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07434 (RPL)ding Address ss 79-805 Fiesta Address Owner - P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 No. 07434 siaww"%0. vir.wu. w.viaess Mailing , BUILDING: TYPE CONST. OCC: GRP.- Address A.P. Number � Legal Description Project Description 9-113-005 Lot 68 Pool So& City Zip La QuInta 922.53 Tel. Contractor F & F Pauls Address _;' Tadjo Blud. City Zip ' India, 92MI ' Tel" 345-5070 State Lic. City & Classif. 41607 Lic. # 130 Sq. Ft. Size No. No. Dw. Stories Units Arch., Engr., Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State Lic. # LICENSED COVRA9TOR'S DECLARATION herebye�o�sC}glicense with (commencing r0700)oDivfsion-a-Q"he'BsinessandPrsiosody snfufoce' dr effect. ..0� u S GNATUR ATE OWNER.,BUIRER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following Estimated ValUatiOn3. G reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a PERMIT AMOUNT permit to construct, alter, 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 or the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 or 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 a civil penalty or 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. Dep. Plan Chk. Bal. -715 Const. 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 improvements are not intended or offered for sale. If, however, the building301.00 Electrical or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale.) Plumbing NOW ❑ I, 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. ' such projects with a contractors) licensed pursuant to the Contractor's License Law.) 13I am exempt under Sec. B. 8 P.C. for this reason Grading 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 $304.59 CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE REMARKS -- ass x•r 17 gt?k li ..,. ilf 4,f;.. (This section need not be completed if the permit is for one hundred dollars ($100) valuationa: 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. y J �3�+y Date 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 CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line 1 I hereby affirm that there is a construction lending agency for the performance of the I, work for which this permit is issued. (Sec. 3097, Civil Code.) �, Side Setback from Property Line Lender's Name t FINAL DATE Issued by: Validated by: INSPECTOR tqp� Date / 28/9ermit Lender's Address y This is a building permit when properly filled out, signed and validated, and is subject to expiration it 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 applicant Date Mailing Address Validation: T _ City, State, Zip .. CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLI ADING FEES 1ST FL. SO. FT. a $ UNITS A.C. UNIT COLL. AREA SLAB GRADE YARD SPKLR SYSTEM 2ND FL SD. FT. BONDING HEATING (ROUGH) MOBILEHOME SVC. BAR SINK POR. SO. FT. a SEWER OR SEPTIC TANK ROUGH WIRING GAR. SO. FT. a POWER OUTLET ROOF DRAINS GAS (ROUGH) DRAINAGE PIPING CAR P. SO. FT. HEATING (FINAL) OTHER APPJEOUIP. WALL SO. FT. �� DRINKING FOUNTAIN SO FT ® URINAL ESTIMATED CONSTRUCTION VALUATION $ G G WATER PIPING NOTE: Not to be used as property tax valuation WATER HEATER FLOOR DRAIN MECHANICAL FEES FINAL INSP. WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER $ GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LUMBER GR. LAUNDRY TRAY AIR HANDLING UNIT CFM FINAL INSP. 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. a c BATH TUB SO. FT. a c WATER HEATER MAX HEATER OUTPUT, B.T.U. SO. FT. RESID a 1 Vi c SEWAGE DISPOSAL SO.FT.GAR a $Lc HOUSE SEWER GAR. FIREWALL 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 PLUMBING71 NDERGROUND 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 G G WATER HEATER SERVICE FINAL INSP. BO D M O C D WATER SYSTEM $ GRADING cu. yd. plus x$ _$ LUMBER GR. FINAL INSP. l L FRAMING FINAL INSP. ROOFING 12 7O6� /� � �j� �/ / � /7 67, l 111 REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION t✓ CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL