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08924 (PAT)Building Address 66-625 Faxtai9 Owner Rita Knorr Mailing 4 P.O. BOX 1504 1 N o . 78-105 CALLE ESTADO Y rc2� LA QUINTA, CALIFORNIA 92253 FF { BUILDING: TYPE CONST.11.�g4 OCC: GRP.; 08324 Address 66-625 Foxtail Circle A.P..Number CityZip Tel. LaQuin>ta 92253 1 Legal Description Contractor Project Descriptions.+ J. T. Conn Cruation Address 75-930 Marigold Lana City Zip Tela LeQui to 92253 365-691:9 State Lie. City & Classif. Lie. # Sq. Ft. No. No. Dw. t Size Stories Units Arch., Engr., Designer New O Add ❑ Alter ❑ Repair ❑ Demolitio Address Tel. City Zip State Lie. # LICENSED CONTRACTOR'S DECLARATION I hereby`affirm that I am licensed -under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of, he Bgsiness and Professions Code, and my license is in full force and effect: ryr� SIGNATURE_ `--��"" DATE - OWNER -BUILDER DECLARATION I hereby affirm that I am exempt fromfthe Contractor's License Law for the following Estimated Valuation reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a S6�Q> �� 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 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 Any Section 7031.5 'any for plan Chk. De p for the alleged exemption. violation of by applicant a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). Plan Chk. Bal. , 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 Const. Professions Code: The Contractor's License Law does not apply to an owner of property whoSID. 00 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.) O 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. A; Such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading O 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, or a certified copy thereof. (Sec. 3800; Labor Code.) Policy No. Company O Copy is filed with the city. O Certified copy is hereby furnished. TOTAL IA CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE REMARKS � �+ d(t 40AIA AO-44-,QAi (This section need not be completed if the permit is for one hundred dollars ($100) valuation _hi 11 f! 1 f U f ffL I x jiff . Y Y 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. 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 forthwith Setback Distances: comply with such provisions or this permit shall be deemed revoked. Minimum Front Setback from Center Line Rear Setback from.Rear Prop. Line 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 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. I certify that I have read this application and state that the above information is correct. Issued by: Date Permit 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. Validated by: Signature of applicant Date Mailing Address Validation: City, State, Zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS SLAB GRADE 2ND FL. SQ. FT. BONDING YARD SPKLR SYSTEM STORAGE TANK MOBILEHOME SVC. BAR SINK POR. SO. FT. ® DUCT WORK ROCK STORAGE GAR. SO. FT. ® POWER OUTLET ROOF DRAINS HEATING (FINAL) OTHER APP./EQUIP. DRAINAGE PIPING CAR P. I SO. FT. TEMP. POLE WALL SQ. FT. GROUT DRINKING FOUNTAIN SO FT ® 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.COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM 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 ® 11/. c SEWAGE DISPOSAL MESH SO.FT.GAR ® 3/.c 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. GAS (ROUGH) METER LOOP 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 FINAL INSP. ROOFING 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