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06326 (SATT)T4,!t 4 4 a" Building A-_ 48,-226 W1* Flar3.ataa Owner Abe 6 The -Ina. Crollt man P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Address 9010 Corbin AVO., 8-3 City Zip Tel. Northrifte 1 91324 - Contractor Address • / f ff ,4 "J G � City_ , : r ,"4 lZip L Z t Tela Palls' Desert: 92260 345--5430 State Lic. LIl/ V --, : = City4 t L. & Classif. +.,rft".% iLic.# Arch., Engr., Designer Address Tel. ZipIState 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 DATE OWNER -BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,13usiness and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to fe a signed statement that he is licensed pursuant to the provisions of the Contractors 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 aleged exemption. Any vitiation of Sectron 7031.5 by 'any applicant for a permit subjects fhe applicant to a dtii 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 Contractors 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, provided that such improvements are not intended or offered for sale. If, 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 buid or improve for the purpose of sale.) ❑ I, 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 braids or improves 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 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 ttke city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed i1 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 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, C" Code.) Lender's Name Lender's 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. 1 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. 06326 iBUILDING: TYPE CONST. OCC. GRP. A.P. Number 617-652-034 ,Legal Description Project Description TrAct 2005.2-2. Plxm 5. toot 3A Sq. Ft. 2001 Size No. Stories No. Dw. Units New ❑ Add ❑ Alter C Repair ❑ Demolition ❑ Estimated Valuation $103,145 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. E• IG Const. ____W3.50 Mech. + 50 Electrical___n2,36 Plumbing 144.50 S.M.I. Grading Driveway Enc. Infrastructure 2*320.76 TOTAL REMARKS A()! 3lr Z77,.4 Y+,r.u. w ..�..• .., 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 IIN,1P�E ,,TOR Issued by: Date / / �3 Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS COLL. AREA SLAB GRADE !G Z- ACf 766OUGH PLUMB. YARD SPKLR SYSTEM 2ND FL. SQ. FT. g HEATING (ROUGH) STORAGE TANK FORMS MOBILEHOME SVC. BAR SINK POR. SO. FT, ® DUCT WORK ROCK STORAGE GAR. SQ, FT, ® POWER OUTLET ROOF DRAINS HEATING (FINAL) DRAINAGE PIPING CAR P. SQ. FT. GAS (FINAL) 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 G�FJNAL INSP. 3� WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED VENTILATION 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 SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1% c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER ,//MESH L6mSULATIONISOUND �3 -eld PPPP 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 _ V- GROUND PLUMBING// 9[ f9 UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE !G Z- ACf 766OUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS /ER OR SEPT".O 4o ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH)% -0- �\ ( vv v 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 x$ _ $ LUMBER GR. G�FJNAL INSP. 3� FRAMING � � 1 O AL INSP. _ � l �tOOFING --� v / J bye 70w�� 7"' REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL BATHING `qo ,//MESH L6mSULATIONISOUND �3 -eld PPPP FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESlINITIALS GARDEN WALL FINAL