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04168 (GRES)-• „ 4_4 P.O' BOX 1504 I 78-105 CALLE ESTADO Addrress 78-359 Iftrra t St'- w-LA:GUINTA,.CALIFORNIA 92253,_ - Owner r•" Boulevard Develop ; Ga i .Mailing BUILDING: TYPE CONST. r OCC. GRP. Address% • �3 • �� ..,, .. 613«%90""0'0"1 • A:P. Number « - . - City Zip Tel. Orange .92686 N�� +}�� Legal Description Contractor Project Description Building 10j, Plan 1 SamRL Address. ` City & Classif Arch., Engr., Designer Address City 461814 Lic. Lic. # Sq. Ft. Size I Zip I State Lic. # ;N ,,'�LICENSED CONTRACTOR'S DECLARATION efaYam licensed under provisions ofChapter 9 (commencing with Section' ;of Vie Businessand Professions Code, and my license is in full force and , -m�rvA,une - oA,t '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 i 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 live hundred dollars ($500). O 1, 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 or 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 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 such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) ❑ 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 ❑ Copy is filed with the city. ' 0 Certified copy is hereby furnished. No. Stories New ❑ Add ❑ Alter ❑ No. DW. Units Repair ❑ , Demolition ❑ Garage Included TOTAL CERTIFICATE OF EXEMPTION FROM REMARKS " WORKERS' COMPENSATION INSURANCE Estimated Valuation $66,73. PERMIT AMOUNT. Plan Chk. Dep. or less.) Plan Chk. Bal.:%,;' Const.3�`i Y Mech.!� ' Electrical 45,,,04 Plumbing 7.•00 S.M.I. 4*66 Grading Driveway Enc. r , Infrastructure041 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: - ' ' pAlft VM TOTAL CERTIFICATE OF EXEMPTION FROM REMARKS " WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars (5100) valuation ,�1�r� �,3 w 17-i`u«1 0 ��Kf,.�f {AAO -VO '-ci_r +,Yfa}t 0 or less.) - I certify that in the performance of thg work for which this permit is issued, 1 shall not ' employ anyperson in any manner so as to become subject to the Workers' Compensation Laws of California. Date --Owner NOTICEJO 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.PToperty 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. 9ryq �x I certify that I have read this application and state that the above Information is correct.'- I Issued by: Date Permit I agree'to comply with all city and county ordinances and state laws relating to building' 4' construction, and hereby authorize representatives. •of 'this city Ao enter the above mentioned property for inspection purposes. :, 'Validated by: r signature of applicant Date ; Mailing'Address ,:.Validation: - City, State, •Zip WHITE FINANCE PINK APPLICANT GREEN - BUILDINf9,' GOLOBNOCID -.ASSESSOR'S OFFICE HARD COPY'- FILE d" ` i •' ... ...,, .. ?�.• •. 1.ti v..i.. .�..a .b,%- .n .r�: a f:. . ,......,. '5 ... .. r. n.... A_a x.._.. _. v,. � .... ,ter ., ., -.. ns .... _. ...._s r:+, _, �� $ •:, ..,1 f. .. t-...'•i:<'♦:� CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL SO FT y $ UNITS LAB GRADE �� ROUGH PLUMB BONDING YARD SPKLR SYSTEM 2ND FL SO FT. a FORMS SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR SO FT. gr GAS (ROUGH) METER LOOP HEATING (FINAL) POWER OUTLET ROOF DRAINS GAR SO. FT. * TEMP. POLE GROUT DRAINAGE PIPING CAR P. SO FT. 6 FINAL INSP. BOND BEAM WATER SYSTEM DRINKING FOUNTAIN WALL SO. FT. 0 _$ LUMBER GR. FINAL INSP. URINAL SO. FT. 0 OFING � ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES I IWATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTO)(DISH) 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 C 1'A c SEWAGE DISPOSAL FINAL INSPECTION SO.FT.GAR @ 3/.c HOUSE SEWER CERT. OCC. GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE bL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB FEE STRUCTURE PLUMBING �,. ECTRICAL HEATING 8 AIR COND. SOLAR SETBACK GROUND PLUMBING/ 8 UNDERGROUND A.C. UNIT COLL. AREA LAB GRADE �� ROUGH PLUMB BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE // LIND. REINF./2—/ �y� ( 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. $ plus x$ _$ LUMBER GR. FINAL INSP. ING Z� FINAL INSP. OFING � f/� � � , Y f� REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR- WAILC;OI MESH SULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL • c� of a u*inta 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] 8 ' .3.5ie2fi C O Ll�/9 //—/0 '98 FRAMING/HARDWARE O/C .� PLAN TYPE: INSULATION Ole' �. Contractor: WERMERS MULTI -FAMILY CORP. SHEAR NAILING Ole— KContractor: 11-13-99 DRYWALL ofC �•� %Z //— 919 JOB FINAL COMMENTS/NOTES: .Sri oK,G /�/�?.e/rI UP�•PAO,� MAILING ADDRESS — P.O. BOX 1504. LA QUINTA, CALLIFORNIA 92253