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07463 (RPL)• � ,rte �� . 78-M La Fonda P.O. BOX 1504 Building7!—,,- - --, - _, ' 78-105 CALLE ESTADO Address (-'� LA QUINTA, CALIFORNIA 92253 Owner Mailing. Address City Zip Tela or w Address ZONE: BY: City Zip Front Setback from Center Line t Tela , Rear Setback, from Rear Prop. Line Estimated Valuation Sio State Lic.: City & Classif. Lic. # Arch., Engr., Date Designer Const. Address 117.00 Tel. City I ZipI 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, 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 tor. the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit w --subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ❑ 1, 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 fr. 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.) /as owner of the property, am exclusively contracting with licensed contractors to con- ysI the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does of apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractors) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec. B. & P.C. for this reason Date AneG .owner =f WORKERS' COMPENSAe DECLARATION I hereby affirm that I have a certificate -f 'consent [o 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'COMPENSATIONINSURANCE (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 ork for which this per sued, I shall not employ any person 'n any manner so o ecome subje� ofkers' Compensation Laws of Cali is _ fate net TICE TO A LICANT. If, after making thi o ertificate ofwn you should become subject to the Workers' Compensation pr 9 stops of th bor 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 if 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 No. 07463 BUILDING: TYPE CONST. OCC: GRP. A.P. Number -769-077-01.0 Legal Description Lot 118 Project Description P001 & Soa Sq. Ft. No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ ZONE: BY: Minimum Setback Distances: Front Setback from Center Line t Rear Setback, from Rear Prop. Line Estimated Valuation Sio PERMIT AMOUNT Plan Chk. Dep. 4%2/90 Permit Plan Chk. Bal. Date 76.05 Const. 117.00 Mech. WAD Electrical Plumbing 24.00 S.M.I. .77 Grading Driveway Enc. Infrastructure ... TOTAL $274.82 Je. REMARKS t�nx:4s dit i3 �rT3fi Y fEP1ttif_ x 4f -4.b4 ZONE: BY: Minimum Setback Distances: Front Setback from Center Line t Rear Setback, from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR 4%2/90 Permit Issued by: Date Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FELo IST FL. SO. FT. ® $ 2ND FL. SO. FT. POR. SO. FT. @ GAR. SO. FT. ® CAR P. SO. FT. WALL SO. FT. SO FT ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN. URINAL WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES HEATING (ROUGH) WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTOHDISH) APPLIANCE DRYER DUCT WORK GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM HEATING (FINAL) 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 BOND BEAM SO. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1% c SEWAGE DISPOSAL LUMBER GR. SO.FT.GAR ® V4c HOUSE SEWER FRAMING FINAL INSP. GAS PIPING PERMIT FEE 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 APPJEOUIP. 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 A/ ;��5% O V; //G�4 /J yy/ j `'�� /,' '7B 7r / REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LT NG /2.v 76 I MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL ::d