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001587 (RPL)Building Address Mailing Address City ... Ic Contractor Address T41 t4 ��.. P.O. BOX 1504 78-105 CALLE ESTADO n. V,*. A QUINTA, CALIFORNIA 92253 -91w ski.. ta 2700 Zip . Tel. No. 001587 BUILDING':, TYPE CONST. OCC: GRP. A:P; Number �-'�34 Legal Description Project Description 30 x 17' Fwl 67-71.1 PMWM :... City Zip 'Tel.. Cathe4ml My 92234 .323-1303_ State. Lic. City " • & Classif. • 195102 Lic. # Sq. Ft. -Size •- No. No. Dw. Stories Units Arch., Engr:, - ......... Designer . New 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 7000) of Division 3 of the Business and Professions Code; and my license is in full force and effecter /L%� i"�YLr . . - `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, alter, improve, demolish, or repair any structure, priorto its issuance also -,requires the applicant for such permit to file 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 th'e"Blisihess'and Professlons Code,'or that: he is,6empt therefrom, .and the basis for the alleged exemption.. Any.. violation of Section 7031.5 -by 'any -applicant -for a permit � ' subjects the'applicantto a civil•penalty of notmore than five hundred dollars ($500).: " * " •' O I, as owner of -the property, or my employees with wages as their soler, .compensatio, will., do. the work, and the structure is not intended or offered foi sale: (Sec. 7044, Buisness and Professions Code: TheContractor's License Law does -not apply, to an owner of property who . builds or improves, the,reon and who does such "work himself or through his own employees,. provided that such, improyements•are not intended, or offered for sale. If, however,. the.building • or improvement is.sold:within one year of completion -the owner -builder. will have the -burden of proving that he did not build or improve for the purpose of sale.) .. - Estimated Valuation' - PERMIT •- r - - AMOUNT ' - ,Plan Chk. Dep-- Plan Chk.B al. 71-R2. . COnSt�_� ' M2ch. - 1 Electrical -+r �`�;e� Plumbing •- . � ��$ El 1, as owner of the.property, am exclusively contracting with licensed contractors to con- struct the project. .(Seca 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.) - 0 1 am -exempt under Sec. . B. & P.C: for this reason .. S.M,I• .. _ - ... - 11 - Grading Driveway Enc. Date 'owner Infrastructure WORKERS' COMPENSATION DECLARATION "'I hereby affirm that I have a certificate of consent to self -insure,: or' a certificateof Worker's Compensation Insurance, or a certified copy thereof: (Sec. 3800; Labor Code.) Policy No. Company 0 -Copy is filed.with.the city. ❑ Certified copy is hereby furnished. TOTAL _AQ REMARKS CERTIFICATE OF EXEMPTION FROM WORKERS'.COMPENSATION INSURANCE - ' (This section need not be completed if the permit is forone•hundred dollars ($100) valuation -of 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'subjectto 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 or the 'Labor Code, you must .forthwith comply with such provisions or this permit shall be deemed revoked. - ,' ZONE: BY: .Minimum Setback Distances: Front Setback from Center,Line Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY 6 Side Street Setback -from, Center Line hereby affirm that there Is construction lending agency for'tfie 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 ' 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—Issued ' I agree to comply with all city and county ordinances and state laws relating to building, construction, and hereby authorize representatives sof this city to -enter, the :above.. .: mentioned property for inspection purpo es..j/ Signature of applicant, if _1e �r .r f r Date Mailing Address r.v p�' (�• FINAL DATE by: Validated by.: Validation: " ' INSPECTOR ' Date A-25-8-4Permit City, State, Zip A1(26 6 25. - -' 22G84 CK' HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS SLAB GRADE 2ND FL. S0. FT. BONDING YARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT, ® POWER OUTLET ROOF DRAINS CAR P. S0. FT. GAS (ROUGH) DRAINAGE PIPING WALL SO. FT. OTHER APP.IEOUIP. DRINKING FOUNTAIN SO 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 WASHER(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. I TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE, TEMIPERM 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% c SEWAGE DISPOSAL GAR. FIREWALL SO.FT.GAR ® 3/ac HOUSE SEWER LATHING 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. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IEOUIP. 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 INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS. GARDEN WALL FINAL