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04162 (SATT)04 6 P.O. BOX 1504 Building 78-419 Terra Cotta Cot78-105CALLEESTADO ' Address y, .LA,OUINTA, CALIF,.ORNIA,92253- Owner soulavard Development � • �' � � �~ BUILDIIVG:'TYPE CONST. OCC. GRP. Mailing Address 777 S. Main St.'# -' t itO 106. A.P. Number 613-790-002 City Zip Tel. 92686 714-54*1-8056 Legal Description Contractor Project Description13, Plan I • Mars . • Address City Zip Tel. State Lic. - City & Classif. 4•62814 Lic. # „; � , Sq. Ft. No. r No. Dw. _ Size Stories Units - Arch., Engr.; DesignerN , � _ New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Add •+ ress= ,> >�i?;�' Tel. • Garage. t=luded ,. ti City ,: .r-!;lt ;_.%�" 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-Divlsion 3 of the•Business ions °and Professions, and my license is in full force and ,effect xFr"w Mme; ".. r" 1. r�. f•:: A" SIGNATURE "' l' _ DATE ' OWNER -BUILDER DECLARATION Estimated Valuation66 7 13 I hereby affirm that I am exempt from the Contractor's License Law for the following It - 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, - - - PERMIT ' the provisions , of the Contractor's License Law, Chapter 9 . (commencing with Section 7000) of ,AMOUNT Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis for Any Section 7031.5 by applicant for Plan Chk. Dep. the alleged exemption. violation of any a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). _ _- Plan Chk. Bal.' ❑ 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 334,09 Const.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 0 00 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 45A4 ' 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 7 .5 . ©0. Strutt 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. - .• - ' • 4.:66 such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading ❑ 1 am exempt under Sec. B. & P.C. for this reason Driveway Enc. Date owner Infrastructurer�� Frin'"IIFl—Toed Lizard, 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 CERTIFICATE OF EXEMPTION FROM -REMARKS ' WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation - •7, ;fMl.'#d:41�nt..�iS'i+i'.h'� iz:.7 �'St'S':•.;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: ' Front Setback from Center Line Rear Setback from Rear Prop. Line? `y CONSTRUCTION LENDING AGENCY ., t Side Street Setback from Center Line Ihereby affirm that there is a construction lending agency for -the performance of the work for which this permit is issued. (Sec. 3097,• Civil Code.) ..' • • - - r r _ ; - - ' Side Setback from Property Line ' Lender's Name Lender's• Address " ,;FINAL DATE INSPECTOR r This is a building permit when properly filled out, signed and validated, and is subject to p /0sy expiration it work thereunder is suspended for 180 days. 127 i 0 O '.,Issued -" - 1 certify that I have read this application and state that the above information is correct. • 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 to enter the above-• mentioned property for inspection purposes.` +-- _ ,Validated by: ' Signature of applicant Date L ' ;Mailing Address a' Validation: 'City, State, Zip GOLDENROD - ASSESSORS OFFICE, HARDJ COPY - FILE WHITE: FINANCE, PINK APPLICANT, GREEN 7 BUILDING, 3i�1;.+_ , 1. L 1. /x , s: �• ,,.. t . .,.... . n•L.'`;•.. -. r '�. � . ,-N . . u ") x_ -.. ... -, 1�i . ♦ J. � �t•s .,.i'\. . .-. ....,\ � r � _ •?r1.r, ri _� s .. .- ... +�w,.� � �, ^ � Y`�1�, v CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL SO Fl y $ UNITS AB GRADE Z _ ROUGH PLUMB BONDING YARD SPKLR SYSTEM 2ND FL SO FT. C FORMS SEWER OR SEPTIC FANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR SO FTof GAS (ROUGH) METER LOOP HEATING (FINAL) POWER OUTLET ROOF DRAINS GAR SO. FT. iK TEMP. POLE GROUT DRAINAGE PIPING CAR P. SO FT. ra FINAL INSP. BOND BEAM WATER SYSTEM DRINKING FOUNTAIN WALL SO. FT. B _$ LUMBER GR. FINAL INSP. URINAL SO. FT. (@ ROOFING 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 WASH ER(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'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 PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB FEE STRUCTURE A PLUMBING ELECTRICAL HEATING 8 AIR COND. SOLAR SETBACK GROUND PLUM 13INVZ-1Z-0- UNDERGROUND A.C. UNIT COLL. AREA AB GRADE Z _ ROUGH PLUMB BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC FANK ROUGH WIRING DUCT WORK ROCK STORAGE / &IIRD. REINF/:? �/` ��[ I Cl !!!!!! GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IEOUIF. 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. AMING � FINAL INSP. ROOFING �. � ��� `0� ✓ . GV' REMARKS: VENTILATION FIRE ZONE ROOFING✓%//�� FIREPLACE SPARK ARRESTOR- G FIREWALL T NG M LLIdETIONISOUND 9-3 FINISH GRADING FINAL INSPECTION ' CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL