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06324 (SATT)T,it!t 4 4 Qum& P.O. BOX 1504 Building w. 7&105 CALLE ESTADO Address 46 222 Calle F1MICt» LA QUINTA, CALIFORNIA 92253 Abe & Thal= Grossman Mailing Address 9010 Corbin AVO., S-3 City Zip Tel. Aotrthridaa 91324 518-354-5836 Contractor ' f- t- .-4 c- ,' r 3'�i�ES""C: 'CJlrt�a Address '• 4 1s • t.. p,; Cit Zip fc r Tel. i zt-Imsert 92243 345-5430 State Lic.J/ City & Classif. ' ` -44533$---- Lic. # _26o_ Designer Address Tel. City I Zip I State Lic. # LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm that 1 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 OWNEWBUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,8usihess and Professions Code: Any city or county which requires a pennft to construct, after, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to Me a signed statement that he is licensed pursuant to the provisions of the Contactors 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 subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ❑ 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 Professions Code: The Contractor's License Law does not appy to an owner of property who bullds 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. Il, however, the building orimprovement is soM 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.) O I, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project (Sec. 7044, Business and Professions Code: The Contractors License Law does not appy to an owner of property who builds or improves thereon, and who contracts for such projects with a cowrador(s) licensed 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 1 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 ❑ Copy is filed with the city. ❑ Certified copy is hereby fumished. 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 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. Date Owner NOTICE TO APPLICANT: ff, 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 permit 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, Cin? Code.) Lender's Name Lenders Address This is a building permit when property 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. BUILDING: TYPE CONST. OCC. GRP.; A.P. Number 617-652-032 06324 Legal Description Project Description Tract 20052--2s Plan 5, 14t 32 t.t� ttfatl i IufFt4 ,.,, IJ ,r , 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 9./19/89 Issued by: Date Permit Validated by: Validation: Sq. Ft. 2041 Size No. Stories No. Dw. Units New ❑ Add ❑ Alter C Repair ❑ Demolition ❑ Estimated Valuation $103.145 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. $ 548.10 Const. 553.50 Mech. 66.50 Electrical 112.36 Plumbing 144.50 S.M.I. 7.28 Grading Driveway Enc. Infrastructure 2,320.76 TOTAL $3,853.00 1's ..� - '' -C-- REMARKS t.t� ttfatl i IufFt4 ,.,, IJ ,r , 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 9./19/89 Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL SQ. FT. ® $ UNITS COLL. AREA SLAB GRADE _ L�� ROUGH PLUMB. YARD SPKLR SYSTEM 2ND FL Sp. FT. HEATING (ROUGH) STORAGE TANK FORMS MOBILEHOME SVC. BAR SINK POR. gp, FT_ ® DUCT WORK ROCK STORAGE GAR. Sp. FT. ® POWER OUTLET ROOF DRAINS HEATING (FINAL) DRAINAGE PIPING CAR P. S0. FT. ® &/ S (FINAL) CI—L�— TEMP. POLE WALL SQ. FT. DRINKING FOUNTAIN, GROUT WATER HEATER URINAL SQ 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 WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER � //(/ i, OZ To � J� I _ f� ` lJ C_ 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. SQ. FT. ® c BATH TUB FIREWALL SO. FT. @ c WATER HEATER MAX HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/. c SEWAGE DISPOSAL SO.FT.GAR ® VAc HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FJPL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR ffo SETBACK %�- GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE _ L�� ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS WER ORS 2IC�[1�ttc ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. MCAS (ROUGH) — -1?0 METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL &/ S (FINAL) CI—L�— TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM $ GRADING cu. yd. Plus—X$—=$ LUMBER GR. INAL INSP,3� SFV FRAMING FINAL INSP. A// ROOFING /— J `[ — qv � //(/ i, OZ To � J� I _ f� ` lJ C_ REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR FIREWALL ,--//GAR. (/LATHING — --�� MESH L6NSULATION/SOUND1— FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS. GARDEN WALL FINAL