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13434 (PAT)4 P.O. BOX 1504 Building 78-105 CALLE ESTADO Address 79--34® Desert Rock �i • LA QUINTA, CALIFORNIA 92253 Owner No. 13434 Jofie ? 1 .DitTI:SU l Mailing BUILDING: TYPE CONST.• OCC. GRP. Address 79_340 Desert Rock Ct • A.P. Number Cityr p Tel. La Quinta'i92253 Legal Description Contractor Project Description Patin C!ovptr' Bruce G. Kramer Address 34E Indian Hills City Zip Tela ` :Mount. Center 92561 49€ 9 553-37€ 0 State Lic. City & Classif. 6.57550 $ 92561 Lic. # 3;2 I Sq. Ft. No. No. Dw. •Arch.; Engr., — s` / Size �� Stories - Units - • - �, Designer New ❑� Add ❑ - Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State > ` — Lic. # LICENSED CONTRACTOR'S DECLARATION 1 I hereaf.[F.r Si by irm that I am licensed under provisions of Chapter 9 (commencing with Section j000) of Division 3 of the Busiiness �an�dFProfessions Code, and my license is in -full force andel . )effect. � ) - -. 1 ,4—/' � r sIGNATDRE T v DATEf - OWNER -BUILDER DECLARATION Estimated Valuation I hereby affirm that I am exempt from the Contractor's License Law for the following 'bj �� •� 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 - AMOUNT requires the applicant for such permit to file a signed statement that he is licensed pursuant to PERMIT - 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 7031.5 by any applicant for a permit Plan Chk. Dep. . subjects the applicant to a civil penalty of not more than five hundred dollars (8500). Plan Chk. Bell. • ❑ 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 andE! * u Professions Code: The Contractor's License Law does not apply to an owner of property who Const. builds or improves thereon and who does such work himself or through his own employees, Mech. 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 of proving that he did not build or improve for the purpose of sale.) ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 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 S. M. 1. •.�� -,such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) - - Grading ❑ 1 am exempt under Sec. B. & P.C. for this reason Driveway Enc. Date Owner Infrastructure r 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. TOTAL CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE ! (This section need not be comple d if the permit is for n hundred dollars ($100) valuation 1 I u or less. I certify that in the performance of thg work f�hich this permit is issued, I shall notAPR 2 employ any person in 'ny manner so as to beco a subrjrect to the Workers' Compensatio Laws of alifo,r,yy'g y' Date L7' Owner >/ �" -- "i - A'A1. 1 � ]NOTICE?TO APPLICANT: If, after making this✓Certiffcate of Exemption you should become ZONE: BY: 19 e -1kae�bject to the Workers' Compensation provisions of 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— hereby ine 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 Lender's Name Lender's 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 -of this city to enter the above-. mentioned property for inspection purposes. Validated by: Signature of applicant Date Mailing Address Validation: City, State, Zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. @ $ UNITS SLAB GRADE ROUGH PLUMB. BONDING Y ARD SPKLR SYSTEM 2ND FL. SQ. FT. @ FORMS SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SQ. FT. @ GAS (ROUGH) METER LOOP GAR. SO. FT. @ POWER OUTLET ROOF DRAINS CAR P. SQ. FT. @ r•'." TEMP. POLE DRAINAGE PIPING WALL SQ. 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 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. SO. FT. @ c BATH TUB GAR. FIREWALL SQ. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID @ 11/4 c SEWAGE DISPOSAL SQ.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 APP.IEQUIP. REIN F. 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 I N SU LATI ONISOU N D FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL ' ra,`: wt as J - , ' � .. � ^ ' _ r•�:s �� .+,tA-�v-`a n'�ry �t r'!a'" 'iK c�•i'Zr�' 'y^ 91T Cl -Ty OF LA QUINTA ITU ENT ��+•+ is � tK:`c [ L;r �i-`i�.c t ; i i+, . AN DATE 11 X 17 PRINTED ON NO. 1000H CLEARPRINT • I ,r - Sf�E VIEW DFA, IL. 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