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09030 (RPL)I (I P.O. BOX 1504 Address 45-3€25 Desert Eagle Court LA QUINOTACCAL FORNIA 92253 Owner „_.,. Development771BUILDING: TYPE CONST., Address 78-193 I diao A City Zip Tel. La Quinta i 92253 Contractor Address I 73•-547 HWV 111 Tela State Lic. I City & Classif. 91A()A7 C S-1 Lic. # Arch., Engr., Designer Address I Tel City I Zip I State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that!( -am licensed under provisions of Chapter 9 (commencing with Section 7000) of,Divisi9D,3'gf4he'Business and Professions Code, and:my license is in full force and SIGNATURE DATE `OWNt_ BUILDER DECLARICTION 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 /or 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 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 /or 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. I/, however, the building or Improvement is sold within one year o/ completion, the owner -builder will have the burden proving that he did not build or improve for the purpose o/ sale.) �7- 0 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 o/ property who builds or improves thereon, and who contracts /or uch projects with a contractor(s) licensed pursuant to the Contractor's License Law.) y' 'fT I 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 O Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed i/ the permit is for one hundred dollars ($100) valuation or less.) 1 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 o/ the Labor 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 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 Address City, State, Zip P. Number No. OCC: GRP. - Legal Descriptionz Project Description nNIT.V Sq. Ft. No. Size Stori 09030 No. Dw. Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ n PERMIT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL AMOUNT 0 61111 21 2 0 REMARKS 005MAQ i'# , _JQ 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 FL. SQ. FT. ® $ UNITS A.C. UNIT 2ND FL. SO. FT. SLAB GRADE YARD SPKLR SYSTEM ROUGH PLUMB. MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® STORAGE TANK FORMS GAR. SO. FT. ® POWER OUTLET ROOF DRAINS DUCT WORK DRAINAGE PIPING CAR P. SQ. FT. //TANK GAS (ROUGH)! 4_y0 `v o� !! WALL SO. FT. DRINKING FOUNTAIN SO. FT. ® REINF. STEEL URINAL ESTIMATED CONSTRUCTION VALUATION $ TEMP. POLE 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 GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED �. $ LAUNDRY TRAY AIR HANDLING UNIT CFM LUMBER GR. 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 SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/a c SEWAGE DISPOSAL FIREPLACE SQ.FT.GAR ® 3/ac HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE d PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK ,ROUND PLUMBING ��i� yp DERGROUND/2-.�,f-9p A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. //TANK GAS (ROUGH)! 4_y0 `v o� !! METER LOOP HEATING (FINAL) OTHER APP.IEOUIP. 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 -GNB;T� ��-i� yQ �iu�= � �Za�;'A� Ay 255 REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION a CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL