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002042 (RER)4 P.O. BOX 1504 Building 78-105 CALLE ESTADO Address 53-485 00a Gq3te!IeU LA QUINTA, CALIFORNIA 92253 Owner pr*3 uAillftr TM No. 00204 Mailing BUILDING: TYPE CONST. OCC. GRP. ' Address � exw-m A.P. Number City Zip Tel Contractor Address ?5 Legal Description Project Description win Wit. City ._. ,... Zip Tel.. M,SpriMs 92262 323-7426 37 State Lic. City & Classif.�� � Lic. #�11W Sq. Ft. No. No. Dw. Size Iwo -Arch., Engr:, _. Stories Units Designer New ❑ Add ❑ Alter ❑. . Repair Demolition ❑ Address Tel. City State JZip Lic. # . i LICENSED CONTRACTOR'S DECLARATION Fire, job ' I hereby affirm that I am.licensed.under provisions of Chapter 9 (commencing with Section 7000) of Divisf'on 3 of th6 Businessoand Professions Code, and my license is in full.force and f effect. SPj/ ��I � "T }ifi . is % SIGNATURE,r N DATE OWNERwBU(LDER DECLARATION Estimated Valuation I hereby affirm that I am exempt from the Contractor's License Law for the following Any reason: (Sec. 7031.5,Business and Professions Code: city or county which•requires a'wls47eRJLl permit torconstruct, 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 is licensed pursuant to PERMIT- AMOUNT the provisions or the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Piofessibns Code, or that. he is exempt therefrom, and the basis for the Any Section 7031.5 by 'any for plan Chk. De p alleged exemption. violation of applicant. a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). " Plan Chk. Bal. _ ❑ 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. 328s3 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. . 62�+t� � provided that' such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year or completion, the owner -builder will have the burden Electrical Z¢o(} 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- ry� Plumbing 12.00 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.L - 2.14 such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading ❑ l 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'- ompany'O 0Copy is filed with the city. ❑ Certified copy is hereby furnished: TOTAL�d.51: _ 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 certifythat 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" Com pensation Laws of California. Date Owner NOTICE TO APPLICANT. If, after making this Certificate or Exemption you should become ZONE: BY: ' subject to the Workers' Compensation provisions of the Labor Code, you must 'forthwith comply with such provisions or this permit shall be deemed revoked. - Minimum Setback Distahces: - Front Setback from Center Line ' Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line Ihereby 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 2-10-85 read this application and state,that the above information is correct. -Issued Date Permit I agree to comply with all city ,and county ordinances and state laws relating to building .by: construction, and hereby authorize representatives of this city to 'enter the above• mentioned property for inspecti t purposes: f ! / Validated by: _ Signature of applicant �l f f'r rdC Il / f - ( Date Mailing Address f Validation: City, State, Zip A 4 2 0 1 2 10 184,51 R HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS SLAB GRADE ROUGH PLUMB. BONDING Y ARD SPKLR SYSTEM 2ND FL. SQ. FT. p FORMS SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® GAS (ROUGH) METER LOOP GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS GAS (FINAL) TEMP. POLE DRAINAGE PIPING CAR P. I SQ. FT. GROUT WATER HEATER WALL SQ. FT. (l l 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. P1 rj 6� FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM FIRE ZONE ROOFING 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. SQ. FT. ® c BATH TUB LATHING SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER FINISH GRADING GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE LPL.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 (l l FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ _$ LUMBER GR.1 FINAL INSP. P1 rj 6� FRAMING µ / FINAL INSP. /O 0 I 1 �v ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING (FINAL INSPECTION /o CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS, GARDEN WALL FINAL :d