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14683 (BLCK)a t ' 444 P.O. BOX 1504 No. Building 78-495 CALLE TAMPICO Address 53-160 A* +e. Villa_ LA QUINTA, CALIFORNIA 92253 x Owner Fuca. is ' r"aoi gage Exchange Mailing 707-EWY� BUILDING: -TYPE CONST: OCC: GRP. Address A.P. Number City Zip ]Tel. Ranc1'st> 1 Arag�, C 92270 324-8585 Legal Description Contractor, Project Description ' nc, 401of 41 -high -block garden wall a�qddress, City Zip Tel.' Pa m SPringw,, A 92264 -(619) 323m022( State Lic. City & Classif.. B -700.1,97 Lic. # Sq. Ft. No. No. Dw. Size • Stories .Units Arch., Engr.; - . • ' Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION ' . �I hereby affirm that I amslicensed� ri�erjllrovisions of Chapter 9 (commencing with Section 000) of Division 3 of th`e:Busines's d rofessions ode, and my license is in full force and ' ffect. $1GNATURE ✓ 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 `Y permitto construct, after, improve, demolish, or repair any, structure, prior to .its issuance also - •� requirestheapplicant for such permit to file a signed statement that he is licensed pursuant to - PERMIT - AMOUNT, the provisions o!. the Contractor's License law, Chapter 9 (commencing with Section 7000) or - - Divisfori 3 or the Business and Professkms Code; or that. he is exempt therefrom, and .thw basisI - for,. the alleged exemption. Any violation of. Section 7031.5 by Any. applicant for a permit - Plan ChK: Dep. - 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..Professions Code: The . Contractor's License Law does not apply to an owner oL property who . 25� Div 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 have the burden • Electrical of proving that he did not build or improve for the purpose or sale.) O 1, 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 - does not apply to an, owner• of property -who builds or improves thereon, and who contracts for. S.M.I. such projects with a contractors) #tensed pursuant to the Contractor's License Law.) - Grading ❑ 1 am exempt under Sec B. & P.C. for this reason ,. 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, ora certified copy thereof. (Sec. 3800, Labor Code.) Policy No: Company ' n rnnv is fuan ,.,lth the city, ❑ Certified copy is hereby furnish -M CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATIONANSURANCE' (This section need ..not be completed iffthe permit is'!or one, hundred dollars ($100) valuation or less.) ll I certify that in the pert. n . thg workf r which this permit is issued, l shall not employ anyersori`any ma`nncome subject to the'Workers' Compensation ' aws,of da tt1'�fornla. d! aie7" Owner . NOTICE �//`TO Aj0 PPUCANT: ff. 'after' ma)ring' this Certificate of Exemption you should become. - subid0 to the Workers' C6mpensa8on 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 SOBJECT 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. ATTORNEYS 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 applicapt"D Date Mailing Address. City, State, Zip TOTAL z!) . Liu. REMARKS CVMD 1G Ct.en.. cont.. on ' iob ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line \ Side Street Setback from .Cent�One� Side Setback from Property'L• ine FINAL .DAT EINSPEC�,T.OR Issued by- Date Per iit+o� ZX Validated by:i Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMB i. IST FL. SQ. FT. ® $ UNITS SLAB GRADE 2ND FL. SQ. FT. BONDING YARD SPKLR SYSTEM POR. SO. FT. @ MOBILEHOME SVC. BAR SINK GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS CAR P. SQ. FT. ® GAS (ROUGH) • DRAINAGE PIPING WALL SQ. FT. OTHER APPJEOUIP. DRINKING FOUNTAIN SQ. FT. ® TEMP. POLE URINAL ESTIMATED CONSTRUCTION VALUATION $ GROUT WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SYSTEM WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP. GARBAGE DISPOSAL FURNACE UNIT WALL. FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM A„��M �V�� 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. SO. FT. ® c BATH TUB SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1% c SEWAGE DISPOSAL GAR. FIREWALL SO.FT.GAR ® 3/.c HOUSE SEWER LATHING 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 t� J WATER SYSTEM GRADING cu. yd. $ plus x$ _$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING /_ �i A„��M �V�� 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