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001907 (PLBG)P.O. BOX 1504 No. .001907 Building 54,940 jr4eTLJ& , Wa 78-105 CALLE ESTADO • Address LA QUINTA, CALIFORNIA 92253 Owner Mailing Address City Contractor Address _ - City' �ty State Lic. & Classif. 256184 Arch., Engr., Designer Zip - Tel. Tela 3235 328-1747 .City Lic. # BUILDING: TYPE CONST. OCC:=GRP. A.P. Number Legal Description Project Description . . IrAtall 2ww 0maw Wzyoml Sq. Ft. No. Size - -Stories No. Dw. Units New 11,, 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 70 00) of Division 3 of the Business and -Professions Code, and my license is in full force and effect. _.nom DATE i OWNER -BUILDER DECLARATION Estimated Valuation 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, 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 •. AMOUNT the provisions of the Contractor's License Law, Chapter 9 (commencing with Section .7000)- of •i ' ' - Division 3 o the Business and Professions Code, orthat: 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): plan Chk. Bal. 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 CohSt.. Professions Code: The Contractor's License Law does not. apply to an owner of property -who ^ A 11 builds or improves thereon and who does such work. himself or through his own employees, Mech. .. 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 - - 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.1. such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading ❑ 1 am exempt under Sec.- . B. & P.C. for this -reason Driveway Enc. Infrastructure Date owner `f€'3.E9i i ri as WORKERS' COMPENSATION DECLARATION Ihereby 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. TOTAL '70.00 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 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., If, 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 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.). - Side Setback from Property Line Lender's Name Lender's Address FINAL DATE INSPECTOR This is a building permit when properly filled out, signed and validated, and is subject to . expiration if work thereunder is suspended for 180 days. I certify that I have this - II1.c"6�G"Permit read application and stale that the above information is correct. Issued by: Date 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. r Validated by: Signature of applicant tV� ft r tr ✓ Date Mailing Address r ~" ' ' " "`� " Validation: City, State, Zip A339U 11 22 ?a00 CK HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS SLAB GRADE 2ND FL. SQ. FT. BONDING YARD SPKLR SYSTEM POR. SQ. FT. ® MOBILEHOME SVC. BAR SINK GAR. SQ. FT, ® POWER OUTLET ROOF DRAINS CARP. SQ. FT. GAS (ROUGH) DRAINAGE PIPING WALL SQ. FT. OTHER APPJEQUIP. DRINKING FOUNTAIN SQ. FT. ® TEMP. POLE URINAL ESTIMATED CONSTRUCTION VALUATION $ GROUT WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SYSTEM WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP. 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, TEMIPERM 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 GAR. FIREWALL SQ.FT.GAR ® 3/ac HOUSE SEWER LATHING GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE IVECH.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. 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 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 WA�L LINAL _•� _ Hondrickson SEWERS GREASE TRAPS AND SEPTIC TANKS cobstruction, Inc. POST OFFICE BOX U CATHEDRAL CITY, CALIF. 92234 Telephone (619) 328-1747 • CRANE AND DOZER RENTALS %W9 M 21VIESSIDE COUNTY DEPARTMD DIVISION ff OF PUBLIC HE"TK'-L at SMIROMMENTAL MMTH �P _.Fo6d.Establlshment 11, Sewaoe,Di 93 Trailer ParkGal.§6tic* I M11 MI rl Motel, Apt., Hol!) Sq. Ft. &S 1�4 I's Dwelling so"ll x Seepage it Commercial Building Connection to Sewer 104 Swimming Pool 6,on­site regenerating water softening devices`:,may be discharged into the individual sewage disOQsal �ystem- herewith approved without clearance from the Water Quality Control Board." t, 'WLib— Mater supply serving this installation rnustbe from an approved source. Doi, sewage disposal installation must conform with requirements of current Uniform 'Plumbing', (!6j(FeV) 10' kny.. cutting, grading. Of- filling it ex*.es,s of four .(4) feet will nullify sewage disposal aPOr6vAl. �pproyal has been obtained from the Regional',WMer Quality Control Board for installation of -fhe _7 's, ige d isp&l, system. ;s 'o certify that' the RiversideCounty Department of Public Health:,a 'e r, .,,saaiiqi`�'n;the. itim(s)'che'cked'above; M BUILDING PERMIT _ DEPARTMENT OF BUILDING & SAFETY PERMIT NO. COUNTY OF RIVERSIDE' - 1349455 1 - CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES 1ST FL. _ 2ND FL. POR. _ GAR. CAR P. WALL ESTIMATED CONSTRUCTION SQ. FT. ..@ $ UNITS SQ. FT. @ MOBILEHOME SVC. SQ. FT. "` POWER OUTLET SQ. FT. SQ. FT. 8 SQ. FT. @ SQ. FT VALUATION NOTE: Not to be used as property tax valuation SWIM POOL, PVT FIELD OFFICE - NO. PLUMBING FEES YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING FLOOR DRAIN MECHANICAL FEES SWIM POOL, COMM Job Address SpaceZip �`-� tlO 4e- 6/14%e o WATER SOFTENER VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD SIGN Com7ityy IC - r i"• 1. �'�• �� WASHER (AUTO) (DISH) APPLIANCE ❑ DRYER .�Off. GARBAGE DISPOSAL FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED AH Permit Fee $ Aicro Film Fee Co $ LAUNDRY TRAY AIR HANDLING UNIT CFM IDLE METER Ck.br KITCHEN SINK ABSORPTION SYSTEM O B.T.U. TEMP USE PERMIT SVC Lot Size . /O �Ua WATER CLOSET COMPRESSOR 0 HP POLE, TEMP/PERM S LAVATORY HEATING SYSTEM ❑ FORCED ❑ GRAVITY AMPERES SERV ENT Zone J 7 �• SHOWER BOILER B.T.U. SQ. FT. Ga ¢ BATH TUB dumbing Fee Dbl $ SQ. FT. Ga ¢ Plan No. WATER HEATER Firiol Date ��— SQ. FT. RESID Qct 11Atr SEWAGE DISPOSAL temol. Fee - -$ SQ. FT. GAR C Y,tr 6e HOUSE SEWER r7itness Fee $ leinsp. Fee •$ Owner/Agent GAS PIPING PERMIT FEE PERMIT FEE 3Q PERMIT FEE - DBL.. - TOIA`rL�EE� rtaa. Nm. FEE MICRO FEE MECH. FEE 'PL�.oFEvE. I _I CONST.UFEE 36 E� TF�E SM� FEE PLUMB. FEE PERMIT NO. 3494 5 5 Supp. Permit Job Address SpaceZip �`-� tlO 4e- 6/14%e o 9 -s3 Ow Owner 132awl l 6 Com7ityy IC - r i"• 1. �'�• �� volmoon .Q� Date Dist. .�Off. AH Permit Fee $ Aicro Film Fee Co $ Use of Perm d •%{G� '/ �G�� -��� r��C J /� �Q .�W�. .� `2: JC G/f v Parcel No. 7 �/ - Use No. Ck.br Mech. Fee Dbl $ sl. Ck. Fee ,$ / - Set Backs - Lot Size . /O �Ua .onstruction Fee Dbl $ legal Description %�{ /O r , ��j "�'�,f6 3 �'� S G G �+C �:+•• F`� S S5 R Electrical Fee Dbl 8 Zone J 7 �• Grp Type Unit MI Fee $ !/ dumbing Fee Dbl $ Bond Amt. $ Plan No. Plan Checker _ 1. Firiol Date ��— Insp�e7ct/ori ip. Imp. Fee $ temol. Fee - -$ Const. Lender Branch - "I certify that in the performance of the work for which this permit is issued I shall not employ any person m any manner so as to become subject to the workmen's com. pensotion laws of California.'*.,,... xw Address City Zip Owner Signature •+`�_ , Builder Signature 'egistr. Fee $ dileage Fee $ r7itness Fee $ leinsp. Fee •$ Owner/Agent Tel. Zip oral Fees Is 641 P0 Address, s / ` 5 G/ .G/ ` o Ade V� 4 O City - -4,4 * r y� Zip {� M.O. ❑ Gash ❑ Check received by Contractor Tel. License p rees required ewoge System .. .. T LL P ewer District :arm 284.208 IRev. 4.77) ©s Address _ City Zip Workers' Comp. yes ❑ no THIS PERMIT SHALL BECOW VOID IF WORK' IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF verified by: WORK FOR' 1'20 DAYS SHALl80 E PE�ECOME VOID. 4A \T I HEREBY AGREE THAF!((Lf OR CONN ON WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVERSIDE COU AND THE STATE OF CALIFORNIA. ' I• HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE' STATE OF CALIFORNIA. - - -