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13731 (RR)a. P.O. BOX 1504 t• - ^ N o . 1.3731 BuildinAddrres9 Washington St.. LA QUINOTA, CALIFORNIA 92253 J. Owner Triad Enterprises BUILDING: TYPE CONST. OCC: GRP: - Mailing Address P'.0. Box Be A.P. Number city la Tel. Via, OT;"ta,, CA 9.2253., 564-!2277 Legal Description Contractor Rc roo CL1;s'' om �'ED>afing C6.: . Project Description Address - 3�99m Rancho Los Coyotes CSlld i*,,'.a te Zip 92233 Tel State Lic. City & Classif. 25'Q3$ Lic. #2 Arch Engr.F .•y:F. Designer Address ' c: Tel. CityZip 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. SIGNATURE 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 ortcounly which requires a '- permit to construct, alter, improve,- demolish, or repair any structure, l 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.(3500). ❑ 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 Sq. Ft. Size New ❑ Estimated Va PERMIT Plan Chk..Dep. Plan Chk. Bal. ,'Const.' Mech. nn No. Dw. Units Repair ❑ e AMOUNT or improvement is sold within one year of completion, the owner -builder will have the burden EIBCirICdl' - of proving that he did not build or improvefor 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 - - •i* doesnot apply to -an owner of property who builds or improves thereon, and who contracts for. .S•M•1. <- such projects wither contractor(s) licensedpursuant to the Contractor's. License.Law.).,, Grading ❑ 1 am exempt under Sec. • B. & P.C. for this reason - Driveway Enc. .DateOwner Infrastructure ` WORKERS' COMPENSATION DECLARATION I hereby affirm that I haves 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. ❑ Certified copy is hereby furnished. .. TOTAL Zu.©U CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE REMARKS (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 t - 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 SetbaQlt_ Distances:-. `�''""FronY.Setback from Center Line- Rear Setback=from=Rear=Pr CONSTRUCTION LENDING AGENCYrTN Np7Lin t Side Street Setback from Centerl�L'iyne I hereby affirm that there is a construction lending agency for the performance of the - r tnl U II'" work for which this permit is issued. (Sec. 3097, Civil Code.) Side Setback from Property I Lender's Name i Li Lender's Address FINAL DATE lI• T4 'III 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 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 t to enter the above-. (� mentioned property for inspection purposes. - Validated by: - !.pit Signature of applicant Date ;R. F.` __. .moi .. ..J M.•.•+ J t S µkw Mailing Address `Validation: t City, State, Zip - CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS SLAB GRADE ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL. SQ. FT. FORMS SEWER OR SEPTIC TANK POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS CAR P. SQ. FT. OTHER APPJEQUIP. DRAINAGE PIPING WALL SD. FT. TEMP. POLE DRINKING FOUNTAIN. SQ. FT. ® GROUT URINAL ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP. WATER PIPING NOTE: Not to be used as property tax valuation WATER SYSTEM FLOOR DRAIN MECHANICAL FEES — 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. SQ. FT. ® c BATH TUB SPARK ARRESTOR SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL LATHING SQ.FT.GAR ® 3/ac HOUSE SEWER GAS PIPING PERMIT FEE MIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEECONST. rPL.CK.FEEE 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 '7 9� -O LN 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