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04191A TA P.O. BOX 1504 Buildin78-105 CALLE ESTADO Address 78-405 Terrel 00tita Cto� _Q LAUINTA,CALIFORNIA9.2253 g Owner zoulevard Development q_ailing, Address 777 S, in St. aUita, City Zip Tel_ 1. Orange 1 1 92696 UA Contractor L06 41- -547-805 BUILDING: TYPE CONST. OCC. GRP. A.P. Number 613-7%0-002 Legal Description Project Description BuUdincr 23, Plan. 2 Sq. Ft. 912 No. No. D w Size Stories Units. New 0 Add 0 Alter 0 Repair 0 Demolition 0 Garage included City City Zip Tel. ..State. Lic. & Classif. 4628 14 City Lic. # Arch:; Engr., Designer Address Tel. L06 41- -547-805 BUILDING: TYPE CONST. OCC. GRP. A.P. Number 613-7%0-002 Legal Description Project Description BuUdincr 23, Plan. 2 Sq. Ft. 912 No. No. D w Size Stories Units. New 0 Add 0 Alter 0 Repair 0 Demolition 0 Garage included City Zip State ,S Lic. #, LICENSED CONTRACTOR'S DECLARATION I hereby affirm that,I am licensed under provisions of Chapter 9 (commencing with Section 7000) Of Divlsion3 of the Business and Professions Code, and my license is in full force and effect. SIGNATURE ,.DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractors License Law for the following Estimated Valuation $651,225 ­ 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 for to file that he. is licensed to PERMIT AMOUNT requires the -applicant such permit a signed statement pursuant 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 'any for Plan Chk. Dep. for the alleged exemption. Any violation of Section 7031.5 by applicant a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500) Plan Chk. Bal. 0 -275A) I 0 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 Const. 331.00 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. 36.00 provided that such improvements are not intended or o ifered for sale. If, however, the building ' or improvement is sold within one year of completion, the owner -builder will have the burden' m Electrical 44.76 of proving that he did not build or improve for the purpose of sale.) 0 1, 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 Contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for S.M.I. 4459 such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading '0 1 am exempt under Sec. B. & P.C. for this reason Driveway Eric. Infrastructure 1'#467.3.7 Date Owner Frinae-Tood Li card 38.18' 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 0 Copy is filed with the city. 0 Certified copy is hereby furnished. TOTAL 5, Z �1 7 Z 1 1, -J I CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit Is for one hundred dollars ($100) valuation or less.) I certify that in the performance of thp 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 UCTION 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 6/6u/88. expiration It work thereunder is suspended for 180 days. 1 I certify. that I have read this application and state that the above information I 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 enter the above- 'to, mentioned property for inspection purposes. ,• Validated by: Signature of applicani Date Mailing Address Validation: City, State,* Zip WHITE FINANCE, PINK APPLICANT, GREEN- BUILDING, GOLDENROD -ASSESSOR'S OFFICE, HARD COPY- FILE r..L CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES ISI FL SO F1 Ip S UNITS RADE/Z -/�� ROUGH PLUMB BONDING YARD SPKLR SYSTEM 2ND FL SO FT. g FORMS SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR SO FT. 0 GAS (ROUGH) METER LOOP HEATING (FINAL) POWER OUTLET ROOF DRAINS GAR SO. FT. ry TEMP. POLE GROUT DRAINAGE PIPING CAR P. SO FT. 6 FINAL INSP. BOND BEAM WATER SYSTEM DRINKING FOUNTAIN WALL SO. FT. a _$ L MBER GR. FINAL INSP. URINAL SO. FT. (d ROOFING ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to De used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTONDISH) 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 1 V: c SEWAGE DISPOSAL SO.FT.GAR re 3V:c HOUSE SEWER FENCE FINAL 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 8 AIR COND. SOLAR SETBACK GROUND PLUMBINGL UNDERGROUND A.C. UNIT COLL. AREA RADE/Z -/�� ROUGH PLUMB BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE REINF. --g s/ etf- 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$ _$ L MBER GR. FINAL INSP. &AMING �� FINAL INSP. ROOFING � /4 n —� ' REMARKS: VENTILATION FIRE ZONE ROOFING . FIREPLACE SPARK ARRESTOR' GA FIREWALL ING MESH TION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL