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08598 (SFD)0 Building Address I Owner Mailing Address a City � UP Contractor ' u P.O. BOX 1504 78-105 CALLE ESTADO ,atm 1,0 , LA QUINTA, CALIFORNIA 92253 45-2115 :1 :)E --O- _e�-r City --- - - -Zip - - - - ATO State'fi'c�'`""u I City & Classif. Lic. # Arch., Engr., Designer s www Yw wnw+� �w Address I Tel. ity ' ------.__ __ Z1p_"" State MA RAI_33"7 1 Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 000) of Divisionr3-of the Business and Professions Code, and my license is in full force and If act. _ t" f i;'d /f/ „f C OWNER -BUILDER DECLARATION I hereby affirm that I am exempt fromthe Contractors 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 o/ the Contractor's License Law, Chapter 9 (commencing with Section 7000) o/ Division 3 o/ the Business and Professions Code, or 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). 01, 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. I/, however, the building or improvement is sold within one year o/ completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose o/ sale.) O 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.) ❑ 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 ❑ 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 of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Ihereby 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 it 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 BUILDING: TYPE CONST. 6J - No. 08598 i 10 605� _OCC: GRP.. P. Number :gal Description Tract #33935 T*Da z I .OT 10 Project Description Mode( Sq. Ft. Size 2173. No. Stories No. Dw. Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation J„s.rC. 5c7 122 C$7s00 PERMIT AMOUNT Plan Chk. Dep. 250.00 Plan Chk. Bal. 345.02 Const. _ 720.00 Mech. 60.00 Electrical 122038 Plumbing 138.50 S.M.I. $.61 Grading Driveway Enc. Infrastructure 2,758.21 TOTAL 4.15 72 REMARKSfi �; •9. Wv 4H aY Y t 6 1 Y A s. K w 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: Date4/3 Permit Validated by: . Validation: r CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS SLAB GRADE 13 OUGH PLUMB. YARD SPKLR SYSTEM 2ND FL. SO. FT. STORAGE TANK FORMS / _O — SEWER Q " MOBILEHOME SVC. BAR SINK POR. gQ, FT. ® /� //SOUND. REINw�— %G� �� ?(,//to ! s W �REINF. OAS (ROUGH) ��-C7 GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS STEEL GAS (FINAL) j DRAINAGE PIPING CAR P. I SQ. FT. ® GROUT WALL SQ. FT. SERVICE DRINKING FOUNTAIN. SQ FT ® BOND BEAM URINAL ESTIMATED CONSTRUCTION VALUATION $ GRADING cu. yd. $ -Plus-x$-=$ WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES ROOFING 0 OQO WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED 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. SQ. FT. RESID @ 11/4 c SEWAGE DISPOSAL M�INSULATIONISOUND��3 /O SQ.FT.GAR ® 3/ac HOUSE SEWER FINISH GRADING 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 ,ROUND PLUMBIC Ci _al�j UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE 13 OUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS / _O — SEWER Q " OUGH WIRING.` 7 9v DUCT WORK ROCK STORAGE /� //SOUND. REINw�— %G� �� ?(,//to ! s W �REINF. OAS (ROUGH) ��-C7 METER LOOP HEATING (FINAL) OTHER APPJEQUIP. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM FINAL INSP l� Gl GRADING cu. yd. $ -Plus-x$-=$ LUMBER GR. -� J �L �s� FINAL INSP. T (i/ MITFRAMING ROOFING 0 OQO — REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL//-�-�p LATHING�� 1 H bRyWAr..d._ M�INSULATIONISOUND��3 /O FINISH GRADING FINAL INSPECTION 3 CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL 7d