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04161 (SATT)• mun�ny Address City Sam Iress State Lic. ya�i & Classif. I Arch., Engr., Designer,. Address';4"" `E BUILDING:4TYPE CONST. OCC. GRP. - A[t lain 0*.. •;6tit-A 106 A.P. Number 613-790-002 Zip Tel.. , 92686 7t4.7��#i3E legal Description Project Description Bul..ding 13, Plan I ip City Lic. # . „ , ,.,, „ •. Sq. Ft... 92k No. No. Dw. Size Stories Units Tel. I New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ City- �^ . r4 Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) tof Divvision 3bf the Business and Professions ode, and my license is in full force and 7 f... ,r • .,� , f �! effec. J,�.. 1r,�.a w<:'i',•:r...g,;-� .+Ia- i/,,r�•�1f.:rrt' - , -SIGNATURE DATE 't Estimated Valuation ' . reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a P.O. BOX 1504 'x Building3 Address 78"40'1 Terra Cotta Cte 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 , the provisions of the, Contractor's License Law, Chapter 9 (commencing with Section 7000) of Owner Y Plan Chk. Dep. - ,l Plan Chk. Bal. - - e77.-82 COr1St. '�il / . 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 • mun�ny Address City Sam Iress State Lic. ya�i & Classif. I Arch., Engr., Designer,. Address';4"" `E BUILDING:4TYPE CONST. OCC. GRP. - A[t lain 0*.. •;6tit-A 106 A.P. Number 613-790-002 Zip Tel.. , 92686 7t4.7��#i3E legal Description Project Description Bul..ding 13, Plan I ip City Lic. # . „ , ,.,, „ •. Sq. Ft... 92k No. No. Dw. Size Stories Units Tel. I New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ City- �^ . r4 Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) tof Divvision 3bf the Business and Professions ode, and my license is in full force and 7 f... ,r • .,� , f �! effec. J,�.. 1r,�.a w<:'i',•:r...g,;-� .+Ia- i/,,r�•�1f.:rrt' - , -SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following, Estimated Valuation . reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a - - PERMIT - AMOUNT 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 permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). O I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Dep. - ,l Plan Chk. Bal. - - e77.-82 COr1St. '�il / . do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Professions Code: The Contractor's License Law does not apply to an owner of property who Mech..00 AA ali C - builds or improves thereon and who does such work himself or through his own employees, -provided that such improvements are not intended or offered for sale. If, however, the building Electrical • t - • orimprovement is sold within one year of completion, the •owner -builder will have the burden of proving that he did not build or improve for the purpose of sale.) Plumbing75.00 ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- strucl the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for S.M.I. - such projects with a contractors) licensed pursuant to the Contractor's License Law.) ❑ 1 am'exempt under Sec. B. & P.C. for this reason Grading _ .. - Driveway Enc. Date Owner Infrastructure q q inge-Toed .I1z&xd 16 ' - WORKERS' COMPENSATION DECLARATION. I hereby affirm that I have a certificate of consent to self -insure, or a certificate of ` Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) - - r Policy No. Company ❑ Copy is filed with the city. ' ❑ Certified copy is hereby furnished. r. TOTAL REMARKS r C. '=r: <r;•.:Wit*,-.:t.rA istf' Pe:,:.f'"k -A ' .�'3,'•i.4°?di1+rr''••••T'.�J' li:P:i=i,' ��'.�syf` til, [r 1 3 -{ •r - CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred "dollars ($ f 00) valuation - or less.) , . I certify that in the performance of Ing 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 Certlficate.,o! Exemption you should become subject. to'the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. • ., - . ZONE: BY: " Minimum Setback Distances: Front Setback from Center Line' ' Rear Setback from Rear Prop. Line' corusrRucrloN LEtyolNc 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. 309,7, Civil Code.) •1 Side Setback from Property Line ' Lender's Name Lender's Address ' This is a building? permit when properly filled out, signed and validated, and is subject to9�a1�4 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. 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. FINAL' DATE' x - Issued by: Validated by: INSPFCTO F S5 Date Permit` Signature of applicant Date—' 1 '.Mailing Address Validation: i -ASSESSOR'S OFFICE, HARD COPY - FILE + •- .- .. ... i.:-_..�.... ..._.., - _ _. �..•r .,i �__ ..,. _. ..._:� _'.r :e1.. _ �,.'. City, State, Zip y v . WHITE .FINANCE, PINK =APPLICANT, GREEN - BUILDING,'GOLDENROD iii,•, „s..i"-t!^.r ...; t3 ,r .., L...i,-.. _ _.._ .: }`'.. . ai _.. _.. �. 4.. .-•, .- .. CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL SO FT W $ UNITS COLL. AREA GRADE __�� ROUGH PLUMB YARD SPKLR SYSTEM 2ND FL SO FT. a HEATING (ROUGH) STORAGE TANK FORMS MOBILEHOME SVC. BAR SINK POR SO FTof DUCT WORK ROCK STORAGE UND. REINF. j2, -- —g li POWER OUTLET ROOF DRAINS GAR SO. FT. HEATING (FINAL) OTHER APP.IEOUIP. REINF. STEEL GAS (FINAL) DRAINAGE PIPING CAR P. SO FT. Q GROUT WATER HEATER DRINKING FOUNTAIN WALL SO. FT. 0 FINAL INSP. BODOD BEAM WATER SYSTEM URINAL SO. FT. 0 GRADING cu. yd. $ plus x$ =$ ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES �./✓`% WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTOXDISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED 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 1'A c SEWAGE DISPOSAL ULATIONISOUND 3/i SO.FT.GARar 3i c HOUSE SEWER FINISH GRADING GAS PIPING PERMIT FEE FINAL INSPECTION PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.rEE CONST. FEE ELECT. FEE SMI FEE PLUMB FEE STRUCTURE PLUMBING ELECTRICAL HEATING 8 AIR COND. SOLAR SETBACK UND PLUMBIN 1Z UNDERGROUND A.C. UNIT COLL. AREA GRADE __�� ROUGH PLUMB BONDING HEATING (ROUGH) STORAGE TANK FORMS R O ROUGH WIRING DUCT WORK ROCK STORAGE UND. REINF. j2, -- —g li GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BODOD BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ =$ MBE" R. FINAL INSP. Vd4A-MING FINAL INSP. ROOFING �./✓`% V /� `� ( �/ REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR, GAR. FIREWALL MESH ULATIONISOUND 3/i FINISH GRADING FINAL INSPECTION ' CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS , GARDEN WALL FINAL