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04160 (SATT)134; 60 P.O. BOX 1504 Building. 78-105 CALLE ESTADO ` Address 78 -359, Torra Cotta Ct. ,LA QUINTA, CALIFORNIA 92253 'y Owner ' Boulevard DevelopmentBUILDING:-TYPE CONST. OCC. GRP.Mailin , Address 777 II e101a in St., Suite 104. , A: P: Number •. .. 43-:790" 002 ' r - � � �� •• -City - Zip Tel. • I nnq() 92686-X47-80 6 Legal Description Contractor Project Description Building 32' Plan i Came Address City Zip Tel. ' State Lic.6�IIi�i City 36 & Classif. Lic. # w .• M v M Sq.•Ft. ° No. ° No. Dw. Arch., Engr.Size Stories Units - Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. Garages incl—Wed City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am.licensed under provisions of Chapter 9 (commencing with Section - r••• 7000) of, Division 3 of the Business and Professions Code, and my licensei is in full force and effect:,. SIGNATURE - X DATE OWNER -BUILDER DECLARATION Estimated Valuation $66031 •,' 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, after, 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 - i .AMOUNT . the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of k; • Division 3 of the Business and Professions Code, or that -he is exempt therefrom, and the basis Any Section 7031.5 'any for Plan Chk. Dep.' for the alleged exemption.'. violation of -by applicant a permit,- subjects the•applicanf to a,civil penalty of not more than five hundred dollars (8500). 'y Plan Chk. Bal. 3 ❑ I, as owner of .ihe pfoperty, 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. Professions Code: The Contiactor'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. �{ �c 367�.{q'�i0 ' . 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 ..or • Electrical !�p• pp�y, g6.Li cp ' 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 to con- Plumbing 75.00 - struct the project. (Sec.. 7044, Business and Professions Code: The Contractor's License Law does not of property who builds or improves thereon, and who contracts for S.M.I. _ At C - 4 apply -to an owner such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) ' Grading .66 ❑ 1 am exempt under Sec. B. & P.C. for this reason Driveway Enc. . Date owner Infrastructure 1r501.45 intra-T"d L; iznrd - lb WORKERS' COMPENSATION DECLARATION C y% t _t" wk�- ' 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. TOTAL CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation �y, txx j, ,,{{, !t�� i �`46Y3='S'."si'�ti«f�`�'. iii 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, 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 - -1 B cf expiration itfwork thereunder is suspended for 180 days..' , 612 ! . I certify that I have read this application and state that the above information is correct ` ,'Issued by: D to Permits - 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: State, Zip ,,City, .. WHITE FINANCE, PINK APPLICANT, 'GREEN BUILDING, GOLDENROD - ASSESSORS OFFICE HARD COPY - FILE yS_^f?� \ _. r. .. ... .i rr.. .... ....."L'7.•.''' i,:��._ - . 1.xeUY w ._.. .: i' -_. ''�- .w• i �? -..•i' _ :ltr . •-.�• •.. �i}-:T .,•:':t .: T... .� ....:.R:a --.: CONSTRUC710N ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES iST FL SO Fl rp s UNITS ROUGH PLUMB BONDING HEATING (ROUGH) STORAGE TANK YARD SPKLR SYSTEM 2ND FL SO FT. q DUCT WORK ROCK STORAGE • ND. REINF.) �� MOBILEHOME SVC. BAR SINK POR SO FT. a AINF. STEEL Z GAS (FINAL) TEMP. POLE POWER OUTLET ROOF DRAINS GAR SO. FT. 0 FINAL INSP. BOND BEAM WATER SYSTEM DRAINAGE PIPING CAR P. SO FT. fa LU BER GR. FINAL INSP. Z, 71, G FINAL INSP. DRINKING FOUNTAIN WALL SO. FT. @ REMARKS: URINAL SO. FT. (a FIRE ZONE ROOFING ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES SPARK ARRESTOR, WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTONDISHI 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 1+/4 c SEWAGE DISPOSAL SO.FT.GAR ar V c HOUSE SEWER 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 ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING/ UNDERGROUND A.C. UNIT COLL. AREA 'LAB GRADE r 'L / "�� ROUGH PLUMB BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE • ND. REINF.) �� GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IEOUIP. AINF. STEEL Z GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. 00s plus xi =E LU BER GR. FINAL INSP. Z, 71, G FINAL INSP. ROOFING VENTILATION REMARKS: FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR, G FIREWALL ING MESH �'tJCATIONISOUND FINISH GRADING FINAL INSPECTION ' CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL