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10805 (MISC)P.O. Building 7&105 CA Address 5 3-8 1 VALLEJO LA QUINTA, C Owner PAT MARTIN Mailing Address SAME City Zip Tel. . LA QUiNTA 192253 564-1714 Contractor PARACY CONST. Address _. 81-826 TRADER PL City Zip Tel.: INDY® 92201 775-176 State Lic. City & Classif.. Lic. # 2111 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 OWNEWBUIL'DER DECLARATION I hereby affirm that I am exempt from the Contractors License Law for the following reason:. (Sec. 7031.5,Sustness 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 Me a signed statement that he is licensed pursuant to the provisions of the Contractor's 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 violation of. Section 7031.5 by 'any applicant for a permit subjects the applicant to a civil penalty of not more than five 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 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.) ❑ I, 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) licensed pursuant to the Contractor's License Law.) -O 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 Worker's Compensation Insurance, or a.certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company ' ( f�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 (5100) valuation or less.) I certify that in the performance of the work for which this permit is issued, 1 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 subject to the Workers' 'Compensation provisions of the Labor Code, you must forthwith' comply with such provisions or this 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, Civil Code.) . Lender's Name Lender's Address 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- Mail i ng ateMailing, Address . City, State, Zip 'GII+ 6U . BOX 1504r' No. 10805 LLE ESTADO y ' ALIFORNIA 92253 ` ��/// BUILDING: TYPE CONST. �� OCC: GRP.• A.P. Number— Legal Description Project Description 170 T.TV -AR 7FT X '10 Sq. Ft. No. No. Dw. Size - Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ :stimated Valuation $4,250 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. $72.00 Mech. Electrical ' Plumbing S.M.I. .50 Grading Driveway Enc. Infrastructure TOTAL M.50 REMARKS . '.: °,;��$'1A. ts.«..3,,,•t'�'C!r 4:�`�# 4•r�`I'Hf,.L `''1 i f:.r 3'SC� 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 Issued by; Date =1 : Permit Validated by: Validation: CONSTRUCTION ESTIMATE i a', NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. @ $ UNITS t 2ND FL - SO. FT. @' YARD SPKLR SYSTEM POR. SO. FT. @ MOBILEHOME SVC. BAR SINK GAR. SO_ FT. @ POWER OUTLET ROOF DRAINS CAR P. SO. FT. @ DUCT WORK DRAINAGE PIPING WALL SO. FT. @ DRINKING FOUNTAIN. SO FT @ HEATING (FINAL) URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN • WASHER(AUTO)(DISH) - APPLIANCE DRYER W/ GARBAGE DISPOSAL FURNACE UNIT WALL _ FLOOR SUSPENDED. _ LAUNDRY TRAY - AIR HANDLING UNIT CFM 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. SO. FT. @ c BATH TUB SO. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. _ SO. FT. RESID @ 1 V. c SEWAGE DISPOSAL- - - - SO.FT.GAR @ 3Ac HOUSE SEWER SPARK ARRESTOR, GAS PIPING' PERMIT FEE PERMIT FEE PERMIT FEE DBL _ TOTAL FEES MICROF7 MECH.FEE - PLCK.FEE CONST. FEE ELECT. FEE • SMI FEE PLUMB. FEE STRUCTURE / PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK f GROUND PLUMBING UNDERGROUND A.C.'UNIT COLL. AREA SLAB GRADEROUGH 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 APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT .. WATER HEATER SERVICE FINAL INSP. 7 BOND BEAM W/ WATER SYSTEM _ GRADING cu. yd.. $ plus x$ _$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING REMARKS: ' VENTILATION ,FIRE ZONE 'ROOFING:- OOFING -FIREPLACE FIREPLACE SPARK ARRESTOR, R. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING - FINAL INSPECTION121. CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL