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001605 (RPL)P.O. BOX 1504 No. 0.1605 Building 78-105 CALLE ESTADO Address 53-533 1VenidaWU - LA QUINTA,.CALIFORNIA 92253 Owner Mailing BUILDING: TYPE CONST. OCC: GRP. Address C Ttz A.P. Number CityZip Tel. . Tom. �� _ �� •�• •_ . .- �Q•.8:�$>� Legal Description - Contractor Project Description Address. 1 .. LU .City., rip ` Tel. 8 rnt 0 2AA lAh-49011 State Lic. City & Classif:-.. Lic. # Sq. Ft: No. No. Dw. • Size. Stories - Units Arch:, Engr.; .. Designer " _ New Add 0 Address Tel. CityZip State Lic. # LICENSED C.ONTRACTOR'.S DECLARATION r hereby affirm that I am licensed underprovisions 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.... n SIGNATURE DATE " OWNER -BUILDER DECLARATION'Estimated 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.gity 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 Valuation • r - -PERMIT. - ks' ' 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 - - :Plan..Chk. Dep.. 'subjects the applicant td a civil penalty of not'rnore than five hundred dollars ($500)... O t, as owner of the property, or my employees. with -wages as their sole compensation, will .• Pian Chk• Bal. Cdr1St. 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 Mech. - builds or improves thereon. and who does such. work himself or through his own employees, _ provided, that' such. fmprovements are not intended.or: offered for sale. If, however, the building E12CtfICal or improvement is sold within one year of completion, the owner -builder willhave the burden of proving that he did not build or improve for the purpose of sale.) . . .. __ _ . Plumbing ❑ 1, as owner of the property, am exclusively contracting.with.licensed contractors to don- • -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:) - - O l am exempt under Sec... .. B. & P.C. for -this reason - Grading Driveway Enc. work for which this permit is issued. (Sec. 3097, Civil Code.). ' , Date'. Owner Infrastructure Lender's Address ' FINAL DATE --' INSPECTOR Thls,is a building permit when properly filled'out, signed and -validated, and is subjec410 ' • expiration if work thereunder is suspended for 180 days. WORKERS' COMPENSATION DECLARATION a' hereby affirm that *1 have's certificate of 'consent to self-insure;'or a certificate of Issued by: Date/Permit- Worker's Compensation Insurance, or a certified copy thereof. (Sec: 3800, Labor Code.) i Policy No. Company ❑ Copy is filed with the city. O Certified copy is hereby. turn Ished. Validated by: TOTAL 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) ... _ ... .. Alter 0 Repair O -Demolition ❑ AMOUNT . 56.22 .. . - Fg~`iAi..so 12.60 .74 L 73.46 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'forthwltn 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 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 Thls,is a building permit when properly filled'out, signed and -validated, and is subjec410 ' • 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- agree to comply with all city and county ordinances and state laws relating to building' i 'construction, and hereby authorize representatives -of . this, city to enter the above-. mentioned property for inspection purposes. Validated by: Signature of applicant ..-Date- .DateMailing MailingAddress _ Validation* - City, State,` Zip B 1 8 8 4 7 10 27346 CK HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ 2ND FL. SQ. FT. POR. SO. FT. ® GAR. SQ. FT. ® CAR P. SO. FT. WALL SO. FT. ® SO. FT. ®. ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK I 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.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APP./EQUIP. LAUNDRY TRAY AIR HANDLING UNIT CFM TEMP. POLE 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. SQ. FT. ® c BATH TUB SQ. 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 REMARKS: VENTILATION GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE J 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 I HEATING (FINAL) OTHER APP./EQUIP. 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 �f / FINAL INSP. /� /.t /� /_ ` ! �Q ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION cf 0 CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS• GARDEN WALL FINAL