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09274 (MECH)P.O. BOX 1504 N o . Building 78-105 ALLE ESTADO Address 4$-7 7 W SH.INGTON LA QUINTACCALIFORNIA 92253 09274. Owner Us MR. MCCABE BUILDING: TYPE -CONST. UNE -OC.C: GRP. Mailing 48—.771 WASHINGTON Address LA OUINTA A.P. Number City Zip TAUINTA CA 17—el— 92253 S64 -►4.804 Legal Description Contractor Project Description RRPLA6-ING CAS ARRVIP.R NUTPR VALLEY PLU14BING Address TO HOUSE'ABOUT 13 -FRET. 46—lis City Zip Tel.: TND O.CA 92202 4i -- 347-3624 State Lia State City, & Classif.730$$ Lic. # 4$ Sq. Ft. No. No. Dw.... 'Units' Size Stories Arch:, Engr., - Designer New ❑ Add ❑ Alter ❑ Repair p Demolition ❑ Address Tel. City Zip 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 effect. —// 0 - -" �� '" SGNATUREf jt..,... • ^ DATE OWNER -BUILDER DECLARATION Estimated Valuation I hereby affirm that I am exempt from the Contractor's License Law for the following !9300.00 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 ' requires the applicant for such permit to file a signed statement that he is licensed pursuant to PERMIT AMOUNT 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 Any Section 7031.5 'any for Plan Chk. Dep. , exemption. violation of by applicant a permit ";_ subjects the applicant to a civil penalty of not more than five hundred dollars ($500). Plan Chk. Bal. :' ❑�I, as owner of the property, or my employees.with wages as their sole compensation, will 'tlothe work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. .s' (� ,-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 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 ❑ 1 am exempt under Sec. B. & P.C. for this reason Driveway Enc. Driveway if g ,13,43 Date owner Infrastructure WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Cc pensation Insurance, or ace if`id co thereof. Sec. 3800, Labor Code.) Polic��i�'��Qompany STAR V>�N) i]Copy is filed with the city. a Certified copy is hereby furnished. TOTAL S30.00 CERTIFICATE OF EXEMPTION FROM REMARKS 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 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 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 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. SO. FT. ® $ 2ND FL. SD. FT. POR. SQ. FT. ® GAR. SQ. FT, ® CARP. SQ. FT. WALL SQ. FT. ® SQ'FT® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET ` ' YARD SPKLR SYSTEM BAR'SINK ROOF DRAINS , DRAINAGE PIPING DRINKING FOUNTAIN. URINAL WATER PIPING NOTE: Not to be used as property tax valuation BONDING FLOOR DRAIN MECHANICAL FEES FORMS WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APP.IEQUIP. LAUNDRYTRAY AIR HANDLING UNIT CFM TEMP. POLE 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.j SQ. FT. ® c BATH TUB SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11A c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER REMARKS: 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. 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.` _ �-q ( FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING ' FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION 13—C(-011 CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL