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04171 (GRES)-4,_ 04111. P.O. BOX 1504 Building 78-105 CALLE ESTADO Address 70-305 Terra cotta Ct • LA QUINTA, CALIFORNIA 92253 Owner . . . ` 2oulevard Develooment BUILDING:, TYPE CONST. OCC. GRP. Mailing Address .177 S.. ftin Sty s SUite A-PNumberr, r 1 ••�9 t� 1R CityZip Tel. ,.. ,r,e268«y+.�g� Legal +Description ContractorProject Description- Sam escription 'Building_8 • �1an 2'' S - - Address City Zip Tel. State Lic. City & Classif:...; Lic. # _ ,F .::, Sq. Ft: No. No. Dw. Size Stories Units! Arch., Ehgi - .;k, ix, . , Designer.,:x>:,'t'._Y,+- New ❑ Add'❑ ` Alter ❑ Repair ❑ Demolition ❑ 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 7000) of Division 3 of the Business and Professions Code, and my license is in full force and Affect. t` :�� • ,r" ,�% F% i .. SIGNATURE 'DATE - t OWNER -BUILDER DECLARATION Estimated. Valuation I herebyaffirm that I am exempt from the Contractor's License Law for the following . reason: (Sec. 7031.5, Business -and Professions Code: Any city or county which requires a 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 that. he Is exempt therefrom, and the basis _ 3 for thel 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 five hundred dollars (E500). Plan Chk. BBI. ❑ 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 Const. ¢� f�y� Professions Code: The Contractor's License Law does not apply to an owner or property who �'�/{tl i builds or Improves thereon and who does such work himself or through his own employees, Mech. 3 •. provided that such improvements are not Intended or offered for sale. If, however, the building ,.G wMfi - V is V ' or improvement is sold within one year of completion, the owner -builder will have the burden Electrical 44.70 of proving that he did not build or improve for the purpose of sale.) 0 I, as owner of the property, am exclusively contracting with licensed contractors to con" Plumbing 75.00 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 S.M.I. 4.5-9 such projects with a contractor(s) licensed pursuant tothe Contractor's License Law.) Grading 0 I am exempt under Sec. B. & P.C. for this reason ,Date Driveway Enc. owner Infrastructure _ _:;_ _ •' jtrt":S00(4 .XtU:U 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.) r " Policy No. company O Copy is filed with the city. ❑ Certified copy is hereby furnished. - — - - - TOTAL a i14 A I A 14L CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars (x100) valuation 1cac* -.F) a:,� •tt•,S,trC+' 2-7.110y 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 Minimum Setback Distances: comply with such provisions or this permit shall be deemed revoked. r Front Setback from Center Line Rear Setback from Rear Prop. Line. -4 - : 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 This is a building permit when properly filled out, signed and'validated, and is subject to FINAL DATE INSPECT R - expiration if thereunder is suspended for 180 days. ' :. work I certify that 1 have read this application and state that the above informationis correct. Issued by:* Date Permit of - 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 + GOL09NOOD • •SSESSOR S OFFICE, HARDCOPY - FILE - ;"r`•' ti WHITE FINANCE PINK APPLICANT, GREEN-' BUILDING, CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES iST FL SQ FT N $ UNITS SLAB GRADE ROUGH PLUMB BONDING YARD SPKLR SYSTEM 2ND FL SO FT. gr FORMS SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK FOR SO FT. of GAS (ROUGH) METER LOOP HEATING (FINAL) POWER OUTLET ROOF DRAINS GAR SO. FT. Or TEMP. POLE GROUT DRAINAGE PIPING CAR P. SQ FT. f� FINAL INSP. BOND BEAM WATER SYSTEM DRINKING FOUNTAIN WALL SO. FT. (a _$ LUMBER GR. FINAL INSP y MING / URINAL SD. FT. (d ESTIMATED CONSTRUCTION VALUATION $ REMARKS: WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTOHDISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED S ARK ARRESTOR LAUNDRYTRAY AIR HANDLING UNIT CFM AR. FIREWALL Z� 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 g 1I% c SEWAGE DISPOSAL SQ.FT.GAR rg 14c HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE LAECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB FEE STRUCTURE PLUMBING eldn ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBIN 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./I /`—Ci cv 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 y MING / FINAL INSP. FING �� ®.-g REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE S ARK ARRESTOR AR. FIREWALL Z� LATHING MESH 91 NS` ULATIONISOUND�� FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATUIIIES/INITIALS GARDEN WALL FINAL -c1 ofLa,Qui n a. 78.495 CALLS TAMPICO LA QUINTA, CALIFORNIA _4 (760) 777-7012 [FAX] (760) 777-7011 INSPECTION RECORD Permit # 9808-002 .STRUCTURAL RETROFIT OF UNIT ADDRESS DATE INSPECTION [YES/NO] &J&4 11-9-99 FRAMING/HARDWARE PLAN TYPE: 4L- 98 INSULATION Contractor: WERMERS MULTI -FAMILY CORP. SHEAR NAILING �k �• f f - /o 9S DRYWALL ek ��• 98 JOB FINAL m�- COMMENTS/NOTES: - amino �I,GNie/!� t/P�%�RD,� MAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALLIFORNIA 92253 x i 1 MAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALLIFORNIA 92253