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04230 (GRES)P.O. BOX 1504 . Building 78-105 CALLE. ESTADO Address 78-329 ira Cot Ct. LA OUINTA, CALIFORNIA 92253 n • .n v • r , 1. ._ .. f .. ' Owner 4 BUILDING:.TYPE CONST.. OCC. GRP. Mailing �, - Address .t -77 -S,Main St.* >S'lYte 106 A.P.,Number .1613 '790-001 City - Zip Tel. o�"t'�.�' qe 92686 71547-,8056 ILegal Description Contractor Project Description 8U*ffd"tiiq _9'x Plan 2 Ste- - . . City Zip Tel. State Lic. City & Classif. Lic. # Sq. Ft. l �i No. No. Dw. Size r Stories Units r< Arch., Engr., Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ ' Address Tel. Garage included - City Z;,,�: rz „r' t 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 SIGNATURE •*'w""-= r �r-i`DATE _ OWNER -BUILDER DECLARATION I hereby affirm 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, 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 Estimated Valuation - PERMIT AMOUNT Plan Chk. Dep. 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 fora permit subjects the applicant to a civil penalty of not more than five'hundred dollars ($500). - O I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. 1. e _ Const.Professions _ _ do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon and who' does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he, did not build or improve for the purpose of sale.) , ❑ I, as owner of the property, am exclusively contracting with licensed contractors tc con_ Mech. Electrical + 1. - Plumbing struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for S.M.I. t•'! ; a r such projects with a contractors) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec. B. & P.C. for this reason Grading 'Driveway Enc. Date owner Infrastructure r rring -TVA J�Us 4 =a' 1t�$,;t: 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 ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. TOTAL 1,;ZiUI:i.at?`! REMARKS CERTIFICATE OF EXEMPTION FROM • WORKERS' COMPENSATION INSURANCE .,(This section need not be completed if 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 ,�t g�!�,�g y�� s�� e A � q '• ild Pi s'�:;\5 9 fy •1r ,r +ty•^09, "'�?Y�ad �?"' 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 sub)ect�fo 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 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'• r + Lender's,Address ' This is a building permit when properly filled out, signed and validated, and is subject to FINAL DATE -INSPECTOR expiration if work thereunder is suspended for 180 days. I 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: f Date Permit . „ Signature of applicant - Date • Mailing Address : ^ Validation: ` City, State, Zip GOLDENROD - ASSESSORS OFFICE H D COPY - FILE , c:v. Vic.. Rr. � ::2.:::5 i.� .•+, . j•' } WHITE - FINANCE, PINK -APPLICANT, GREEN BUILDING', w.. r _ -,-.+ .r'•:• _ .... ., 1 ...... ,. �. .r..t .-..... ..- _.. ..rr". CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES ISI FL SO F1 !p S UNITS COLL. AREA SLAB GRADE I 1 i(2 ROUGH PLUMB YARD SPKLR SYSTEM 2ND FL SO FT. 4t HEATING (ROUGH) STORAGE TANK FORMS - MOBILEHOME SVC. BAR SINK POR SO FT. a DUCT WORK ROCK STORAGE CJ OUTLET ROOF DRAINS GAR SO. FT. 0POWER HEATING (FINAL) OTHER APP.IEOUIP. REINF. STEEL GAS (FINAL) DRAINAGE PIPING CAR P. SO FT. 0 GROUT WATER HEATER DRINKING FOUNTAIN WALL SO. FT. Q FINAL INSP. BOND BEAM WATER SYSTEM URINAL SO. FT. (# GRADING cu. yd. $ plus x$ _ $ ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTONDISH) 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. SO. FT. RESID a 11/. c SEWAGE DISPOSAL LATIONISOUND SO.FT.GAR @ 3/.c HOUSE SEWER FINISH GRADING GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE EPL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB FEE STRUCTURE PLUMBING _ -.4 ELECTRICAL HEATING 8 AIR COND. SOLAR SETBACK GROUND PLUMBIC UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE I 1 i(2 ROUGH PLUMB BONDING HEATING (ROUGH) STORAGE TANK FORMS - SEWER OR SEPTIC TANK ROUGH WIRING • DUCT WORK ROCK STORAGE CJ 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. ry �' 3' A ING -05 llff__4j4? FINAL INSP. FING �— �J REMARKS: ' VENTILATION FIRE ZONE ROOFING FIREPLACE SP RK A�RRESTOR- C X5 10A W FIREWALL 2_43 LATHING MESH LATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINiT1AlS _ GARDEN WALL FINAL City of LaQuinta 78495 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] 7,02+24, fI `I' - 9 FRAMING/HARDWARE • Ole- _ 1 PLAN TYPE: ,3 it-- 9� INSULATION Conrracror: WERMERS MULTI -FAMILY CORP. SHEAR NAILING olle . %,�-/Q 9$ DRYWALL mK � JOB FINAL jew, COMMENTS/NOTES: MAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALLIFORNIA 92253