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06285 (SFD)T4hf P.O. BOX 1504 No. 06285 Building 46-'205 C.Ue Flor4ataS 7&105 CALLS Address LA QUINTA, CALIFOORNIARNIA 92253, . vwnc-r Abe Thelma GrroseDiait BUILDING:'TYPE CONST. OCC: GRP. A.P. Number 627-652-0133 Legal Description Tissot 20052-2 P2& 3 Project Description Lot 3 Mailing Address 9020 Carbi.a Ave.. .S-3 City 1A>;thr�BR� Zip 92324 Tel. S2R-349�-i894 Contractor �+ i. �� iJ �• z t :� s.. .� Address i ; ;T,7-,2A0�*i�uncaota Const. City PAlm--D3gart Zip ;e i 1 Tel. -345-3430 Electrical State Lic. * 8r Classif. - , >3. City Lic. # Sq. Ft. 1980 No. No. Dw. Size Stories Units Arch., Engr.; Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. Driveway Enc. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under Provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect SIGNATURE I DATE OWNEWBUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Busmess and Professions Code: Any city or county which requires a permit to construct, after, 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 of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Dfidsion 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 subjects the applicant to a civil penally of not more than five hundred dollars ($500). ❑ 1, 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 Professions Code: The Contractor's License Law does not apply to an owner of property who &Ads 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. ft, however, the building 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.) ❑ 1, 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 enproves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec. B. & P.C. for this reason Date ' owner WORKERS' COMPENSATION DECLARATION 1 hereby affirm that I have a certificate of consent to self -insure, or a certificate of Workers Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company ❑ Copy is filed with the city. El Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM 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 thg 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 N077CE TO APPLICANT: ft, 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 Perit shall be deemed revoked. CONSTRUCTION LENDING AGENCY 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.) Lenders Name Lenders Address 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. 1 certify that I have read this application and state that the above information is correct. 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 City, State, Zip stimated Valuation $102,220 PERMIT AMOUNT Plan Chk. Dep. 't Plan Chk. Bal. 5 545.43 Const. 650.00 Mech. 60,5Q Electrical 23 .7 Plumbing • 244.50 S.M.I. 7.22 Grading Driveway Enc. Infrastructure 21, 300.09 TOTAL S3s32 .dt Ott �.� •r;r' REMARKS - ��lt:.`.).��'iXi�t�Xtt't'A��•r-•a;ie'-ycC :fir S:� 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 DATEINSPP7C�T�OR Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ UNITS COLL, AREA SLAB GRADE 6 ROUGH PLUMB. YARD SPKLR SYSTEM 2ND FL. SO. FT. HEATING (ROUGH) STORAGE TANK FORMS MOBILEHOME SVC. BAR SINK POR. SO. FT. ® DUCT WORK ROCK STORAGE GAR. SO. FT. ® POWER OUTLET ROOF DRAINS HEATING (FINAL) DRAINAGE PIPING CAR P. I SD. FT. TEMP. POLE WALL SO. FT. DRINKING FOUNTAIN GROUT WATER HEATER URINAL SO FT ® FINAL INSP. ESTIMATED CONSTRUCTION VALUATION $ WATER SYSTEM WATER PIPING NOTE: Not to be used as property tax valuation GRADING cu. yd. plus x$ 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 LAUNDRY TRAY AIR HANDLING UNIT CFM 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 SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1% c SEWAGE DISPOSAL SO.FT.GAR ® 3lhc HOUSE SEWER INSULATION/SOUND r GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE FPLUMB.FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK 4 GROUND PLUMBING UNDERGROUND A.C. UNIT COLL, AREA SLAB GRADE 6 ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS EWER OR SEPTIC TA : ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) S q METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM $ GRADING cu. yd. plus x$ =$ LUMBER GR. FINAL INSP. ! RAMING/ _`� FINAL INSP. (jf�0OFING (2W - REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR FIREWALL �i�GAR. //1/kTHING /1417-10 III�� MESH INSULATION/SOUND r FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL