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04269 (SATT),. fit -4269 -' P.O. BOX 1504 , Building 70-411 Terra Cotta Ct. 78-105 CALLE ESTADO ^. . :.:Address LA QUINTA, CALIFORNIA,92253 ' Owner n Soulevard BUILDING: TYPE CONST. OCC. GRP. Mailing Address 777. S Main St • Suits fQ4 • rr - , .. .. A.P. Number ' City. Zip Tel. or, Imste 92686 714- 547t9O56 Legal MDescription Contractor Project Description re�•�•�« Palm Royale Pian 3 iBuilding 13 Address' City Zip Tel. ; State Lic. City & Classif. ' '462814 Lic. # Sq. Ft. No. No. Dw..' Size - Stories 14, Units Arch., Engr., w ^ Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address-- 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. wti -e F_ . "� - J.• • f •r` SIGNATURE��: '' Y' DATE °� ''' OWNER -BUILDER DECLARATION'° Estimated Valuation y ^ I hereby affirm that I am exempt from the Contractor's License Law for the following Any $56086 reason: (Sec. 7031.5,Business and Professions Code: 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 permitto lila a signed 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 Any Section 7031.5 'any for - ..• Plan Chk. Dep. • for, the alleged exemption. violation of by applicant a permit ' subjects the applicant to a civil penalty of not more than live hundred dollars ($500). Plan Chk. Bal. 434404 ' ❑ 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. •*.y 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. • 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 Electrical 410 of proving that he did not build or improve for the purpose of sale.) O I, as owner of the property, am exclusively contracting with licensed contractors to con- att'f Plumbing struct the project. (Sec. •7044, Business and Professions Code: The Contractor's License Law builds improves thereon,,and for f� S.M.I. does not apply to an owner of property who or who contracts such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) 4 V Grading ❑ 1 am exempt under Sec. B. & P.C. for this reason Driveway Enc. A4, Date Owner Infrastructure tr •`+� .� yyYYngpp-Aoe/ J Yard yyV O .11 ..- Fringe-Toed - 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. O Certified copy is hereby furnished. ' TOTAL.YF9.% CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE REMARKS N' - nr, a :. w ,. s • ray a J' ^ (This section need not be completed if the 'permit is for one hundred dollars ($100) valuation'' `�'�' �" f•i"`'"` `�' • 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, 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: ' n ' ' 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 I' 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 Y construction,. and hereby authorize representatives -of thls••city to enter the above ' mentioned property for inspection purposes. , " Validated by: ` Signature of applicant" ^' Date Mailing Address '� � alidation: City,- State, Zip I WHITE FINANCE PINK APPLICANT GREEN BUILDING, GOLDENROD ''ASSESSOR'S OFFICE, HARD COPY -FILE .. j?.i. +.. 1 .ya. . '..,r� � :,; tr!. ,...:.3;..'w. -�.e: i. , '! •rc ,::h`.?.!`t�''ac, ^i.r;. r..:.::•" ..'.t. i ^+". . _... i',1. , .; e ..1.0 c.�...,--..i. 'fo<: �t.¢tk:lr rv.'r.. '� _ _.i; _ .. _.?�.�a.:S. �..? ,.:IM;.: CONSTRUCTION ESTIMATL NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL SO FT Qt $ UNITS B GRADE 12 _C 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. a GAS (ROUGH) METER LOOP HEATING (FINAL) POWER OUTLET ROOF DRAINS GAR 50. FT. la TEMP. POLE GROUT DRAINAGE PIPING CAR P. SO FT. ra' FINAL INSP. WALL SO. FT. C WATER SYSTEM DRINKING FOUNTAIN GRADING cu. yd. $ plus x$ _ $ URINAL SO. FT. rd FINAL INSP. �/ T l ( ING 7-Z ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) 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 @ t w c SEWAGE DISPOSAL SO.FT.GAR er 3/4c HOUSE SEWER FINAL INSPECTIOII1W GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE I L.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB FEE STRUCTURE PLUMBING ELECTRICAL HEATING 8 AIR COND. SOLAR SETBACK ROUND PLUMBIN >Z UNDERGROUND A.C. UNIT COLL. AREA B GRADE 12 _C ROUGH PLUMB BONDING HEATING (ROUGH) STORAGE TANK $ FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE EINF/. j/•(6/' �C! GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IEOUIP. 00 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. �/ T l ( ING 7-Z FINAL INSP. ROOFING REMARKS: VENTILATION • FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL 3 MESH 0,4 dtATIONISOUND r FINISH GRADING FINAL INSPECTIOII1W CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESlINITIALS , GARDEN WALL FINAL