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10607 (AR)P.O. BOX 1504 /\� 0.' 10607 Building Address 52-880 .Villa LA QUINTA, CALIFORNIA 92253 Owner Thomas Griffiths Mailing BUILDING: TYPE CONST. OCC: GRP. Address P. Q'. Box 1053 A.P. Number City Zip Tel. t. La Ouinta 92253 564-3498' Legal Description Contractor Project Description Ownea 13ui ides Address Garage P>dr�:i. ie3r; cu c'a n e City Zip State Lic. City & Classif. Lic. # Sq. Ft. 8032 No. No. Dw. Size Stories Units Arch., Engr., Designer Cody Brady Architects New ❑ Add ❑ Alter ❑ Repair ❑- Demolition ❑ Address Tel. R. a. Box 1198 564-4i50-4, City Zip ) State La Qui nta 92253 Lic. # C 5€91 LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under'provisions of Chapter 9 (commencing with;Section 7000) of Division I oof.the,Bussiness and Professions Code%and my lic ns is in full force and effect.. /� _SIGNATURE / •F,� .w..�zf" 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 permit to construct, alter, improve, demolish, or repair any structure,* prior to its issuance also AMOUNT 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 Division 3 of the Business and Professions Code, or that. he Is exempt therefrom, and the basis e, for the alleged exemption. Any. violation of Section 7031.5 by 'any applicant for a permit Plan Chk.'DI?p. - 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 Plan Chk. Bal. • , : �•' do the work, and the structure is not.intended or offered for sale. (Sec. 7044, Buisness and Const.7�, �Q 'Pro/essions 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 havethe. burden EIBCtrICdl - 31 • 6 4 of proving that he did not build or Improve for the purpose of sale.) n ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-. Plumbing 1.7.00 .. 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.l. ,;{, ,. 60 such projects with a contractor(s) licensed' pursuant to the Contractor's License Law.) Grading ❑ I am exempt under Sec. -- 8. & P.C. for this reason _r Driveway Enc. 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 Compensation Insurance, or certified copy thereof. (Sec. 3800, Labor Code.) - Policy No. Company ❑ Copy is filed with the city. 0 Certified copy is hereby furnished. TOTAL 332.39 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 lel certIf that in the performance of th work for which this permit is issued, I shall not a};1:r; ' AIR ; ', ;'''-••�,�'- fj employ any person in any manner so as to become subject to the Workers' Compensation - - - -- - _ - 3 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 Minimum Setback Distances: comply with such provisions or this permit shall be deemed_revoked. 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 FEE%, 1ST FL. SO. FT. ® $ 2ND FL. SO. FT. POR. SO. FT. ® GAR. SO. FT. ® CAR P. S0. FT. WALL SO. FT. ® SO FT @ ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD S?KLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN. URINA4 WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES BONDING WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH)- APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED ROCK STORAGE LAUNDRYTRAY AIR HANDLING UNIT CFM GAS (ROUGH) 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 SERVICE SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/. c SEWAGE DISPOSAL SO.FT.GAR ® VVic HOUSE SEWER LUMBER GR. 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 Z PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK CP GROUND PLUMBING lA liv 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. �/ 2� r /7 ROOFINGq) //A(� 114411 `� REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING Sl� cdR MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESJINITIALS GARDEN WALL FINAL T l, — ---=- — - ---- D to/ j r a � — CIL-_