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10703 (SOTB)APPROVED BY PLANNING Al L`, P.O. BOX 1504 / ` j N Q . 10703 Building 78.105 CALLE ESTADO Address 45-360 DESERTEACLE COURT LA QUINTA, CALIFORNIA 92253 %� Owner `'' Mailing GERALD & MARY SHEA BUILDING: TYPE CONST. OCC: GRP. Address SAME A.P. Number City Zip Tel. LA QYJINTA 92253 Legal Description ' Contractor Project Description GAZEBO OWNER ".BUILDER Address o' SAME City Zip Tel.: " SAME State Lic. City & Classif. Lic. # Sq. Ft. No. No. Dw. I Arch.,•Engr., Size Stories Units j Designer New ❑ Add ❑ Alter ❑ 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 Estimated Valuation i 1 hereby affirm that I am exempt from the Contractor's License law for the following afi I reason: (Sec. 7031.5,Buslness and Professions Code: Any city or county which.repuires a $ a permit to construct, atter, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to rile a signed statement that he is licensed pursuant to PERMIT AMOUNT the,provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) o/ Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and. the basis . plan Chk. De i for. the alleged exemption. Any violation o/ Section 7031.5 by 'any applicant for a permit p subjects the applicant to a civil penalty of not more than five hundred dollars ($500). Plan ihk. Bal. ❑ I, as owner of the property, or my employees with wages as their sole compensation, will I do thewos . • rk, and the structure is not intended or offered for sale. (Sec. 7044, Brisness and Const30 (70 ProfessionCode: The Contractor's License Law does not apply to an owner o/ property who builds or onproves thereon and who does such work 'himself or through his own employees, Mech. i 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 -builder will have the burden Electrical o/ proving that he did not build or improve /or the purpose of sale.) ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing i struct the project. (Sec. 7044, Guiness and Professions Code: The Contractor's License Law does not apply to an owner o/ property. -who builds or improves thereon, and who contracts for S -.M -I, - such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading ' 0 I am exempt under Sec. B. 8 P.C. for this reason Driveway Enc. �O te'/ °J f� -Owner-�•-^ �� 'ivr.. Infrastructure 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. O Certified copy is hereby furnished. TOTAL $30.00 CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE , (This section need not be completed if the permit Is for one hundred dollars ($100) valuation or less.) - x t,rw: .v v11, 4 tr V a 4V 1 certify that in the performance of the 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 tij - l f, q f j^ate-, 1 %''7 Towner . r • J T" r . �t �• r! NOTICE TO APPLICANT: If, after -making this Certificate of 'Exemption Iyou should become ZONE: BY: subject to the Workers' Compensation' provisions oi_the Labor code, you must. forthwith Minimum Setback Distances: comply with such provisions or this permit shall be deemed revoked. " Front Setback from Center Line Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY Side Street Setback.from Center Line 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 Setback from Property Line t Lender's Name Lenders Address FINAL.DATE INSPECTOR 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 certify that I have read this application and state that the above information is correct. Issued by: Date Permit I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives sof this city to enter the above.. i mentioned property for inspection purposes. Validated by: Signature of applicant Date Mailing Address Validation: City, State, Zip J CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ UNITS SLAB GRADE ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL SO. FT. ® FORMS " ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SO. FT. GAS (ROUGH) METER LOOP GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. SO. FT. TEMP. POLE DRAINAGE PIPING WALL SO. FT. GROUT DRINKING FOUNTAIN SO FT ® FINAL INSP. URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER SYSTEM WATER PIPING NOTE: Not to be used as property tax valuation _$ FLOOR DRAIN MECHANICAL FEES FINAL INSP. WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY 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. SO. FT. ® c BATH TUB GAR. FIREWALL SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1% c SEWAGE DISPOSAL MESH SO.FT.GAR ® 3Ac 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 SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. 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 REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINRIALS GARDEN WALL FINAL