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9416 (SFD)• 44I��I�f11I11� 11(/ P.O. BOX 1504 N o . 9416 Building 78-105 CALLE ESTADO Address 78-960 Dei. Monte Court LA QUINTA, CALIFORNIA 92253 Owner BUILDING: TYPE CONST. ' OCC: GRP. Mailing Address 3380 Shelby Street A.P. Number City Zip Tel. t�ntarifa 917641.564-0973 Legal Description3rc�Ck®� Contractor Project Description Lot 2 Model IC S_A Address City Zip Tel.: State Lic. City & Classif. i 412636 Lic. # logo Sq. Ft. No. No. Dw. Size 22fl4 Stories Units Arch., Engr., Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. CityJZip State Lic- # -7 LICENSED CONTRACTOR'S DECLARATION I herebyy affirSthat,l,am l censed under Provisions,of Chapter 9 (commencing vylth Section 7000) of,DiviSion'3.df the,;Business and Professions,Code, and my license•is'in f- 1 -force and effect✓` /.// , _ '' �' _ _ . : _. , / t -'1:_-c _ .G�. I_ U W N CM-13UiU!!r MyUr%A AMA 1 IUN 1 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, after, 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 aWsion 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 -budder will have the burden Of proving that he did not build or Improve for the purpose or sale.) O I, 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.) ❑ 1 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 a' Copy is filed with the city. ❑.Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (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 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: 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. CONSTRUCTION LENDING AGENCY I hereby affirmthat 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 car tity 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 Mallinq Address City, State,. zir. 3timated Valuation PERMIT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure 37.04 AMOUNT 704.03 856.50 79.00 12l . 00 162.50 11.34 23.34 TP TOTAL 5y1�o3U "`•`" REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST Fi. SO. FT. ® $ UNITS COLL. AREA 2ND FL SQ. FT. ROUGH PLUMB. YARD SPKLR SYSTEM POR. SQ. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. I SO. FT. ® DUCT WORK DRAINAGE PIPING WALL SQ. FT. �FiAS (ROUGH) / DRINKING FOUNTAIN. SQ. FT ® HEATING (FINAL) URINAL ESTIMATED CONSTRUCTION VALUATION $ GAS (FINAL) WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER HEATER WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER WATER SYSTEM GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED GRADING Cu. yd. plus x$ LAUNDRY TRAY AIR HANDLING UNIT CFM 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. SQ. FT. ® c BATH TUB SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1V* c SEWAGE DISPOSAL SQ.FT.GAR ® V4c HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PLCK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR S BACK `/�6ROUNO PLUMBI 7'00 UNDERGROUND A.C. UNIT COLL. AREA LAB GRADE ^' ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING. DUCT WORK ROCK STORAGE 'FOUND. REINF. �� FiAS (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. AL INSP. VDFRAMING /1•—/tQj— 1 t FINAL INSP. ROOFING .%�—&71 �v �-6 a REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND / — 17 'v FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS t •. GARaEN WALL FINAL :-✓ CONSTRUCTION EST;MATE 40. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT $ 2ND FL. SO. FT. ,!y POR. 50. FT. Ia GAR. SO. FT. ,if I CAR P. SO. F, :ALL SO. FT. a't _ SO. FT %i ESTI ,A r EC CCNSTRUCTION VALUAT ON 4 UN;iS COLL. AREA ASGRADE 44/2 YARD SPKLR SYSTEM MOBILEHOME SVC. BAH SINK POY:ER OUTLET ROOF i:RA:•.S PGr,'AS ROUGH WIRING 0-1INK I •!G ' _ . ' . DUCT WORK UPINAL /L D. RE!NF• G �/ N •-rER Zf-!!,G :JUTE. Nr;; L: a used as :roperly tax Valuation =L^vR OPA-. ! i MECHANICAL FEES REINF. STEEL GAS (FINAL! ENT i'•Sr FM FAN EVAP.CCJCL "OoD SIGN i GROUT YIATER HEArER 'UI. .,. uNir 1VA L FLOOR SLS. c �ACrJ:: Rr TFA•- dR H:.:JL'_ IING.:fJIT CF',I ( BOND BEAM KIrC`IEN SiI.K 250RP":O J T'STcM B.i.0 TEMP ; SE PER.•IT SVC `.ArER CLOSET CMPREcgOR -p POLE TE.WPER'A LAVArCRY iEATJNG SYSTEM FORCED GRAVITY .AMPERES SERV EN • SHOWE74 OILER B.T.U. SO. FT. n' c BATH 7US SO. Fr. rb c WArER HEATER tAX. HEATED OUTPUT, B.T U. SO. FT. RESID •q'• I%. c SEWAGE DISPOSAL SO FT.GAR :,C. HCUSE SEv.—a GAS PIPIPIG EP.MiT FEE PER\Ill' FEE PERMIT FEE 4L TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE EU_JCT. FEE S'Al FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK �y$OUND PLIJMBIN 47- UNDERGROUND A.C. UNIT COLL. AREA ASGRADE 44/2 ROUGH PLUMB. BONDING HEATING (ROUGH! STORAGE TANK PGr,'AS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK POCK STORAGE /L D. RE!NF• G �/ N GAS ,ROUGH, METER LOOP HEATING (FINAL) OTHER APP.!EOUIP. REINF. STEEL GAS (FINAL! TEMP. POLE GROUT YIATER HEArER SERVICE FINAL INSP. BOND BEAM 'NATER 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 INSULATIONISOUND FINISH GRADING _ FL,NAL INSPECTION CERT (A,- GF F:F f W C PINAI INSPECTOR'S SIGNATURESIINITIALS