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04254 (BLCK)ceitovo, 4 - 14 Qlal4tm •, 6-:• 4 •.t,XY?b . �,Y , 1 h.r... r r •. j,.'y' . P.O. BOX 1504 " Building,' 78-105 CALLE ESTADO Address 5J 960 Villa LA QUINTA, CALIF_ ORNIA 92253 jOwner "VA wisatern An. ar can Coast. Co*_BUILDING: -TYPE CONST. _ . • OCC. GRP. ,iMailing . 774"-174-x}11 Address; • �• ids Brix 1379 A.P. Number Cjt Zip Tel. i n 9225. a6 -Z01 Legal Description Contractor - Gary. Reynolds Address " •..-..:. + ,% e v f. BOX 6 9 7 Project Description�4a1� City, • : ' F q]Zip Tel. - - State Lic. t 8� Classif. ,► �� City Lic. # Sq. Ft. No. No. Dw. .:.x�. Size �" ,. ' "' '.Stories ' ` "" Units Arch., Engr.;;_ r Designer , New ❑ Add ❑ Alter ❑ Repair ❑. Demolition ❑ Address Tel. City Ant, Zip State Lic. # • ' �i yrrt,�_: i `, ,a �.- 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 �effectat: r , 'q ' SIGNATURE - DATE Lri. 4i, , ,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 or county which requires a Estimated Valuation, PERMIT- -- - AMOUNT ' permit'to construct_ alter.. Improve,, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to rile a signed statement that he is licensed pursuant to the provisions of the, Contractor's License Law, Chapter 9 (commencing with Section 7000) of Plan Chk. Dep. - 1 ••� = 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 acivll penalty of not more than five hundred dollars ($500). - ' O 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 . . Plan ChkBal y KL tT •rF Const. 25.00 Mech. 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 Electrical - ,. or improvemenf,i5 sold:wlthfn one year o/ completion, the owner -builder will have Me 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 con- - 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, �t r a. such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) O I am exempt under Sec. B. & P.C. for this reason Grading Driveway Enc. Date owner Infrastructure r « I WORKERS' COMPENSATION DECLARATION - - - ,i-,; .• t Lhereby 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.) 'r Policy No. Company • O Copy is filed with the city. ❑ Certified "copy is hereby furnished. ' , TOTAL .0 REMARKS CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE - (This section need not be completed if the permit is for one hundred dollars ($100) valuation orless.).. ' .. tl certify that In the performance of the work for which this permit Is issued, I shall not employ any parson in any manner so as to become subject to the Workers' Compensation Laws of California. , . . . I - -p r3N" 4-A""4YstY Xsf °3••f(: IL s�'il M_ a fit$ a d`? Date' • ` Owner. - ' NOTICE , TO' APPLICANT: If,after making this Certificate of Exemption you should become subject to.fhe Workers' Compensation provisions of,fhe Labor .Code, you must :forthwith . comply with such provisions or this permit shall be deemed revoked. - ZONE: BY: _ Minimum Setback Distances: - - -• • - Front Setback from Center Line ' !`CONSTRUCTION Rear Setback from Rear Prop. Line + - .,'A LENDING AGENCY P Side Street Setback from Center Line ;- 1 hereby affirm that there is a construction lending agency for the performance of the.r' 'work for which this permit is issued. (Sec. 3097, Civil Code.) - • _ 'Side Setback from Property Line r . Lender's , Name „ Lender's: Address ' .This is a building r permit when properly filled out, signed validated; and is to expiration if work thereunder is suspended for 180 days. : - • • • :. FINAL DATE ' .- - '• ` - INSPECTORy - 7/6/88, I certify that 1 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 I above- bove- me • mentioned property for inspection purposes. r t, Issued by: 'Validated by: Date.! Permit. " Signature of applicant Date + Mailing Address" Validation: - t city" state,*..Zip GOLDENROD - ASSESSORS OFFICE HARD COPY -•FILE Ir Y i ' t t ,.!•i: . ..c ..4.-A! rr�-:Y.--�... d. ., .•.. �f.. w«, \ e.. ii •I..«'i.e•a•i .j- r. . ,i �^.... ,-..�. WHITE FINANCE PINK APPLICANT GREEN --BUILDING,• a. _�'. ��•-�.,..-,.....t1', t'?1.....n.l, 1. .._ c... .. -. __. f:t 11..:vr .,.. -.. %"-?.N.QIG_... CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES ' IST FL SO F1 y S UNITS SLAB GRADE 2ND FL SO FT. @ BONDING YARD SPKLR SYSTEM STORAGE TANK MOBILEHOME SVC. BAR SINK POR SO FT a DUCT WORK ROCK STORAGE GAR SO. FT. Ct POWER OUTLET ROOF DRAINS HEATING (FINAL) OTHER APP.IEOUIP. DRAINAGE PIPING CARP. SO FT. ra TEMP. POLE WALL SO. FT. (d GROUT DRINKING FOUNTAIN SO. FT. (d FINAL INSP. URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER SYSTEM WATER PIPING NOTE: Not to be used as property tax valuation _$ FLOOR DRAIN MECHANICAL FEES FINAL INSP. WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER 1 GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM VENTILATION 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 GAR. FIREWALL SO. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID g 1 V. c SEWAGE DISPOSAL SO.FT.GAR (g V4c HOUSE SEWER 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 8 AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB BONDING HEATING (ROUGH) STORAGE TANK E,QPMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REIINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IEOUIP. INF. STEELAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM -7 WATER SYSTEM GRADING cu. yd. $ plus x$ _$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING ' 1 REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR, GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL 7d