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14264 (RER)Building Address ',7A— Owner I ' VC.. W P.O. BOX 1504 78-495 CALLE TAMPICO Fonda LA QUINTA, CALIFORNIA 92253 Luz M. Fregoso ,& .Carlota Caballero MailingBUILDING: TYPE CONST. Address P.O. BOX 1050 A.P. Number City Zip Tel. La Quinta 922.53 Legal Description Remodel (Deli.) Contractor Project Description game Address City Zip State Lic. &Classif. Arch., Engr., Designer No. OCC. GRP.: Address Tel. City Lic. # Tel. CityI Zip I 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 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 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.) I 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 Copy is filed with the city.\ O Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM r WORKERS' COMPENSATION INSURANCE (This section need not be completed i1 the permit is for one hundred dollars (S100) valuation. or 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 subject to the Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT., ff, 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.. 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 if work thereunder is suspended for 180 days. Icertify 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. Sq. Ft. Size New ❑ Fldd Air Curtin a Locker Add No. No. Dw Stories Units Alter ❑ Repair ❑ Demolition ❑ ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Pr p. Line Side Street Setback from t ine Side Setback from Prop ine FINAL DATE I INSP R Q Issued t ValidatE Signature of applicant Date Mailing Address Vdlldati City, State, Zip Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. 20.00 Mech. Electrical 25.00 Plumbing S.M.I. n Grading Driveway Enc. Infrastructure TOTAL r 45.00 REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Pr p. Line Side Street Setback from t ine Side Setback from Prop ine FINAL DATE I INSP R Q Issued t ValidatE Signature of applicant Date Mailing Address Vdlldati City, State, Zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBINU FEES 1ST FL. SO. FT. ra $ 2ND FL. SO. FT. POR. SO. FT. 0 GAR. SO. FT. ® CARP. SO. FT. WALL SO. FT. 0 SO. FT. (a ESTIMATED CONSTRUCTION VALUATION S UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING i DRINKING FOUNTAIN URINAL WATER PIPING NOTE: Not to be used as property tax valuation ROUGH PLUMB. FLOOR DRAIN MECHANICAL FEES HEATING (ROUGH) WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER ROCK STORAGE GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM OTHER APPJEOUIP. 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. SO. FT. ® c BATH TUB WATER SYSTEM SO. FT. !a c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID @ 1+A c SEWAGE DISPOSAL SO.FT.GAR ® 3.c HOUSE SEWER FINAL INSP. i!„(O //.. [ 7Cll ROOFING GAS PIPING PERMIT FEE REMARKS: 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 APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. S plus xi =S LUMBER GR. FINAL INSP. 0 o (// (( �w✓ FRAMING FINAL INSP. i!„(O //.. [ 7Cll ROOFING �� ..PP I • � �` r ��1��- �' l3'C�r��'„w� e�vv��/C/(0✓✓', REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL mare. �n0awnH1VnrWINIIIAw GARDEN WALL FINAL T A-001 G r Y-OFEW, A &SAFETY'DEPARTMENT 4 CONDITIONALLY CrIllE 7--j & AS-. PEfDl AND ALL APPLICABLE CODES IDATE A P P R n fir D&Y P N N1 �IN Gri & D t' V E L 0 Pllvl E- N T DEPARTMENT BY 0-SCITE EXHIBIT L L : No lr—?c1-e41or WaAkk (,IqLL 7,—J.J al i. � W VL A P P R n fir D&Y P N N1 �IN Gri & D t' V E L 0 Pllvl E- N T DEPARTMENT BY 0-SCITE EXHIBIT L L : No lr—?c1-e41or WaAkk (,IqLL 7,—J.J al \1 , V LIX awz CITY OF LA QUINTA BUILDIRIG & SAFETY DEPARTMENT C, Cl ;",,' D, 1 T 10 N A L LY r r...D FOR AND ALL APPLICABLE CODES DATE BY