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10554 (RPL)4t • 1��1�1+'IN P.' O. BOX 1504 iNo. 10554 (ding 7&105 CALLE ESTADO Iroaa 79-325 Desert Rock Cir LA QUINTA, CALIFORNIA 92253 Santa Rosa DevPe Address 45--275 Desert Eagle Ct I La Quanta 92253 345-lim6 rntractor Stevie Dodson Canstruction (dress 6$'--8805 A Perez Rd #E3 ty Zip Tel.: Cat c v 92234 324-1232 ate Lic. City 'lasslf. A 574127 LIC lt�� Arch., Engr., Designer Address Tel. Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION . I herebyy affirm that lam licensed under provisions of Chapter B (commencing with Section 7000) of Dlvlelon 3 of the Business and Professions Code, and my license Is In full force and !Oct. "i SIGNATURE DATE OWNER -BUILDER DECLARATION' I hereby affirm that I am exempt from the Contractors License Law for the following reason: (Sec. 7031.8,Sualness and Professions Code: Any city or County which requires e permit to construct„ atter, Improve, demolish, or repair any structure, prior to Its Issuance also r requires the applicant for such permit to file a signed statement that he la licensed pursuant to. the provisions of 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 7031.8 Dyy' 'any applicant for a permit subjects the applicant to a.clvll penalty of not more then five hundred dollars.(5800). ' ❑ 1 as owner of the property, or my employees with wages as their sole compensation, will do {he work;'and the structure Is not Intended or offered for sale. (Sec. 7044, Sulsness and Professions Code: The Contractor's License Law does not apply to an'owner of property who bullds' 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 -builder will have the burden of proving that he did not build or Improve for the purpose of sale.) as owner of the property, am exclusively contracting with licensed contractor" to eon, 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(") licensed pursuant to the Contractor's License Lew.) o Gam exempt under Sec. B. & P.C..for this reason BUILDING: TYPE CONST." OCC: GRP.. P. Number ,Legal Description Project Description POOL AND SPA Sq. Ft. No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ -Demolition ❑ Estimated Valuation 13 �1.00© PERMITI :I AMOUNT Plan Chk., Dep Plan. Chk. Bal. Const. . Mach. Electrical Plumbing. S.M.I. Grading Driveway Enc. Date owner Infrastructure WORKERS' COMPENSATION DECLARATION I. hereby affirm that I have a certificate of consent to self -Insure or a certificate of Worker'" Compensation Insurance, or a certified. copy. thereof..(Sec..3806, Labor -Code.). Policy No. ,Company '• ,• �. �. KCopy Is filed with the city, ❑ Certified copy Is hereby furnished.,- ' . • t ; TOTAL CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed N the permit Is for one'hundred dollars'!($100) valuation or /sea.) o I certify that In the performance of the work for whlch.thle permit is Issued, I shall not employ any pparson In any manner so as to become subject to the Workers' Compensation Lowe of California. Date Owner NOTICE TO APPLICANT: If, alter 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. 3087, 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 Illy that I have read this application and state that the above Information Is correct, I agree to comply with all•clty 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! Melling Address City, State, 21p REMARKS rF • s I:? . :a rW b"4 A 4 4S3 rt- .1. ..ru . t r 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: Date Permlt Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ UNITS A.C. UNIT COLL. AREA SLAB GRADE YARD SPKLR SYSTEM 2ND FL. SO. FT. POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS DUCT WORK DRAINAGE PIPING CAR P. SO. FT. GAS (ROUGH) METER LOOP WALL SO. FT. DRINKING FOUNTAIN. SO FT ® REINF. STEEL URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax Valuation FLOOR DRAIN MECHANICAL FEES SERVICE WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER WATER SYSTEM 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 ® 1% 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 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 iq � �+ L' ^ /� 31- ! f2— REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACESPARK ARRESTOR ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH-GRADING FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL