINC ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMB NG UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADEROU PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS OR SF K ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF, k GAS (ROUGH) —740 /,me ETER LOOP HEATING (FINAL) OTHER APP./EQUIP. REINF. STEEL GAS (FINAL) 7�c L �l . POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM $ GRADING Cu. yd. plus x$ _$ LUMBER GR. FINAL INSP. 2 FRAMING 14 /Q 07D v i � FINAL INSP. 44 ROOFING J /"J �� VENTILATION �T L 1 GG i �y REMARKS: FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL k/ I LATHING f�i ! / MESH INSULATIONISOUND qt(qwt-0.1, FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL ti