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04234 (GRES). � 04234 .. _ . " 14 P.O.' BOX 1504 Building.78-105 CALLE ESTADO Address 78-349 Tarr i Cotta Ct. LA QUINTA, CALIFORNIA 92253 y Owner BoUlaaard Development BUILDING: TYPE CONST. OCC. GRP. Mailing Address 777-S main St. j Sutta f06,613-790-001. A,P.. Nurnber City Zip Tel. Orange 1926961714.-!547 -13056 -Legal .Description Contractor Project Description �Blltildincy �3.0,. Plat! a SWW Address City Zip Tel. State Lic. City & Classif. 463814 Lic. # Sq. Ft. 76 No. No. Dw. -Size Stories - Units Arch., Engr., Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. CilZage 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 effect. SIGNATURE r DATE OWNER -BUILDER DECLARATION Estimated Valuation A I hereby affirm that I am exempt from the Contractor's License Law for the following( $s" 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 PERMIT AMOUNT the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) or 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 Plan Chk. Dep. subjects the applicant to a civil penalty of not more than five hundred dollars (5500). 0 I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. JU • s UO Professions Code: The Contractor's License Law does not apply to an owner or property who s builds or improves thereon and who does such work himself or through his own employees, Mech. w . provided that such improvements are not intended or offered for sale. if, however, the building t�YL 1•Y e� or improvement is sold within one year of completion, the owner -builder will have the burden Electrical ,1 .s • or proving that he did not build or improve for the purpose of sale.) 05 O I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing . a 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, such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading ❑ I am exempt under Sec. B. & P.C. for this reason Driveway Enc. Date owner Infrastructure 6� M 1 2 /rV 94 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 w y U 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 1*Ff"��•-bi'��''"�ar� 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. 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 This is a building permit FINAL DATE IN PECTOR when properly filled out, signed and validated, and is subject to lOR 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- mentioned property for inspection purposes. Validated by: Signature of applicant Date Mailing Address Validation: City, State, Zip WHITE -FINANCE, PINK -APPLICANT, GREEN -BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY- FILE CONSTRUCTION ESTIMATE I NO. I ELECTRICAL FEES NO. I PLUMBING FEES IST FL SO FT y $ UNITS �j 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 FTa ROCK STORAGE OUND. REINF./�J r —�do I �i GAS (ROUGH) OUTLET ROOF DRAINS GAR SO. FT. toPOWER REINF. STEEL GAS (FINAL) TEMP. POLE DRAINAGE PIPING CAR P. SO FT. @ WATER HEATER SERVICE FINAL INSP. DRINKING FOUNTAIN WALL SO. FT. Q GRADING cu. yd. $ plus x$ _ $ LUMBER GR. URINAL SO. FT. fB FINAL INSP. FING $ ESTIMATED CONSTRUCTION VALUATION $ 24 WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES VENTILATION WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTONDISHI APPLIANCE DRYER FIREPLACE 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 g IA c SEWAGE DISPOSAL SO.FT.GAR (g 3V.c HOUSE SEWER CERT. OCC. 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 r�� ELECTRICAL HEATING 8 AIR COND. SOLAR SETBACK GROUND PLUMBIC! �j UNDERGROUND A.C. UNIT COLL. AREA LAB GRADE Z� %j� ROUGH PLUMB BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTI: TANK ROUGH WIRING DUCT WORK ROCK STORAGE OUND. REINF./�J r —�do I �i 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. F ING FINAL INSP. FING $ 24 REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR* LATHING MESH TIONISOUN D2:� FINISH GRADING FINAL INSPECTION v CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS _ GARDEN WALL FINAL city of LaQu*inta 78-495 CALLE TAMPICO �m LA QUINTA, CALIFORNIA (760) 777-7012 [FAX] (760) 777-7011 �p INSPECTION RECORD Permit # 980&002 STRUCTURAL RETROFIT OF UNIT ADDRESS DATE INSPECTION [YES/NO] 2 —341V 7:9664 ,Q //- 9 - Q6 FRAMING/HARDWARE , p/,/, A I �, PLAN TYPE: ,3 //- 9 - 98 INSULATION I .,J� Contractor: WERMERS MULTI -FAMILY CORP. SHEAR NAILING // - /3 - 9 DRYWALL JOB FINAL COMMENTS/NOTES: C-.)S.rn�t'.,S� 4-40RI'n �1F'�iPAO� MAILING ADDRESS — P.O. BOX 1504 - LA QUINTA, CALLIFORNIA 92253