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15027 (CSCS)Building Address 50"855 Washi Owner A -.ex Solomgn P.O. BOX 1504 78-495 CALLE TAMPICO 49.te F LA OUINTA, CALIFORNIA 92253 Address 2500 S. Palm Canyon #118 . City Zip Tel. .Palm Springs, CA 92262 864-3809 Contractor • ' Lorenz 'C6nstructIliGn Address . 33115 Victoria Brook Lane City Zip Tel.: Lake Elsinore, to 92530 State Lic.�� City �� & Classif.. Lic. # -Arch., Engr., Designer Address Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby afiirmtfiat I am licensed/under provisions of Chapter 9 (commencing With Section 7,M) of DIvvisign 3 of the Businessand Professions Code, and my license is in full force and .effect: .r t!/ >! OWNEWBUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec., 7031.5,Susiness 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 the provisions of the Contractor's License law, Chapter 9 (commencing .with Section 7000) ,of Division 3 of the Business and Professions Code, or Nat. 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 rive 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 thathe 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 propertywhobuilds or improves, thereon, and who contracts for. such projects with a contractors) 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 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,�� 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 ff 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 -own r NOTICE TO APPLICANT: ff, 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. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,'AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE; INTEREST, AND ATTORNEY'S FEES. 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 -of this city to enter the . above-., mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip No. 15427 BUILDING: TYPE CONST. . OCC: GRP. 82 /CP A.P. Number Legal Description Project Description Soul o Asia Re'staura3k3t T.,L. 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 Validat, Validat Sq. Ft. Size No. Stories No. Dw. Units New ❑ Add .0 Alter❑ Repair ❑ -Demolition ❑ Estimated Valuation' PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. 2. e a Const. �n Mech. Electrical Plumbing � w S.M.I.• Grading Driveway Enc. Infrastructure - TOTAL 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 Validat, Validat CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING; FEES 1ST FL. SO. FT. ® $ 2ND FL. SQ. FT. POR. SO. FT. ® GAR. SO. FT. ® CAR P. SQ. FT. WALL SQ. FT. SQ. FT. ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET y 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 APPJEOUIP. LAUNDRYTRAY AIR HANDLING UNIT CFM TEMP. POLE I IKITCHEN 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 SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1+/e 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 APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM i 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 IA a CITY OF LA QUINTA o, BUILDING & SAFETY DEPARTMENT 777-7012 INSPECTION REQUEST1 0 )M QUINTA 777-715�fTY : Owner Alex Soloman APR 19 1995 Contractor Lorenz Construct I"INANCE DEPT : Permit Number 15027 :... POST ON JOB IN CONSPICUOUS PLACE INSPECTOR -MUST SIGN ALL APPLICABLE SPACES JOBADDRESS 50-855 Washington Ste. F Soul of Asia Restaurant T.I. TYPE OF INSPECTION DATE INSP. FOUNDATION & SETBACK FOOTING STEEL MAIN GROUND SYSTEM GROUND PLUMBING PRE-GUNITE . F..: DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED CONCRETE SLAB JOISTS & GIRDERS ELECTRICAL GROUND WORK DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SI NED ROUGH ELECTRIC • ROUGH PLUMBING ROUGH GAS & GAS TEST HEATING & VENT -A/C FIREPLACE ROOF a BOND BEAM O.K. TO WRAP GROUT 0 4' O 8' FRAMING INSULATION PRE -ROOF COVER NO' ORK UNTIL ABOVE HAS BEEN SIGNE DRYWALL INTERIOR - EXTERIOR LATH POOL PRE PLASTER POOL FENCE & GATE SEWER SEPTIC TANK ABOVE APPROVALS DO NOT INCLUDE RIGHT TO 1/9 5 ' TURN ON UTILITIES OR OCCUPY BUILDING