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06418 (SFD)• . Gu.. P.O. BOX 1504 N o . Building 78-105 CALLE ESTADO Address 54-732 Shoal Creek LA QUINTA, CALIFORNIA 92253 Owner Address 42-600 Cook St.,. #200 City Zip Tel. PA -10 Desert 92260 568--282$ Contractor Nation�3. i.s.� � iiort�sge Address Same State Ltc. 288130city 328 & Ctassif. Lic. # - - r q., Size Size Arch., Engr:, Designer Address TTel. BUILDING: TYPE CONST. OCC: GRP._ A.P. Number PGA WBSTo Phase 18A City '. (Zip (State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that.) am licensed under provisions of Chapter 9 (commencing with Section 70pp) of Division 3 of the Business and Professions Code, and my license.i"s in full force and SIGNATURE C= ,.,:%�^; ,i, : A 1 DATE 7 O"MBUILDER DECLARATION 1 hereby affirin'that I am exempt from the Contractors License Law for the following reason: (Sec. 7031.5,1and Professions Code: Any city or county which requires a permit to construct, alter, improve, demorah, 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 the provisions of the Contractors 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 for the alleged exemption. Any vkofatiorn of Section 7031.5 by 'any applicant for a permit subjects the applicant to a twin penalty of not more than two hundred dollars ($500). ❑ 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 Professions Code: The Conhadoes 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, provided thaf,such improvements are not intended or offered for sale. If, however, the building or improvement is said within one year of completion, the owner -builder will have the burden 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- Strutt the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not appy to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec B. & P.C. for this reason Date owner WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Workers 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. CERTIFICATE OF EXEMPTION FROM WORKERS COMPENSATION INSURANCE (This section need not be completed it 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 person in any manner so as to become subject to the Workers' Compensation Laws of California Date Owner NOTICE TO APPLICANT: H.- after making this Certificate of Exemption you should become subject to the Workers' C.ormpensation provisions of the Labor Code, you must forthwith comply with such provwons or On permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Cin? Code.) Lenders Name Lenders Address This is a building permit when property 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: 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. Signature of applicant— Date Mailing Address City, ' State, Zip' I� z�� 06418 Description :t Description Tract 20717-3, Plan 3ir 1627 .No. - Stories No. Dw. New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $113,1727 PERMIT - AMOUNT Plan Chk. Dep. Plan Chk. Bal. 563.06 Const. 6a r50 Mech. .4 1.00 Electrical 101.12 Plumbing 131.00 S.M.I. 7.98 Grading Driveway Enc. Infrastructure $2,558.86 1:279.43 Less Credit 1,279.43 TOTAL I M822.09 REMARKS rtr'asstq'-T 111 :4'73 Ch0,.i13irti ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR 9/28/89 Issued by: Date Permit Validated by: „ Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS B GRADE ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL SQ. FT. ® FORMS ER OR SEPT CIA ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® GAS (ROUGH) '�%, �. f— METER LOOP HEATING (FINAL) POWER OUTLET ROOF DRAINS GAR. SQ. FT. ® TEMP. POLE GROUT DRAINAGE PIPING CAR P. SQ. FT. ® FINAL INSP. BOND BEAM WATER SYSTEM DRINKING FOUNTAIN. WALL SQ. FT. _$ LUMBER GR. FINAL INSP 2 /_ o FRAMING �� URINAL SQ. FT. @ � )/�� L[/ l ESTIMATED CONSTRUCTION VALUATION $ REMARKS: WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED SPARK ARRESTOR LAUNDRYTRAY AIR HANDLING UNIT CFM FIREWALL KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER. B.T.U. SQ. FT. ® c BATH TUB FINISH GRADING SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® IV4 c SEWAGE DISPOSAL SO.FT.GAR @ V4c HOUSE SEWER 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 & AIR COND. SOLAR S ACK OUND PLUMBING (i UNDERGROUND A.C. UNIT COLL. AREA B GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS ER OR SEPT CIA ROUGH WIRING DUCT WORK ROCK STORAGE D. REINF. GAS (ROUGH) '�%, �. f— METER LOOP HEATING (FINAL) OTHER APPJEOUIP. EINF. STEE GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ _$ LUMBER GR. FINAL INSP 2 /_ o FRAMING �� FINAL INSP. OFING©� r � )/�� L[/ l REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR FIREWALL 6 //GAR. THING MESH (INSULATIONISOUND 1' FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL