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04170 (GRES)Building Address Owner Mailing Address City . Or& Contractor Address State LC: ` Designer Address 04170 P.O: BOX 1504 78-105 CALLE ESTADO 78-.303 Terra Cotta `Ct • LA QUINTA, CALIFORNIA 92253, Boulevard Development BUILDING: TYPE CONST. OCC. GRP. 77.7 sg o . Nain St.* Suite tGO r .. , . �,. A:P. Number 613X790-001 Zip Tel. 4 -o ge 9268 7$a-��7,�s,��•� Legal Description `` I Pro'ect Des r' t'on "Plan 2, Building 0 � ctpl :w« Tel. City Lic. # a _.w >Sq. Ft. .. _ 912 No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Tel. Carair a included City Zip ( State Lic. # LICENSED CONTRACTOR'S DECLARATION • I hereby affirm that I am licensed under Provisions of Chapter 9 (commencing with Section 7000) 4?f.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,Business and Professions Code: Any city or county which requires a ltimated Valuation permit to construct, atter, Improve,. demolish, or repair any structure, prior to its Issuance also 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 thathe is exempt therefrom, and the 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 rive hundred dollars ($500). ' Plan Chk. Bal. t. 275. 1 O I, as owner of the property, or my employees with wages as their sole compensation, will d do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. `{�Q Professions Code: The Contractor's License Law does not apply to an owner of property who 3' M builds or improves thereon and who does such work himself or through his own employees, Mech,�. 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 `1�3° of proving that he did not build or improve for the purpose of sale.) 'O I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 7 {jlj struct the project. (Sec. 7044, Business and Professions Code: The Contractors License Law �, - does not apply to an owner of property who builds or improves thereon, and who contracts for S.W.,: wL ,4 .59 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'—Owner 401. j \ qInfra{Vsy�trr{1ructuryye, �y yy4* ryry��+yyyy �1' 40,0 Id 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. r+as .an.w n v TOTAL w x. F ,w . . , ac 1 amt t -7 A CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit Is for one hundred dollars ($100) valuation ~• 3- -l4 Y O Y i""• ',v,—T11M172. f1 1' 1 -* ¢ ,j��(�r� ..,ir `: iT$x3`r`� :d'" t'!:(!} _ 71;--C.,, € s.'i ,a 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 ZONE: BY` - subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Alllnimum Setback Distances: ' Front Setback from Center Line Rear Setback from Rear Prop. Line 1 CONSTRUCTION LENDING AGENCY Street Setback from Center Line Ihereby affirm that there is a construction lending agency for the performance of the, 't ---..;Side, work for which this permit is issued. (Sec. 3097, Civil Code.) Slde 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� I certify that I have read this application and state that the above information Is correct. Issued by: Date Permit - 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 --,- mention , ad property for inspection purposes. Validated by: Signature of applicant Date Mailing Address Validation: J City, State,. Zip 1. WHITE FINANCE PINK APPLICANT, GREEN - BUILDING, ".A G0LOEN1QD = ASSESSOR'S OFFICE, HARD COPY- FILE -. .� "`R_e 'y✓" _ -,1-.• ',-� -`.. K,>,S•^ - - .. �..,. -_ .. .V� ., a _- _T_ _,iY ne.. '.yr` ., ui...`i.• CONSTRUCTION ESTIMATL NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL SO FT rp $ UNITS ROUGH PLUMB BONDING HEATING (ROUGH) YARD SPKLR SYSTEM 2ND FL SO FT. g SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK MOBILEHOME SVC. BAR SINK POR SO FTCr METER LOOP HEATING (FINAL) OTHER APP.IEOUIP. POWER OUTLET ROOF DRAINS GAR SO. FT. GROUT WATER HEATER DRAINAGE PIPING CAR P. SO FT. 6 BOND BEAM WATER SYSTEM DRINKING FOUNTAIN WALL SQ. FT. III LUMBER GR. FINAL INSP.?// MING ( FINAL INSP. URINAL SO. FT. to /jRpzj �,+ ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation VENTILATION FLOOR DRAIN MECHANICAL FEES FIRE ZONE ROOFING WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTOXDISH) 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 WATER HEATER MAX. HEATER OUTPUT. B.T.U. SQ. Ff. RESID a Iw c SEWAGE DISPOSAL SO.FT.GAR r 3V c HOUSE SEWER FENCE FINAL 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 n�LECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING �� UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE . _ILy Qjy ( f/ (/ ROUGH PLUMB BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF/ t -g-4 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. y0. $ plus x$ $/�D LUMBER GR. FINAL INSP.?// MING ( FINAL INSP. Z N -2� O / p'�1 0. ✓� �j�,/eo, /jRpzj �,+ REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR - GAR. FIREW L THING MESH SULATION/SOUND r FINISH GRADING FINAL INSPECTION ' CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESlINITIALS GARDEN WALL FINAL