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06439 (RPL)N TA-tyl P.O. BOX 1504 N o . 0 643`+ Building7&105 CALLE ESTADOi Address ` S�ZSg�� f:�B LA QUINTA, CALIFORNIA 92253 Owner w , ��tYiT$Bfl "BUILDING: TYPE CONST. ..00C,. GRP. Mailing _ .. _ x Address 42-600'Coak St., Si;>sifta21 0 A.P. Number PQ4 Rett t City Zip Tel. - Y start 92260 568-2828 Legal Description _. Contractor Project ~Description ' Pnr1. 1G Alrsa j Address . G€#•- 465 Perez Road City Zip Tel 32872681 • ,, stheartdcity State Lic. City. 8 Classif. 2757Lic. # 6,9 Sq. Ft. No. No. Dw. Size - "}• Stories -- Units Arch.,• Engr., Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition' ❑ Address Tel. City Zip State Lic. # it LICENSED CONTRACTOR'S DECLARATION I hereby affirm that9 am licensed under provisions-of_Chapter 9 (commencing with Section _ 7000) of: Div`ision'31of the B nessand Profe"ssion" Code and'm license is in full force a d eff�ec�: - r"'•r;�'°,.;,� �, !:"`.:^-,,.r•:.:y�..:,,v,a,,..�.• y1 siaNATURE - - /ATE ;:r`;;•; =',.. ` OWNER-BUILDER DECLARATION ' • _ Estimated Valuation ;I.hereby affirm 'that, l am exempt from the Contractors License Law for the following 4 reason:: (Sec.,, 7031-5,Business and Professions Code:. Any city or county which requires a .> 000 permit'to construct, `after,- improve,. demolish, or repair any structure, prior to its issuance also requires the applicant for'such permit to rile a signed statement'that he is licensed pursuant to PERMIT - It AMOUNT, the provisions o/ the Contractor's License Law, Chapter 9 (commencing with Section 7000) , o/ Division 3 of the Business and Professions Code, or that. 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. r�e'� subjects the applicant to a civil penalty of not more than rive hundred dollars ($500). ' I Plan Chk. Bal. , 5P -34 _-5:5 - O 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 COfISt Professions Code:. The Contractor's License Law does not apply to an owner of property who . - - builds or Irnproves- thereon and who does such work himself or through his own employees, Mech. 309.0 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-budder will have the burden Electrical, ;', 27. ..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 • 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.I. Q40' �• such projects,with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading O I am exempt under Sec B. 8 P.C. for this reason .. Driveway Enc. Date- Owner Infrastructure - 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.) - - „�L,•,�..l`.,aaF•.'� _ Policy No' Company O. 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 i/ the'pemJis for one hundred dollars (S100J valuation , 3;3t 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: ff. 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 ' CONSTRUCTION LENDING AGENCY 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 Side Setback from Property Line + Lenders Name 1 Lender's Address t - ' This is a building permit when property filled out, signed and validated, and is subject to FINAL DATE INSPECTOR expiration if work thereunder is suspended for 180 days. j r '.I certify that I have read this 10/3/89 - . ty application and state that the above 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 tof -this city to enter -the above-. • - ` mentioned property for inspection purposes: V81(dated by: _ - Signature of applicant Date Mailing Address Validation: + City„ State, Zip ` CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS COLL. AREA SLAB GRADE ROUGH PLUMB. YARD SPKLR SYSTEM 2ND FL SQ. FT. ® HEATING (ROUGH) STORAGE TANK FORMS MOBILEHOME SVC. BAR SINK POR SQ FT ® DUCT WORK ROCK STORAGE FOUND. REINF. POWER OUTLET ROOF DRAINS GAR. SO. FT. ® HEATING (FINAL) OTHER APP./EQUIP. REINF. STEEL GAS (FINAL) DRAINAGE PIPING CAR P. SQ. FT. @ GROUT WATER HEATER DRINKING FOUNTAIN. WALL SO. FT. FINAL INSP. BOND BEAM WATER SYSTEM I URINAL SO FT ® GRADING cu. yd. $ plus x$ _$ ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES � � 4 / �O WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER VENTILATION GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FIRE ZONE ROOFING LAUNDRY TRAY AIR HANDLING UNIT CFM FIREPLACEii2%/�"�`� 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 SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac 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 SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING. DUCT WORK ROCK STORAGE FOUND. REINF. AS (ROUGH)l� /L GAS(ROUGH)lin METER LOOP HEATING (FINAL) OTHER APP./EQUIP. 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 � � 4 / �O REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACEii2%/�"�`� SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL