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04670 (MFD5)0 4670 P.O. BOX 1504 Building 5 r' LSU i'itestone78-105 CALLE ESTADO Address LA QUINTA, CALIFORNIA 92253 Owner Sunries Cortr,a y aY BUILDING: TYPE CONST. OCC. GRP. Mailing Address 75-005 Country Club Dr. A.P. Number.. PGA We$t­ 'The Greens City Zip Tel. �R » Palm Desert 92260 568-282.8 _ _ Legal Description ContractorPlii 3E! ��-� Flan E Project Description Address City Zip Tel. s» State Lic. & Classif. 258130 City5��f Lic. # 398 „ Sq. Ft. 1536,_ No. No. Dw. Size Stories Units Arch., Engr., Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State Lic. If 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, -'''•r DATE OWNER -BUILDER DECLARATION I'hefeby,affirm that I am exempt from the Contractor's License Law for the following Estimated Valuation 1t taCtl� IOQ � reason: (Seca 7031.5,Business and Professions Code: Any city or county which requires a PERMIT AMOUNT permit to. construct, alter, 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) o/ Plan Chk. Dep. Division 3 o/ the Business and Professions Code, or that. he is exempt therefrom, and the basis /or the alleged exemption. Any violation o/ Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. ^ . 0 Const. 4j5 5� 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 . Mechp i 4I(f ® 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. 1/, however, the building Electrical �' . 22 or improvement is sold within one year el completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale.) Plumbing 91.00 ❑ 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 builds 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. 8 P.C. for this reason S.M.I. 7.68 Grading Driveway Enc. Date owner Infrastructure ♦ • I22 + l Less Dred WORKERS' COMPENSATION DECLARATION I hereby affirm that I 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 furnished. TOTAL *2.rr iG!�e d 3�„� �"�•; . f�,� CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation REMARKS dui Et �fC) mss. `l� r 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: If, alter 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. ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line 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.) Side Setback from Property Line Lender's Name FINAL DATE INSPECTOR 10/13/88 1 Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration it 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 do enter the above- mentioned property for inspection purposes. Issued by: Validated by: Date Permit Signature of applicant Date Mailing Address Validation: GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE City, State, Zip WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES tST FL SO Fl 0 S UNITS SLAB GRADE ROUGH PLUMB BONDING YARD SPKLR SYSTEM 2ND fl SO FT. a FORMS SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR SO FT. a GAS (ROUGH) METER LOOP HEATING (FINAL) POWER OUTLET ROOF DRAINS GARSO. FT. TEMP. POLE GROUT DRAINAGE PIPING CAR P. SO FT. a FINAL INSP. WALL SO. FT. @- WATER SYSTEM DRINKING FOUNTAIN GRADING cu. yd. $ plus xi =$ URINAL SO FT fa FINAL INSP. FRAMING ESTIMATED CONSTRUCTION VALUATION S WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTONDISH) APPLIANCE DRYER FIRE ZONE ROOFING GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FIREPLACE LAUNDRYTRAY 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 C 11A c SEWAGE DISPOSAL SO.FT.GAR @ 3/4c HOUSE SEWER FINAL INSPECTION 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 8 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 ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus xi =$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL 7d