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04232 (GRES)City lZip ( 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 effect. r1 SIGNATURE r11" "' DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License law for the following `reason: (Sec. 7031.5,Susiness 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 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 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. 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.) O I, 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 such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) O 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 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. REMARKS P.O. BOX 1504 Building Address m �` i 3333 �r,,,� 'Terra Cotten Cts 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 ` . Owner oulev rd Developne t c .. Mailing PERMIT BUILDING:' TYPE CONST. OCC. GRP. Address 777 S. Main St., Suite lob A.P. Number 613-790-001 CityZip �. Tel. : • - Qrl,nCe 92686 714t547-:806 Legal Description Contractor Electrical Minimum Setback Project Description -Building 9. Plan kJ Plumbing Same 63.00 w Address 3,416 Grading City Driveway Enc. Zip Tel. • State Lic. ��� 1,279494 City Llzar& 70 & Classif. FINAL DATE INSPECTOR Lic. # .' ... Sq. Ft:* No. No. Dw. expiration it work thereunder is suspended for 180 days. .- 6/29/80. TOTAL 162,01S.67 Size Stories Units - Arch., Engr., construction, and hereby authorize representatives of this city to enter the above- Designer mentioned property for inspection purposes. Validated by: New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address . Mailing Address Tel. macre ixAQlLida rd City lZip ( 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 effect. r1 SIGNATURE r11" "' DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License law for the following `reason: (Sec. 7031.5,Susiness 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 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 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. 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.) O I, 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 such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) O 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 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. CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation r y 's CM')", moi ,4'g1Cr, rj tfi ;,,,f.,�+.t;'.,, ,t k.k _ ;;�) • j Estimated Valuations' PERMIT AMOUNT ' Plan Chk. Dep. , Plan Chk. Bal., �. Const. ZONE: 304.00 Mech. 33.00 Electrical Minimum Setback 41..78 Plumbing _ 63.00 S.M.I. 3,416 Grading Side Street Setback from Center Line Driveway Enc. • Infrastructure 1,279494 Frince-Toed Llzar& 38. IR, Lender's Address FINAL DATE INSPECTOR This is a building permit when properly filled out, signed and validated, and is subject to expiration it work thereunder is suspended for 180 days. .- 6/29/80. TOTAL 162,01S.67 CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation r y 's CM')", moi ,4'g1Cr, rj tfi ;,,,f.,�+.t;'.,, ,t k.k _ ;;�) • j 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: 11, alter 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. - 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 Lender's Address FINAL DATE INSPECTOR This is a building permit when properly filled out, signed and validated, and is subject to expiration it work thereunder is suspended for 180 days. .- 6/29/80. I car Illy 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- mentioned property for inspection purposes. Validated by: Signature of applicant Date Mailing Address Validation: City, State, Zip y ' WHITE -,FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HAIR p C Y - FILE: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL SO FT y 1 UNITS UNDERGROUND A.C. UNIT YARD SPKLR SYSTEM 2ND FL SO FT. 0 ROUGH PLUMB BONDING MOBILEHOME SVC. BAR SINK POR SO FT. y SEWER OR SEPTIC TANK ROUGH WIRING POWER OUTLET ROOF DRAINS GAR SO. FT. Cl GAS (ROUGH) METER LOOP HEATING (FINAL) DRAINAGE PIPING CARP. SO FT. 0 GAS (FINAL) TEMP. POLE DRINKING FOUNTAIN WALL SO. FT. a WATER HEATER SERVICE FINAL INSP. URINAL SO. FT. 43 WATER SYSTEM ESTIMATED CONSTRUCTION VALUATION $ GRADING Cu. yd. $ _plus_x$ WATER PIPING NOTE: Not to be used as propeAy tax valuation FLOOR DRAIN MECHANICAL FEES FINAL INSP. WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTONDISH) APPLIANCE DRYER REMARKS: 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, TEM/PERM 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 1+i. c SEWAGE DISPOSAL MESH 14 4 SO.FT.GAR @ Av:c HOUSE SEWER ULATIONISOUND GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE hL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB FEE STRUCTURE PLUMBING ^ p� ELECTRICAL HEATING 8 AIR COND. SOLAR SETBACK GROUND PLUMBING -/ UNDERGROUND A.C. UNIT COLL. AREA AB GRADE `� �� ROUGH PLUMB BONDING HEATING (ROUGH) STORAGE TANK FRMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE OUND. REINF.I - 0 /�gU/ lll��� 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 AMING .��-� FINAL INSP. OFING - sA I REMARKS: VENTILATION- FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR" IREWALL .2-- l LATHING -�'- MESH 14 4 ULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL city of LaQui'nta 7&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] 7�- 33.3 -��, v %/ -5 - 9B FRAMING/HARDWARE BiG �• PLAN TYPE: II-5 - 9B INSULATION Contractor: V IERMERS MULTI -FAMILY CORP. %-� - g g SHEAR NAILING / - /m Q8 DRYWALL //' 98 JOB FINAL COMMENTS/NOTES: - g) &F pECc� .tIA�Glnry /o -z9 - l8 ., �• MAILING ADDRESS — P.O. BOX 1504. LA QUINTA, CALLIFORNIA 92253