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04273 (SATT)1 P.O. BOX 1504 Building' 78-431 Terra %Dtt`.a Ct. 78-105 CALLE ESTADO Address - L"A'OUINTA; CALIFORNIA 92253" Owner �;• a .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 for the'alleged Any Section 7031.5 by 'any for Mailing s exemption. violation of applicant a permit subjects the applicant to a civil penalty or not more than five hundred dollars ($500). BUILDING: TYPE CONST. OCC. GRP. , Address :171 S. Ma 5tr !s�$�� 5� 3'�79i�—G�t}2. , do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. �♦� • •� A:P° Number'" •- City 9 V�{ , Zip Mech. Tel." provided that such Improvements are not intended or offered for sale. If, however, the building �) 912686 or improvement, is, sold, within one year of completion, the owner -builder will have the burden ?J4-$,47-- 6 I Legal Description Contractor ;t Project Description''• Plumbing Same .. Address- -does not apply to an owner of property who builds or Improves thereon, and who contracts for S.M.I. 3.9165 1 Grading - .❑ 1 am exempt under Sec. B. & P.C. for this reason City Zip Tel. State Lic.� 2ii 4 City T36 & Classif. Lic. # - Sq. Ft. No. No. Dw: Size Stories Units Arch., Engr., 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 Ilcense is in full force and ' effect.µ,.. SIGNATURE 4 - DATE , t+ OWNER -BUILDER DECLARATION Estimated Valuation ssl ssro Ihereby affirm that I am exempt from the Contractors License Law for the following! reason: (Sec. 7031.5,Business and.Professions Code: Any city or county which requires a ' permit to construct, atter. Improve, demolish, or repair any structure, prior to its Issuance also - requires the applicant or such permit to file 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 for the'alleged Any Section 7031.5 by 'any for Plan Chk. Dep... s exemption. violation of applicant a permit subjects the applicant to a civil penalty or not more than five hundred dollars ($500). Plan Chk. Bal. $ M A 1 ❑ 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. �♦� • •� ' Professions Code: The Contractor's License Law does not apply to an owner of property who 9 V�{ , builds or'improves thereon and who does such work himself or through his own employees, Mech. - 33.00 - 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;j,• j1j or 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-. Plumbing 63-00 strucI 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. 3.9165 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 Infrastructure 1#279,94 F—IrIncen=Tned TJ zA rd -1 38.10 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. ❑ Certified copy is hereby furnished. - - - — - TOTAL CERTIFICATE OF EXEMPTION FROM REMARKS + (This section need not be oCOMPENSATION INSURANCE mple ed peoATIor one hundred dollars ($100) valuation e� ,,,�qq 1� •yp „t + .� tt �+Gf��.i�y'+�� •�ft�i.it'd".eY,�`."+�u�:lw'f�'�i<� or less.) I certify that in the performance of ihp 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 -04 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 r - ' CONSTRUCTION LENDING AGENCY ' . Side Street Setback from Center Line I hereby affirm that there is a construction lending agency for the performance of the , from work for which this permit is issued. (Sec. 3097, Civil Code.) `•• Side Setback Property Line Lender's yName �... _ Lender's 'Address `= FINAL DATE ' I,yNSP GTO.R This is a building permit when properly filled out, signed and validated, and is subject to y �� O expiration it work thereunder is suspended for 180 days. a 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 ,. construction, and hereby authorize representatives, of IN city to enter the above mentioned property for inspection purposes. - Validated by: Signature of applicant Date - i Mailing Address ° ' Validation: Clty,�,State, Zip ; -e :? Cy WHITE -- FINANCE, PINK APPLICANT, GREEN - BUILDING, GOLDENROD OFFICE, HARD COPY - FILE D --,ASSESSOR'S CONSTRUCTION ESTIMATL NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL SO FT (a $ UNITS A.C. UNIT YARD SPKLR SYSTEM 2ND FL SO FT. gr ROUGH PLUMB MOBILEHOME SVC. BAR SINK POR SO FTa HEATING (ROUGH) STORAGE TANK FORMS POWER OUTLET ROOF DRAINS GAR SO. FT. fp ROUGH WIRING DUCT WORK DRAINAGE PIPING CAR P. SO FT. a GAS (ROUGH) WALL SO. FT. a METER LOOP DRINKING FOUNTAIN HEATING (FINAL) URINAL SO. FT. a GAS (FINAL) ESTIMATED CONSTRUCTION VALUATION $ TEMP. POLE WATER PIPING NOTE: Not to De used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER HEATER WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED WATER SYSTEM LAUNDRY TRAY 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 11/4 c SEWAGE DISPOSAL SO.FT.GAR rsg Ji c HOUSE SEWER FIRE ZONE ROOFING 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 PLUMBING UNDERGROUND A.C. UNIT COLL. AREA B GRADE (Z LZ --C� ROUGH PLUMB BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE D. REINF/'L��/�C� f� !—( 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$ =$ LU BER GR. FINAL INSP. RAMING FINAL INSP. ROOFING ' REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR G/ . FIREWALL MESH Of INSULATIONISOUND 3-� FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL .citY of La Qu i pta 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA (760) 777-7012 .[FAX] (760) 777-7011 INSPECTION RECORD Permit* 9808=002 STRUCTURAL RETROFIT OF UNIT ADDRESS DATE INSPECTION [YES/NO] 9 R �oLl�fi /2 -/o- 9cg FRAMING/HARDWARE PLAN TYPE : 02 -10 - 96. INSULATION OK J"J" Contractor: WERMERS MULTI -FAMILY CORP. SHEAR NAILING /,2:-//- 98 DRYWALL _'-f, 42 1 oo JOB FINAL COMMENTS/NOTES: .Sn70� ,QL�4�ins U��Q�E� . f , MAILING ADDRESS — P.O. BOX 1504 - LA QUINTA, CALLIFORNIA 92253