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14312 (PAT)P.O. BOX 1504 N o . 14312 78-495 CALLE TAMPICO Address 18-765 Grand Traverse LA QUINTA, CALIFORNIA 92253 Owner Nick Romano Mailing BUILDING: TYPE CONST. OCC.GRP.. Address Same A.P. Number City Zip Tel. La Q•tlinta,. CA .92253 Legal Description Contractor Project Description -Pati© Burgebs Builders Address. �y ys.. P.O. Box 11162 / �v lm Desert, ilp 92255 Tel(619)3,4-7-$52.1 State Lic. B 541464 City 2212 & Classif. Lic. # - Sq. Ft. 270 "No. No. Dw. Arch:; Engr., Size Stories - Units Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. CityT ip State Lic. # LICENSED CONTRACTOR'S DECLARATION . jI hereby affirm that I am licensed under provisions of Chapter 9.(commencing with Section . . �a c oft Division 3 of the Business andlProfessions Code, and my license is in full force and llY?ee Z.�../' C�...� 714,.] r\ •_.^"",�,�,.�'"'�' SIGNATURE A DATE OWNER -BUILDER DECLARATION V81UatlOn3Ari�l �p I hereby affirm that I am exempt from the Contractors License Law for the following • reason: (Sec. 7031.5,Business and Professions Code:. Any city or county which requires a permit to construct, atter, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to rite 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 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 penally of not more than rive hundred dollars ($500).. Plan Chk. Bal. 4-3.95 ❑, I, as owner of the property, or.my employees with wages as their sole compensation; will + r n do the work, and the structure is not intended or offered for. sale. (Sec. 7044, euisness and• v Professions Code: The Contractor's License Law does not apply to an owner of property who COr1St. 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 a 5 does not apply to an•owner of property who builds or improves thereon, and who contracts for $,M•1• such projects with a contractor(s) Pcensed 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 j WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Corn sation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Polidy No.�Company JCbpy is filed with the city. O Certified copy is hereby furnished. TOTAL 104.45 CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE (This section need not be completed If the permit is for one hundred dollars ($100) valuation or less.) ! I certify that in the performance of the work for which this permit is issued, I shall not ' employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. bate Owner NOTICE, TO APPLICANT. If, alter making this Certificate of Exemption you should become ZONE: 'BY: _ subject to the Workers' Compensation. provisions of the Labor Code, you -must forthwith Minimum$etbackDlStanceS: ' comply with such provisions or this permit shall be deemed revoked. Front Selback from Centerine Rear Setback from Rea op. 'ne WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL, AND Side Street Setback fro Cente •ne SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,D00), IN ADDITION TO THE COST OF COMPENSATION, - Side Setback fro roperty L' DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND A. ATTORNEY'S FEES. 4) This'is a building permit when broperly filled out, signed and.validated, and is subject to FINAL DATE $PEC I'CJ .. 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 P1Qm I agree to comply with all city and county ordinances and state laws relating -to, building r n 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 1 ' CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBIW FEES 1ST FL. SO. FT. ® $ UNITS COLL. AREA 2ND FL. SO. FT. YARD SPKLR SYSTEM BONDING MOBILEHOME SVC. BAR SINK POR. SO. FT. ® SEWER OR SEPTIC TANK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS F LIND. REINF. ztzo L DRAINAGE PIPING CAR P. SO. FT. HEATING (FINAL) OTHER APP./EOUIP. WALL SO. FT. DRINKING FOUNTAIN SO. FT. ® 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.COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FINAL INSP. 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 SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1 Va c SEWAGE DISPOSAL SO.FT.GAR ® 3/ac 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 F LIND. REINF. ztzo L GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP./EOUIP. 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. //�� LL F�ANG � -q:� FINAL INSP. �.� L REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL , LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIONATURESlINITIALS GARDEN WALL FINAL :9-94 W E D 9 4S P.- E 1 REQUEST FOR ARCHITECTURAL APPROVAL t Hcreowner, Address '7 6 cpS O-A"o `"Q.caqtCes,- _1,4C',U,v.-kv-A Lot No. Description of Improvement 'P,a-jo Qc7c�F prr px�R,�s LA C, �At�U1 a-�5 Items Attached: Plot Plan Rendering Cross Section ARCHITECTURAL CONTROL COMMITTEE Approved Disapproved Conditions of Approval/or Reason for Disapproval Date1 /--� -�� Signature % Kr6hit'lctural Control CdWttee Chairman �r BOARD OF DIRECTORS' APPEAL (Request the Architectural Control Committee to place you on the Agenda of the next Board of Directors Meeting) Approved Disapproved Reason for Approval or Disapproval Date Signature President ' This approval. does not relieve applicant from obtaining the necessary building permits from the governmental agencies involved. This request should be submitted in triplicate. An approved copy will be returned to the applicant, one copy will be retained by the Architectural Committee. and one coov filed with'the—ftard ef•nirprtnrc_