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001667 (BLCK)Building Address 53-575 AVeMW DiM Owner JZip Lic. # ��..[[`�•�� yg ��yy, �y,.�,�,.�, Si.1A:.'S. U�� i21i1lWG.R Mailing Address P..0_ Pox 2288 CityZip SIGNATURE/ DATE T" 9".01 ITel. Contractor reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a Rit JOtlneC90n9t1UCt10R Address ity jZip I ` jTel. State Lic. & Classif. Arch., Engr., ' Designer Address P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 No. 001667 BUILDING: TYPECONST.. f / OCC: GRP. A.P. Number Legal Description .4-111, .� Project Description City Lic. # Sq. Ft. Size New.11 I Tel. No. No. Dw. d • Stories Units Add ❑ Alter ❑ . Repair ❑ Demolition ❑ City State JZip 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.th Business and Professions,Code; and mylicense is in full force .-and effect..- ,...'3,v ..t ' t! t'r'y ri�✓''•.,. .!i,'�,..,,,.r.- ... �^ SIGNATURE/ DATE OWNER -BUILDER DECLARATIONEstimated Valuation .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 ' perrimit, 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 . PERMIT the provisions of the Contractor's License Law, Chapter 9'(commencing with'Section 7000) of.r- " Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis•'" for the Any • Section 7031.5 'any for ' " Chk. De p alleged exemption. violation of by applicant a permit , subjects the applicant to a civil penalty of not more than five hundred dollars ($500). .plan Plan Chk. Bal. " ❑ 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 Const. 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, 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.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 Date Owner WORKERS' COMPENSATION DECLARATION Ihereby' 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 0 Copy is filed with the city. O Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed i1 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 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 if work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct... 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. �s Signature of applicant -' �� �'t/l� Date ! �� r Mailing Address City, State, Zip Driveway Enc. Infrastructure TOTAL REMARKS AMOUNT 19.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 Permit Validated by:_ Validation:_ A 2 2 5 6 HARD COPYI T 8 9 2 0. 0 0 Sl' CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS COLL. AREA SLAB GRADE YARD SPKLR SYSTEM 2ND FL. SQ. FT. p HEATING (ROUGH) STORAGE TANK FORMS MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® DUCT WORK ROCK STORAGE GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS METER LOOP HEATING (FINAL) DRAINAGE PIPING CAR P. I SQ. FT. GAS (FINAL) WALL SO. FT. ® DRINKING FOUNTAIN — SQ. FT. ® URINAL ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP. WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES GRADING CU. yd. $ plus x$ WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP. 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 SPARK ARRESTOR SQ. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1% c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ec HOUSE SEWER MESH GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE IPL.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 APPJEQUIP. 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 INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE_ FINAL cl/Gl . J INSPECTOR'S SIGNATURESlINITIALS. GARDEN WALL FINAL