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002496 (BLCK)Building Address i Owner Mailing Address City • Address .. 53�-M Aveida Diaz DaVLd Girtmet Zip Zip State Lic. & Classif. - 31.734 Arch., Engr., Designer Address 44 . . # . . .. . . .11 P.O. BOX 1504 N o . 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Tel City Lic. # 655 Tel. BUILDING: TYPE CONST. OCC: GRP. A.P. Number 744-151-013 Legal Description Project Description Sq. Ft. No. No. Dw. Size • Stories Units New ❑X Add ❑ Alter ❑ Repair ❑ Demolition ❑ City JZip 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 .a effect. 1. . t. - c l ` - - Al f _ SIGNATURE DATE OWNER -BUILDER DECLARATION Estimated 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 Front Setback from Center Line permit 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 Side Street Setback from Center Line Divlsiori 3 of th'e`Business and Professions Code, or that.he is exempt therefrom, and the basis Plan'C.hk.. Dep. for the alleged exemption. Any violation of Section 7031:5 by 'any applicant for 'a permit work for which this permit is issued. (Sec. '3097, Civil Code.) _ - ' "subjects the applicant to a civil penalty of not more than rive hundred dollars ($500).' 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. ' 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, Mech. - . provided that such improvements are not intended or offered for sale. If, however, the building . expiration if work thereunder is suspended for 180 days. Lcertify 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.) .. , Issued by: ❑ 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.W.- 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 L �'! Date Signature of applicant Driveway Enc. Infrastructure 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.) 'Polioy No. Company ❑ Copy is filed with the city. ❑ 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 Ing 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. TOTAL REMARKS - 1 65 A0 AMOUNT 20.00 Date Owner NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become ZONE: BY: subject to the Workers' 'Compensation provisions'of the Labor Code, you must -forthwith comply with such provisions or this permit shall be deemed revoked. Minimum Setback Distances: - 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 - 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. Lcertify 7-24, 86Permit that I have read this application and state that the above information is correct. Issued by: Date I'agree to'comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives -of this cityrto•.enter the above- mentioned property for inspection purposesI i' ' Validated by: L �'! Date Signature of applicant Mailing Address 1 Validation: City, State, Zip f A 6 0 3 8 1 24 2 a 0 0 CK HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS SLAB GRADE ROUGH PLUMB. BONDING YARD 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 GAS (FINAL) TEMP. POLE DRAINAGE PIPING CAR P. S0. FT. ® GROUT WATER HEATER WALL SQ. FT. ® FINAL INSP. DRINKING FOUNTAIN SO FT ® WATER SYSTEM URINAL ESTIMATED CONSTRUCTION VALUATION $ -$ WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM FIRE ZONE ROOFING 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 LATHING SO. 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 FINISH GRADING 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./EQUIP. 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 SIGNATURES/INITIALS, GARDEN WALL FINAL P.O. BOX 1504 APPLICATION ONLY Building� ��� 78-105 CALLE 9 Address �. -` LA QUINTA, CALIFORNIAORNIA 92253 Owner :1 Mailing / I Address City lZip ITel. Contractor Address ty IZip State Lic. Gity & Classif. �� 7-1 e2 Lic. # Arch., Engr., Designer .e W`1_5.,fe Address I Tel. CityI Zip ( State _. 4� ) A � C"-? -7 `7A / 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 /1Code, and my license is -in f/ull'force and effect. / rt ., _ r 1., 5L, SIGNATURE '.I" DATE OWNER -BUILDER DECLARATION 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, 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 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 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 bnproves 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 of knprove for the purpose of sale.) ❑ 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 of property who builds or Improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) O 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that 1 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. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed If the permit is for one hundred dollars ($100) valuation or less.) I 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' Corpo nsation Laws of California.; r � ( � NOTICE TO APPLICANT: If, afer'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 Lenders 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 certity that 1 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 BUILDING DIVISION BUILDING: TYPE CONST. OCC. GRP. A.P. Number Legal Description D IFF L%il//iZZ Project Description S Sq. Ft. No. No. Dw. / Size Stories / Units New ❑ Add ❑ Alter ❑ Repair ❑ -Demolition ❑ 3.>_ eo ti ? 1 Al Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. 38 Const. Mech. Electrical Plumbing S. M. 1. Grading �,pa Driveway Enc. to_ 0;P Infrastructure �D� % • 7� TOTAL IL S REMARKS 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 5 0 5 3 4 4 25x00 14 CONSTRUCTION ESTIMATE GROUND PLUMBING NO. ELECTRICAL FEES NO. PLUMBING FEES // ? `'� d $ 61 S L; UNITS BONDING HEATING (ROUGH) STORAGE TANK 1ST FL. SO. FT. ® SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. 2ND FL. SO. FT. METER LOOP HEATING (FINAL) OTHER APPJEOUIP. YARD SPKLR SYSTEM GAS (FINAL) yO % 7 O MOBILEHOME SVC. GROUT BAR SINK SERVICE FOR. SO. FT. ® � BOND BEAM WATER SYSTEM GRADING cu. yd. $ Plus—x$_=$ GAR. SO. FT. ® 3 • 70 y `/ / p 7 O POWER OUTLET FINAL INSP. ROOF DRAINS FINAL INSP. CAR P. I SO. FT. ® ROOFING 1 DRAINAGE PIPING REMARKS: WALL SO. FT. VENTILATION DRINKING FOUNTAIN SO. FT. ® FIREPLACE URINAL ESTIMATED CONSTRUCTION VALUATION $ ` WATER PIPING O2 NOTE: Not to be used as property tax valuation LATHING FLOOR DRAIN MESH MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD FINISH GRADING SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER CERT. OCC. GARBAGE DISPOSAL — FURNACE UNIT WALL FLOOR SUSPENDED t7 INSPECTOR'S SIGNATURESIINITIALS LAUNDRYTRAY AIR HANDLING UNIT CFM GARDEN WALL FINAL KITCHEN SINK — ABSORPTION SYSTEM. B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP — POLE, TEMIPERM LAVATORY OZ — HEATING SYSTEM FORCED GRAVITY g(9 AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. ® c BATH TUB Gl SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c33 w SEWAGE DISPOSAL SO.FT.GAR ®1a/c HOUSE SEWER— GAS PIPING PERMIT FEE 0 — PERMIT FEE Q — PERMIT FEE /Q DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.F E CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE 37.5 %+'0-�3� 3y�.�o -?.o/ L/, 8 D 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 INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL