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04180 (GRES)P.O. BOX 1504 Building 78-105 CALLE ESTADO Address 78"-355 Tera Cotta Ct. LA QUINTA, CALIFORNIA 92253 Owner ; r ... w .. ....,. ulievatrd DavelonimAtBUILDING:.,TYPECONST. OCC. GRP. Mailing , Address .. .777 Sia Main Styr . Rite 106_ . - A.P. Number 613-700-001 CityZip Tel. Orange 99686 7-547-8056 Legal Description Contractor Same. Address City lZip -State Lic. & Classif.�� Arch., Engr., • , Designer Address Project Description "Biii1ding '10, Ply! 2 Tel. City Lic. # 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 - effect. r _SIGNATURE - - - "DATE Sq. Ft. No. No. Dw.- °Size Stories Units New ❑ Add ❑ -Alter ❑ Repair ❑ Demolition ❑ Caratxpt 3Lrtitl^1-diled OWNER -BUILDER DECLARATION Estimated Valuation I hereby affirm that I am exempt from the Contractor's License Law for the following ieason: 'V +SG . (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 asigned 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 thathe is exempt therefrom, and the basis for the •exemption. Any Section -7031.5 by 'any for Plan Chk. Dep. alleged violation of applicant a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). Plan Chk. Bal. - • L` 2,75 ? 7. ❑ 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. Sts 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, Mech. 7RI3 3 provided that such improvements are not intended or offered for sale. If, however, the building d , or improvement is sold within one year of completion, the owner -builder will have the burden Electrical 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- Plumbing t� 75. W 0 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. 1. -' , such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading ❑ 1 am exempt under Sec. B. & P.C. for this reason Driveway Enc. Date Owner Infrastructure Y j r=e0. -%Vey°, X#1 Zara r _ 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�7�%� 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�' - 4615 �,96k,1 `t'�yx}fr's-�7ii,7l ;d`" � -e 0: or less.) .... - I certify that in the performance of thg work for which this permit is issued, I shall not employ any parson 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 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 if work thereunder is suspended for 180 days. 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 0 Validation. " ' City, State, 'Zip WHITE -FINANCE, PINK - APPLICANT, GREEN -.BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE ... ,.s.._ 'l.t. ..r �. •... .,a �.•,._ .- �..?. ��R. � •.�.:s---, _. ..e. -.. .-.y r. ... ... -. .. ,�.- .. r. . _, .� - - ..'�'.. ,4.-,.��.,o-:�;r-'`3�`i .. �.-., CONSTRUCTION ESTIMATL NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL SO FT (a i UNITS COLL. AREA SLAB GRADE j� ROUGH PLUMB YARD SPKLR SYSTEM 2ND FL SO FT. Q STORAGE TANK FORMS MOBILEHOME SVC. BAR SINK POR SO FT. Qr ROCK STORAGE UND. REINF/2-- i( GAS (ROUGH) POWER OUTLET ROOF DRAINS GAR SO. FT. * OTHER APP.IEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE DRAINAGE PIPING CAR P. SO FT. 0 GROUT WATER HEATER SERVICE DRINKING FOUNTAIN WALL SO. FT. C BOND BEAM WATER SYSTEM URINAL SO. FT. 43 LUMBER GR. FINAL IN 3 o ESTIMATED CONSTRUCTION VALUATION S FINAL INSP. WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASH ER(AUTONDISH) APPLIANCE DRYER FIRE ZONE ROOFING GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FIREPLACE ILAUNDRYTRAY 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 @ I'A c SEWAGE DISPOSAL SO.FT.GAR fA 3i c HOUSE SEWER FINAL INSPECTION 3 �q L GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE vIECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB FEE STRUCTURE PLUMBING ,--) ELECTRICAL HEATING 8 AIR COND. SOLAR SETBACK GROUND PLUMBIN iZ/ UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE j� ROUGH PLUMB BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE UND. REINF/2-- 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. a plus xa =$ LUMBER GR. FINAL IN 3 o RAMI G 2�� FINAL INSP. OPz OFING l — REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR �FIREW LL 2 If LATHING MESH t�l,$.ULICTIONISOUN i z&�— FINISH GRADING FINAL INSPECTION 3 �q L CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL