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002036 (BLCK)P.O. BOX 1504 Building 78-105 CALLE ESTADO Address 78-4n Calle Felipe LA QUINTA, CALIFORNIA 92253 Owner Address 75-411 Ca,Ue Felipe City Zip Tel. L[ Cuinta 9225.3 Contractor A'r (n City - - • Zip Tela ._ . . as tunta 9 3 564.5449 State Lic. & Classif. 335900 Arch.., Engr., - Designer Address City - Lic. # amlied Tel. No. 002036 BUILDING: TYPE CONST. OCC. GRP. A.P. Number (317-442-051 Legal DescriptionX�#*1 Project Description I 53 fr: of 5 ft. hich block wall Sq. Ft. No. No. Dw. Size Stories Units - New Add O Alter ❑ Repair O Demolition O or less.) I certify that in the performance of the 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. Dale Owner' NOTICE TO APPLICANT: If, 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. ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line f 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 i 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. �•"5ac "C3V I certify that I have read this application and state that the above information is correct. ISSUed by: Date 6 Permit I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives sof this. city to enter the above - mentioned property for inspection purposes. Validated by: Signature of applicand 2 �� Date Mailing Address. % Validation: City, State, Zip A 4 1 5 7 L 5 84,3 Sl HARD COPY City Ziptate T)ELic. # -- LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provision's of Chapter 9 (commencing with Section 7000) of.Division 3 of the Business and Professions Code, and my license is in full force and effectsJ. '✓. .. . , SIGNATURE' - DATE ,., •, r' - • 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 ••� requires the applicant for such permit' -to rile a signed statement that he isdicensed pursuant to PERMIT . • - AMOUNT ' 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 for the alleged exemption. Any violation or Section 7031.5 by 'any applicant for a permit PIan.Chk. De p• subjects the applicant to a civil penalty of not more than five hundred dollars ($500). '•. "' Plari Chk. Bal. ��% •� 0 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 COf1St. Lt3• 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, 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 of sale.) , ❑ I, 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 contractor(s) licensed pursuant to the Contractor's License Law.) Grading ❑ I 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, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. .Company ❑ Copy is filed with the city., ❑ Certified copy is hereby furnished. TOTAL 34 •J CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($1001 valuation - or less.) I certify that in the performance of the 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. Dale Owner' NOTICE TO APPLICANT: If, 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. ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line f 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 i 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. �•"5ac "C3V I certify that I have read this application and state that the above information is correct. ISSUed by: Date 6 Permit I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives sof this. city to enter the above - mentioned property for inspection purposes. Validated by: Signature of applicand 2 �� Date Mailing Address. % Validation: City, State, Zip A 4 1 5 7 L 5 84,3 Sl HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS SLAB GRADE ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL. SQ. FT. FORMS SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® GAS (ROUGH) METER LOOP GAR. SO. FT. ® POWER OUTLET ROOF DRAINS GAS (FINAL) TEMP. POLE DRAINAGE PIPING CAR P. SQ. FT. ® GROUT WATER HEATER WALL SO. FT. FINAL INSP. DRINKING FOUNTAIN SQ. FT. @ WATER SYSTEM URINAL ESTIMATED CONSTRUCTION VALUATION $ _$ WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM FIRE ZONE ROOFING 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 LATHING SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac 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 & 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.!n 6 86 - f GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. 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. ROOFING A. T_ ,�j DEC 17 /C/fQ�27 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