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06288 (SFD)TAW0 f 4 4a" Building 48-213 Calle Pisa" Builds P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Owner s I Abe & Thelma GrosI Address 9010 CorUln kva. >, S--3 City Zip Tel. ftrrbrif a 1 92324 828••349-5844 Contractor . • I L Address 1 , I/ it- r - r 1) , -I• t .7.?-7�t?-��mef30 Lic City Zip i :' c t {, Tela . Palo-�-lam -AS-44=1 State Lic. 4/ 7 t S. , 7 City . I t 8+ Classif. tAAA-4114 Lic. # AM Designer Address City IZip I State Lic. # LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm that I am licensed under Provisions of Chapter 9 (commencing with Section effect Division 3 of the Business and Professions Code, and my license is in full force and effect. SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractors License Law for the following reason: (Sec. 7031.5,9rshess and Protessiens Code: Any city or county which requires a permit to construct, alter, inprove, demolish. or repair any structure, prior to its issuance also requires the applicant for such perm[ to lie a signed statement that he is licensed pursuant to the provisions of the Conbactor's License taw, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and tia/sesssiors Code, or that. he is exempt therefrom, and the basis for the alleged exeirpSon- Any violation of Section 7031.5 by 'any applicant for a permit subjects the applicant to a mv8 penary 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 Contractors License Law does not apply to an owner of property who builds or improves Hereon and who does such work himself or through his own employees, provided that such irgrovemenls are not intended or offered for sale. If, however, the building or improvement is sold wihin 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.) ❑ I, as owner of the properly, am exclusively contracting with licensed contractors to con- struct the project (Sec- 7044, Obsiness 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 such projects with a contractor(s) icersed Pursuant to the Contractor's License Law.) O 1 am exempt under Sec B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I 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- ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be eonpieted it the permit is for one hundred dollars ($100) valuation or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of Califomia. Date Owner NOTICE TO APPLICANT: I, after making thrs Certificate of Exemption you should become subject to the Workers' Coope isation Provisions of the Labor Code, you must forthwith comply with such provisions or the permit shat be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued- (Sec. 3097, Civil Code.) Lenders Name Lenders Address This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives -of this City to enter the above- mentioned property for inspection purposes Signature of applicant Date Mailing Address City, State, Zip No. 06288 JILDING: TYPE CONST. OCC: GRP. P. Number 617-652--006 Description t Description T.cser 20054-2, 'flan 3s Lit & ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date 91/8/89 Permit Validated by: Validation: Sq. Ft.i�$� Size No. Stories No. Dw. Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation 002,1,226 PERMIT AMOUNT Plan Chk. Dep. ` Plan Chk. Bal. 5 • 3 Const. ow • OU Mech. 66.50 Electrical IL1.12 Plumbing S.M.I. • L Grading Driveway Enc. Infrastructure *300 09 TOTAL ytJ< .tib r REMARKS } i, t.f1: i'fr 1. 1111 Ila L r1 - 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: Date 91/8/89 Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS COLL. AREA SLAB GRADE 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 SO. FT. GAS (FINAL) TEMP. POLE WALL SO. FT. DRINKING FOUNTAIN GROUT WATER HEATER URINAL 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 INAL 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 FIRE ZONE ROOFING 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 THING ' SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11% c SEWAGE DISPOSAL SO.FT.GAR ® 3/ac 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 yf �] fAo GROUND PLUMBIN 101 UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS EWER OR SE 7r1 N ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. AS (ROU �� METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REIN F. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING _Cu. yd. $ -Plus-x$-=$ LUMBER GR. INAL INSP. ffl`RAMING FINAL INSP. ROOFING ,^ el � / � 1,^^ `(/ �� C � � �✓ +/J(/'` 1 0 7 REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL THING ' MESH gl�INSULATIONJSOUND FINISH GRADING i FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS � GARDEN WALL FINAL