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15283 (BLCK)t ' Building 53--548 Ave. ValleJo Carolyn lull Address P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 No. 15283 BUILDING: TYPE CONST. OCC: GRP. P. Number City ZIp Tel. Legal Description Contractor Project Description Zia $ of 6 6 Idgh wo LreTsCC' ' -Address City Zip Tel.' State Lia City & Classif.. Lic. # Arch., Engr., Designer 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 license is in full force and effect. SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following . reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a permit to construct, after, 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 the provisions or the Contractor's License Law, Chapter 9 (commencing with Section 7000) 'of Division 3 or 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 applicantfor a permit subjecfs,the applicant to a civil penalty -of not more than rive hundred dollars ($500). �1� owner of the property, or my employees with wages as their sole compensation, will ij3 the work, and. the structure is not intended or offered for sale. (Sec. 7044, Buisness and 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, 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 of proving that he did not build or improve for the purpose of sale.) ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con- 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 such projects with a contractor(s) ffcensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec. B. & P.C. for this reason 1]ate 4/0,. Owner WORKERS' 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. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less.) 1 certify that in the performance of thg work for which this permit, is: issued, I shall not employ any Person in -any mea-n-n'e�3r^s_^,o,,",as t� become subject toahe Wofrkers' Compensation Laws ttoriJ /✓ t/U �A �' ate !Jy Owner td �ti. ir-++ NOTICE TOAPPLICANT: ff, aker making Nis Certificate o! Exemption"you should become • subject to the Workers' Compensation provisions of the' Labor Code, you must forthwith comply with such provisions or this permit shalt be deemed revoked. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND 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, 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. expiration it 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 ateMailing Address City, State, Zip ZONE: BY: - Minimum Setback Distances: 71% ear Setback IN �-/�St a Stjreet S( �u Side Setback JULIr 1.0 1995 FINAL.D„ ATE 1 Issued by y Validated by: fix! Validation: I Center Line Rear Prop. Line k from Center Line Property Line it ,e NA, Sq. Ft. Size 'No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $1,471A0 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. 45.00 Mech. . Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL` 45.0-0, REMARKS ZONE: BY: - Minimum Setback Distances: 71% ear Setback IN �-/�St a Stjreet S( �u Side Setback JULIr 1.0 1995 FINAL.D„ ATE 1 Issued by y Validated by: fix! Validation: I Center Line Rear Prop. Line k from Center Line Property Line it CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING. FEES 1ST FL. SO. 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 GAR. SO. FT. ® POWER OUTLET ROOF DRAINS METER LOOP .HEATING (FINAL) I DRAINAGE PIPING CAR P. SQ. FT. ® GAS (FINAL) 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.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED ioog 'V' o5 - 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. SQ. FT. ® c BATH TUB SPARK ARRESTOR SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID @ 11/4 c SEWAGE DISPOSAL LATHING SQ.FT.GAR @ 3/<c HOUSE SEWER MESH GAS PIPING PERMIT FEE INSULATIONISOUND MIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE EPL.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. GAS (ROUGH) METER LOOP .HEATING (FINAL) OTHER APP.IEQUIP. 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///%/ ioog 'V' o5 - REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SiGNATURESIINITIALS GARDEN WALL FINAL .. -.:.: . r . .. �- � � _ y, . ........ . ;: . ;. ...... . �... . ,, ._ G�- . -y7/� .� /// � :. 1. _. MINA MINDD9� ®FLA QUINIT BUILD `-� f " i• 1 1. , I ` ,. 4 ' i , ,. ,� T. � 91'i 1 , "' ENT LY lie 1 1 • ._ L � I ! A i. l• t I '' f i , � t Q91 i TT-- 1'I't�.ti � < � �r��t q �6 ��1�� ' �s i� ►, e r- y- r,F•Li9, 1 SuLATIf�ti I._. ��^pI I F��1 MMM! VIC AGATE 00 9',WIDE DOUBLE GATE i � ..Co rr _ P ; 1 - i i I ; , i I. ' , • ! ! ;• ._1_; .f � fl�:.l � iJ I ; '. I � _ 1'x'1 �� (-� t- C15 I Qi I W, t .. ! � j z ;. .i ! 1 ._: � ! _. ;. , � ,. 1 ! : 1 '.,i -L•I .L.. t :_ . j _. 1 ., - `�- ' I .e t ... i : I 1 i ' ' !•i i t ' I ! �.i ,. :'i � t ! i I .1 �1 i.s.. I' i .. 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