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04228 (GRES)0422 P.O. BOX 1504 Building 78-105 CALLE ESTADO Address 70•-313 Terra Cotta Ct. LA QUINTA, CALIFORNIA 92253 - F Owner ~ ,.� Boulevard Aevoloo"n :MailinBUILDING: TYPE CONST. OCC. GRP. Address ,177-7.S. 1.4ain St., t Ouit 106 , A.P. Number 613-790-001 - City Zip Tel. 1E gb' 4j '� +. , ' .� ��6 Legal Description _ x Contractor Project Description �� 8 s Plan 2 City Zip Tel. State Lic. �� & Classi_f.. City Lic. # ...: Sq. Ft. -. �� Size No. w No. Dw. Stories Units Arch., Engr., Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. Garave 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) of Division 3 of the Business and Professions Code, and my license is in full force and effecL"�,. SIGNATURE - ' -• ,, GATE y OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following�1 - reason: (Sec. 7031.5,Business 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 requires the applicant for such permit to file 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 of the Business and Professions 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 permitPlan subjects the applicant to a civil penalty of not more than five 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• Buisness and Professions Code: The Contractor's License Law does not apply to an owner of property who Estimated Valuation r PERMIT ' AMOUNT Chk. Dep. Plan Chk. Bal. a Const. 304.00 • Mech. 33.00 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. If, 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.) ❑ 1, 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 Electrical41.76 - Plumbing 63 .00 S.M.I. • - such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) ❑ I am exempt under Sec. B. & P.C. for this reason Grading Driveway Enc. Date - Owner Infrastructure 1 y 279 . 9A Pring® -'hoed L:.zard .38.119 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.) i Policy No. Company ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. TOTALw��a�I CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation.tbF�A�1/ REMARKS 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: If, after making this Certificate of Exemption you should become subject to -the Workers' Compensation provisions of the Labor Code, you, must forthwith comply with such provisions or this permit shall be deemed revoked. ZONE: BY: Minimum Setback Distances: Front Setback from Center Line .. Rear Setback from Rear PiopLine CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line o 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 FINAL DATE INSPECTOR 6/29/98 *y! [� Ce1 t9 47 / Li 9 / 98 Lender's 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. 1 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. Issued by: Validated by: Date Permit - Signature of applicant Date Mailing Address Validation: City, State, Zip GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL SO FT rp 1 UNITS UNDERGROUND A.C. UNIT COLL. AREA YARD SPKLR SYSTEM 2ND FL SO FT. a BONDING HEATING (ROUGH) STORAGE TANK MOBILEHOME SVC. BAR SINK POR SO FT a DUCT WORK ROCK STORAGE FOUND. REINF//-/% !v POWER OUTLET ROOF DRAINS GAR SO. FT. to OTHER APP.IEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE DRAINAGE PIPING CAR P. SO FT. 0 GROUT WATER HEATER SERVICE FINAL INSP. DRINKING FOUNTAIN WALL SO. FT. @ WATER SYSTEM GRADING Cu. yd. S —plus—x$ =$ URINAL SO. FT. pq AMING �� FINAL INSP. ESTIMATED CONSTRUCTION VALUATION S n WATER PIPING NOTE Not to be used as property tax valuation REMARKS: FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED ILAUNDRYTRAY AIR HANDLING UNIT CFM SPARK ARRESTOR* 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 SULATIONISOUND?::— � SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID a t'A c SEWAGE DISPOSAL SO.FT.GAR er Ji:c HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES I. MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB FEE STRUCTURE PLUMBING Qa ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING . UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE l ig ROUGH PLUMB BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING - DUCT WORK ROCK STORAGE FOUND. REINF//-/% !v 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. S —plus—x$ =$ LUMBER GR. FINAL INSP. �`� AMING �� FINAL INSP. OOFING 2 3Q n REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR* GAR. FIREWALL HIN 2� ESH SULATIONISOUND?::— � FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL city of LaQui"nta 78 495 CALLE TAMPICO LA QUINTA, CALIFORNIA (760) 777-7012 [FAX] (760) 777-7011 INSPECTION RECORD Permit # 9808.002 STRUCTURAL RETROFIT OF UNIT ADDRESS DATE INSPECTION [YES/NO] 8 -S3 J 6 72 / -- 99 FRAMING/HARDWARE , o_Y, PLAN TYPE: l )-,3- q(j INSULATION Ott -A - 11. Contractor: WERMERS MULTI -FAMILY CORP. -9,9 SHEAR NAILING sk ,�• �, DRYWALL JOB FINAL COMMENTS/NOTES: 14-A&C- 43) Avoo F 1Z • GK ,t VIZIA115: 10 - 2 9 - 98 .,� • .�. k S'122lE AL1Pl?12 uPG4P0, MAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALLIFORNIA 92253