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003110 (GRES)QUM& P.O. BOX 1504 N o . Building 78-105 CALLE ESTADO Address 78-600 La Fonda. LA QUINTA, CALIFORNIA 92253 Owner Mailing Address 78-6,00 La Fonda City Zip 71- La S�sinta .9225.3 Contractor Address .. 003110 BUILDING: TYPE CONST. OCC: GRP. A.P. Number 769--334-012 Legal Description Project Description, Gauge City Zip Tela State Lic. City & Classif. .. Lic. # Sq. Ft. Size -•- 540: .. No. No. Dw. Stories Units Arch:, Engr., ' Designer New ❑ Add 4:i Alter On. 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 ' 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: An -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, of that. he is exempt. therefrom, and the basis for the alleged exemption. Any violation o/ Section 7031.5 by 'any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). W,. 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. . . Professions Code: The Contractor's License Law does not apply to an owner of property. who Estimated Valuation y{� ., PERMIT ' AMOUNT - ' -- Plan:Chk. Dep.. , Plan Chk. Bal.. S4A _ 4 2 CDnst . ' - 7A ! 50 Mech: - 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 .. Electrical 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.) Plumbing D 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:J ❑ I am exempt under Sec.- B. 8 P.C. for this reason. S:M.I. - - Grading Driveway Ens,, _Date owner Infrastructure>'`i�1(ti,lt"•1^+i%ate ' 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 .O Copy is filed with -the city.. .❑ Certified copy is hereby furnished. TOTAL` 5 REMARKS CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundreddollars ($100) 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 lo•the'Workers" Compensation Laws of California. ' Date -' Owner " NOTICE TO APPLICANT: If, alter making this Certificate o/ 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. ZONE: BY: - Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear. Prop. Line 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.) Side Street Setback from Center Line Side Setback from Property Line Lender's Name FI NAL.DATE Issued by: Validated by: - INSPECTOR Date 5Ll1ja "Permit 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 certthat 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 Address Validation: City, State, Zip HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ 2ND FL. -w SO. FT. ® POR SQ. FT. ® GAR. SQ. FT. ® CAR P. SQ. 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 SLAB GRADE 5/7-11-74 FLOOR DRAIN MECHANICAL FEES BONDING WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED DUCT WORK LAUNDRY TRAY AIR HANDLING UNIT CFM AS (ROUGH) 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 WATER HEATER SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL BOND BEAM SO.FT.GAR ® 3/ac HOUSE SEWER 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 5/7-11-74 UGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE OUNf!!F 7 Z� AS (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. 16— , 04 FINAL INSP. � f0i- It Pqz-ROOFING /-!G`t'�� G— REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL