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13228 (MISC)i ,E Building 4S— Address Owner P.O. BOX 1504 No. 13228 Washington ' LA QUINTACCALIFORNIA 92253 I'v T.D. Desert Development Corp. Mailin Address 41-555 Cook St. #260 City lZip Tel. Palm Desert, (JA 92260 1. 568-2718 Contractor Construction, Inc. add;S goX 1716 Ty Zi Tela Git La Quinta, CA 22.53 771-1941 State Lic. City & Classif. 8 674074 Lic. # 2996 Arch., Engr., Robert, Lamb Hart Designer AMsSCalifornia Street Tel (415) 986-4260 City Zip I State San Francisco, CA, 94111 Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I arr licensed underpprovisions of Chapter 9 (commencing with Section 7000) of DDiivision 3 of the Business and Plbfessions Code, and my license is in full force and effect � i _SIGNATURE y 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, after, 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 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 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.) ❑ 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.) ❑ 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm thatrl 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 witti the city. ❑ 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' 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 Ihereby 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. 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-. mentioned property for inspection purposes. Signature of applicant -Date- Mailing ateMailing Address City, State, Zip BUILDING: TYPE CONST. OCC: GRP. iA.P. Number ,Legal Description Project Description Eisenhower/Washington gate house Rancho La Qui -ata Sq. Ft. Size 186 No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Permit includes guardhouse and trellis only., block walls to be obtained separate Estimated Valuation $190011.00 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. 194.14 Const. 207.00 Mech. 54.50 Electrical 61.01 Plumbing 69.00 S.M.I. 2.00 Grading 20.00 Driveway Enc. .00 Infrastructure 427.73 TOTAL I i U J Z). 40 REMARKS - ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Setback fro �4; re tbac4�°m t Se=m Odpert FINAL DATE 11SF'go Issued by: Date Validated bv: A . ' Validation: t X=6Z t' ne Line Y it CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS COLL. AREA SLAB GRADE ROUGH PLUMB. r 2ND FL. SO. FT. HEATING (ROUGH) YARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOMESVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS FOUND. REINF f GAS (ROUGH) DRAINAGE PIPING CAR P. I SO. FT. p HEATING (FINAL) OTHER APP./EOUIP. WALL SO. FT. GAS (FINAL) DRINKING FOUNTAIN SO. FT. ® URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER HEATER WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SYSTEM WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN - WASHER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP. 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, TEMIPERM 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. SO. FT. RESID ® 1+/a c SEWAGE DISPOSAL SO.FT.GAR ® 3/ac HOUSE SEWER FINAL INSPECTION 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 UND PLUMBI 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 f GAS (ROUGH) METER LOOP ` HEATING (FINAL) OTHER APP./EOUIP. 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. // AMING Q �G� FINAL INSP. OFING // v / Gly �/,,,r � ��' G��// '/'�/ (/J (� /� Ui�� 1� / �� F T� �.o a�— /V 1/ !` `�[//}}�� f _ 6-�� F l 0— t ` ct y 1 rv, 11 C L5 V ' 1 1 16- REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/ SOUN % r FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL EARTH.SYSTEMS CONSULTANTS S C,. BUENA ENGINEERS DIV. 79-811 B CountryClub Drive Bermuda Dunes, CA 92201,- (619) 345-1588 n Client Name r -Client Address 'al qtr Client Phone DATE JOB NO. PROJECT A2. L- Z, ? LOCATION CONTRACTOR_ OWNER ' WEATHER 'TEST TEMP: o at 0 at AM PM PRESENT AT SITE 'MOISTURE DRY MAXIMUM MAXIMUM OPTIMUM NUMBER NO: FIELD TESTING REFERENCE CURVE ' ' 'TEST TEST LOCATIONCOTr : 'MOISTURE DRY MAXIMUM MAXIMUM OPTIMUM NUMBER NO: ELEVATION CONTENT DENSITY DENSITY DRY DRY MOISTURE el Ibs./Cu.fl. DENSITY % DENSITY Ibs1cu. ft. CONTENT % 4,tr 9S - y • _ .. ^mfr :�,�.�•,.. ._ / ` w::C 1 P y'. 4„: ii REMARKS:' 711 r FIELD RE O P RT . CLIENT REPRESENTATIVE SIGNATURE TECHNICIANS S1GNATURE '