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15688 (RPL)A� P.O. BOX 1504 No. 15688 Address 78-810 Spyglass LA QUINTA, CALIFORNIA 92253 Owner. Barnes BUILDING: TYPE CONST: OCC: GRP. Mailing Address Same A.P. Number City Zip Tel. Ci Qu nta, CA 92253 Legal Description' Contractorfool. and Spa DatePalm ENterprises Project Description Address 28-070. A"ve. Ramirez IZip Tel eatnetyt ra l Cityl CA 92239 325d•-21871 State Lic. City & Classif. "C53 $90775 Lic. # 1688 Sq. Ft. No. No. Dw. Arch., Engr., Size Stories Units 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 Divisiort,3 of the Business•ind Professions Code, and my license is in full force and effect -v-, r rC SIGNAIUREr" 4>•�i/%,/ °r.d_•r.'^"" DAT _ 1`�OWN�BUILDER DECLARATION Estimated Valuation I hereby affirm that I am exempt from the Contractor's License Law for the following�� reason: (Sec. 7031.5,Susiness 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 R 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 Nat. he is exempt therefrom, and the basis for the alleged exemption..Any violation of Section 7031.5 by any. applicant,for a permit Plan Chk. Dep. . 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. Bal. do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. 144. Q0 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. 24.00 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 $.o� 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 27.00 struct 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.1. such projects with a contractor(s) (/tensed pursuant to the Contractor's License Law.) ' O I am exempt under Sec. B. 8 P.C. for this reason Grading Driveway Enc. Date owner Infrastructure WORKERS' COMPENSATION DECLARATION I hereby affirm that 1 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.) Poli o. Company C6 T� eCZ R.7� 115 Copy is filed with the City,- ❑ 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 or less.) - - I certify that in the performance of thg work for which this permit is issued, I shall not employ any pperson In any manner so as to become subject to the Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT. N, - 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 WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL, AND Side Street Setback from Center Line SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, Side Setback from Property Line DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. This is a building permit when properly filled out, signed and validated, and is subject to FINAL DATE INSPECTOR 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: 1 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 Mailing Address . Validation: City, State, Zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBINv FEES IST FL. SQ. FT. ® $ UNITS COLL. AREA SLAB GRADE ROUGH PLUMB. YARD SPKLR SYSTEM 2ND FL. SO. FT. p HEATING (ROUGH) STORAGE TANK FORMS MOBILEHOME SVC. BAR SINK POR. SO. FT. ® DUCT WORK ROCKSTORAGE GAR. SO. FT. ® POWER OUTLET ROOF DRAINS HEATING (FINAL) DRAINAGE PIPING CAR P. SO. FT. GAS (FINAL) TEMP. POLE WALL SO. FT. DRINKING FOUNTAIN, SO. FT. ® WATER HEATER URINAL ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP. WATER PIPING NOTE: Not to be used as property tax valuation WATER SYSTEM FLOOR DRAIN MECHANICAL FEES GRADING cu. yd. -Plus-x$-=$ WATER SOFTENER VENT SYSTEM FAN EVAP.0OOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED C/ (�V1• l / ��'� " r�� 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 SPARK ARRESTOR SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL LATHING SQ.FT.GAR ® 3/ac Y HOUSE SEWER MESH GAS PIPING PERMIT FEE INSULATION/SOUND PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MiECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR CON,Q� SOLAR SETBACK ROUND PLUMBIN"pl�� UNDERGROUN 2 A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC -ANK ROUGH WIRING DUCT WORK ROCKSTORAGE FOUND. REINF. GAS (ROUGH METER LOOP HEATING (FINAL) OTHER APPJEQUIP. 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. FRAMING FINAL INSP. ROOFING C/ (�V1• l / ��'� " r�� REMARKS: VENTILATION/� FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING INAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURE311NITIALS GARDEN WALL FINAL