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15670 (SFD)J. 4- P.O. BOX 1504 No. 15673 Building �� max. 78-.495CALLETAMPICO Address LA QUINTA, CALIFORNIA 92253 Owner Jae `.ieA�erggr a Mailing BUILDING: TYPE CONST: �' OCC: GRP. Address �� i�065 boa�a ¢].k, Ste. 21-260A."272-007 A:P. Number .City Zip Tel. 'Lot 09�-'Tract 2391.3 Past A Sf3 , A 92211 019) 777-7768 Legal Description Contractor SP-D' Plan .I Model Same Project Description Address t inters fv ` City.... -' Zip',, ;.. Tel.' State Llc City A Classlf. `� ��23'�. Lic. # � ��,� � Sq- Ft. � No No. Dw- Size 1968 Stories Units Arch., Engr:, . Charles V. Garland Designer New ❑ Add ❑ . Alter ❑ FRepair ❑ Demolition ❑ At dares 63 aathe�dral Cyn Dr. T%1619) 770-7025 � Ci Zip State tithed al.-:iii., , CA 92234 Lfo:# LICENSED CONTRACTOR'SDECLARATION. I hereby affirm-Oat I am licensed,dirde-oprovislogs of,Ghapter9 (commencing with Section 7000) of Division[/3 0 •th Bu att�Fass annd,Professssiidhs Code, and my licennsse9 is iin�full force and effect.Bj�'r.�.+"a`,Z»1,��.., SIGNATURE DATE - OWNER•BUILDER 4EELARATION Estimated Valuation.$1,18,289.00 Ifiereby affirm that I am exempt from ttlr#�Contractor s License law for the following ` reason: (Sec. 7034:5,Business and Professions Code: Any city or county which. requires a • - - ' pemi(t�to'rconstruct; .after,, improve, demolish, or repair any structure, pior to its issuance also AMOUNT requves the applicant-for such permit to file,a signed statement that he is licensed pursuant to PERMIT the provisions o/ 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 perms Plan Chk. Dep. _ 2J�,{j0- - subjecis the applicant to a civil penalty ornot more than five hundred dollars.($500). O I, as owner of the. property, or my employees with wages as their sole compensation, will; Plan Chk. Bal. 345. 43- 995: 3: do the work, and the structure is not Intended or offered for sate. (Sec: 7044; Buisness and Const. ' 706_...Qf 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, Mech. _.th provided that such improvements are not intended or offered for sale. If, however, the building 6� • 0 . .or Improvement is sold "within one year o/ completion,the owner-builder will have the burden Electrical . o/ proving that he did not build or improve for the purpose of sale.) - �- - 14 4 e;0' O' 1, as owner of the property; am exclusively contracting with licensed contractors to con- Plumbing 150.00 ` etruct'the project- (Sec. 7044, Business and Professions Code: The Contractor's License Law r0,Co'e's not apply to 11. of property who builds or improves thereon, and who contracts-for S.M.I. ��, 3 - such projects wiff a contractor(s) Pcensed pursuant. to the Contractor's License Law.) ' O I am exempt under Sec B. & P.C. for this reason r Grading 20 _OO Driveway Enc. LOQ. ti Date owner ` Infrastructure :2,661051 Arts 3 if; Flub I._ Places 28.;,22 WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a cekificate of consi ntito self-insure; or a certificate of Worker's Compensation Insurance, or a certified copy`the`reof. (Sec. 3800' Labor Code.) - •� - Policy No. Companyc.� O Copy is filed with thecity. . O Certified copy Is hereby furnished. TOTAL 44385.53' 4,135...53 CERTIFICATE OF„EXEMPTION' FROM REMARKS • WORKERS' •COMPENSATION INSURANCE - (This section need:not. be completed it the-permit is for one hundred dollars ($100) valuation -' or less.) - - I certify that in the Perfomtance-of thg work for which this permit is issued, I'shall not employ any erson in'any'manner so as to become subject to the Workers' Compensation Laws of Califpornia Date •`Owner NOTICE..1T0 APPLICANT: •d, ager making this Certificate o/ 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 shah be deemed revoked - Minimum Setback Distances: - Front Setback from Center Line Rear Setback from Reear.P op. Line WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE.IS UNLAWFUL, AND Side Street Setback/from Center,Line 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,Side Setback .from Pro�pertL n'e� DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE'LABOR CODE, • INTEREST, AND MATTOFiNEY'S FEES. This is a building permit when properly filled out,-signed and yalidated;,and'is subject to FINAL DATE INSPECT A U expiration if syC/6 work thereunder is suspended for 1B0 days. -. � • I Certify that I have read this application and state that the above information is correct Issued by:. Date - Permit', 11VI agree to comply with all city and county, ordinances and state laws relating to building : - /I' construction, and hereby authorize. representatives -of this city to enter -the , above- • Y ,mentioned property for inspection purposes. - Validated by: �� f 4Sigriature of applicant Date v� Mailing. Address Validation: City, State, Zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBINU FEES 1ST FL. SO. FT. ® $ UNITS ,SLAB GRADE X1 2ND FL. S0. FT. p BONDING YARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CARP. SO. FT. GAS (ROUGH) DRAINAGE PIPING WALL SO. FT. OTHER APPJEOUIP. 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 FRAMING GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM REMARKS: 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 SPARK ARRESTOR SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL 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 X1 ROUGH PLUMB. I BONDING HEATING(ROUGH) STORAGE TANK FORMS SEWEREJ ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP Ily ,HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATE SERVICE FINAL INSP. BOND BEAM WATER SYSTEM rFINAL INSP. , / RADING cu. yd. $ plus x$ _$ LUMBER GR. FRAMING FINAL INSP. ROOFING * VENTILATIO JJ REMARKS: FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION 3 6 CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL