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05345 (BLCK)Building Address 49— City . I Zip - LA QUINA Contractor & Classif. I Lic. Arch., Engr., Designer Address Tel. City (Zip Si ate P.O. BOX 1504. 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 LICENSED CONTRACTOR'S DECLARATION affirm'tha70 I hereby Division 3 off the Business and Professions I am licensed under provisionsC , Chapter 9 (commencing with Section and my license is In full force and OATURE DATE OWNER -BUILDER DECLARATION reason: (SSec x7031 5,11usbress and PPrdesslmis Code that I am exempt from the Myr CRY seor nse un� iw the following permit to consinct, ager, bnprove, 0 1 or mpah any structure, prior to *s Issuance also requires the applicant for such perm* W Me a stared statement that he is bmsed pursuant to the provisions of the Contractor's License law, Chapter 9 (conwWwIng with Section 7000) of Division 3 of -the Business and'Pmfessbw Code. or that. he Is exempt theretrom, and the basis for the a*eged exaWtbn. Any* vkkishon of section 7031.5 by any applicant for a pen?W sublede theAPPOcanl to a critpenaity of not rtwe than the hund1red dollars ($500). ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the.stnreture Is not Intended or offered for sale. (Sec. 7044, Bulsness and Professions Code: The Contractor's License Law does not appy to an owner of property who bukb or trrproves thereon and who does such work himself or through his own enpfoyess, provided that such improveammO are not blended or offered for sale.,0, however. The buWft or improvement is sold w*hm one year of corrwiefen, the owner-bu*W wD have the burden of proWrig that he did not build or mgrove for the purpose of salls.) d 1, as ownerof the property, am exclusively contracting with licensed contractors to con- struct the project (Sec. 7044, Business -and Proressloms Code: The Contractor's License Law does, not appy to an owner of property who builds or 6nproves thereon, and who contracts for such projects with a contractor(s) foensed pursuant to fhe.Conbactor'k License Lew.) . 0 1 am exempt under Sec" R. & P.C. for this Date / .. owner WORKERS COMPENSATION DECLARATION 1 hereby affirm that I have a certificate of consent to self -insure, or a certificate of War= Insurance, or a certified copy thereol. (Sec.. 3800, Labor Code.) Policy No Company ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EIIEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be oorrpteted 9 the perm* is for ane hundred doges ($100) valuation a less.) 1 certify that In the performance of flop work for which this permit is issued, (,.shall not employ arty person In any manner so as to become subject to the Workers' Compensatlon Laws of California Date—Owner NOTICE TO APPLICANT: 9, after malft this certificate of Exenptton you should become subject to the Wor*ers- ConpensaDm provisions of the Labor Cade, you must forthwith Cc -Py with such provlslow or this pemat shat be deemed revoked CONSTRUCTION LENDING AGENCY I hereby affirm that,there is -a consbuction lending agency for the performance of the work for which this permit Is issued. (Sec. 3097, Cha,Llode.) Lenders Name Lenders Addres 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. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize repr rhes -of this city to enter the above- mentioned property for inspection purposes. No. 05345 BUILDING: TYPE-CONST.—OCC'. A.P. Number 631-141-014-015 'Legal Description Project Description SMI R E t ATf'11 GRP. t;lA1.7. Sq. Ft. Size No. Stories No. Dw. Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation 12lS�U PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. 144.00 Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS ' ri cam. azg.�- ,_^•.i'. .h �.��- F: `...1, _r:'C'- _ .. ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date2/13/39 Permit Val idated'by: Signature of applicant (late Mailing address Validation: Cin'. State, ZIP I - CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ UNITS SLAB GRADE ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL SO. FT. @ FORMS SEWER, OR SEPTIC TANK ROUGH WIRING, MOBILEHOME SVC. BAR SINK POR. SO. FT. ® GAS (ROUGH) METER LOOP GAR. SO. FT. ® POWER OUTLET ROOF DRAINS GAS (FINAL) TEMP. POLE DRAINAGE PIPING CAR P. SO. FT. ® GROUT WATER HEATER WALL SO. FT. FINAL INSP. DRINKING FOUNTAIN. SO FT ® WATER SYSTEM URINAL ESTIMATED CONSTRUCTION VALUATION E =$ 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 WASHER(AUTONDISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED VENTILATION ILAUNDRYTRAY 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. SO. FT. ® c BATH TUB LATHING SO. FT. ® c WATER HEATER MAX HEATER OUTPUT, B.T.U. SO. FT. RESID a 1% c SEWAGE DISPOSAL SO.FT.GAR,® 114c 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 ROCKSTORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. = plus xS =$ LUMBER GR.I FINAL INSP. FRAMING _ 2 FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINIS GRADING �} L I CTION7 D —C6_ CERT. OCC. FENCE FINAL. INSPECTOWS SIGNATURESINITIALS GARDEN WALL FINAL