The URL can be used to link to this page

002870 (MFD5)6 4,Y/ 4 Q -de, Building 55-293 pl eStCM Address Owner StL wim omvmy Mailing Address 75-005 Cbuntxv CAMb D.i'M' City lZip ITe,l. Contractor N ti omi mw gve and I arA Address Salm City lZip Tela State Lic. & Classif. Arch., Engr., Designer Lic. # 328 P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 UILDING: TYPE CONST .P. Number egal Description roject Description — No. 002870 OCC. GRP Pim 14 OR LAS ZZ I'd Sq. Ft. QW 592No. No. Dw. Size Stories Units New ft Add ❑ Alter ❑ • Repair ❑ Demolition ❑ Address Tel. CityZip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000'e 000) of Division 3 of the•Business and Professions Code, and my license is in full force and _ effect. ` [ ( / t I• SIGNATURE _ _ DATE OWNER -BUILDER DECLARATION Estimated Valuation I hereby affirm that I am exempt from the Contractor's License Law for the following 1580646.00 reason: (Sec. 7031.5,Business 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- lso -.requires the applicant for such permit to rile a signed statement that he is./icensed pursuant to requires PERMIT - AMOUNT the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of - Division 3 of the Business and Professions Code, or thathe is exempt therefrom, and'the basis Any Section 7031.5 by for - Plan:Chk. Dep. for the alleged exemption. violation of any applicant a permit subjects the applicant to a civil penalty or not more than five hundred dollars ($500). Plan Chk. Bal. 485.64 . ❑ 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 . Const. 58€i Professions Code: The Contractor's 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, Mech. C•q� 00 provided that such improvements are not intended or offered for sale. If, however, the building. _ 7? «tali ' or improvement is sold within one year of completion, the owner -builder will have the burden Electrical - 102.17of proving that he did not build or improve for [he purpose of sale.) -- . .. ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing �� 50 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 S.M.1. ^' - 1.1.10 such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading 0 1 am exempt. under Sec. B. & P.C. for this reason Driveway Enc. Date Owner Infrastructure 2,000.00 WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of'oonsent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company Q Copy is filed with the city. ❑ Certified copy is hereby furnished. TOTAL 3.362.93. CERTIFICATE OF EXEMPTION FROM REMARKS 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 NOTICE TO APPLICANT. It, after making this Certificate of Exemption you should become ZONE: BY: subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. - - 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 I Lender's Name Lender's Address 'signed FINAL DATE INSPECTOR This is a building permit when properly filled out, and validated, and is subject to expiration if work thereunder is suspended for 180 days. I s w 1 27 7 Permit certify that I have read this application and state that the above information is correct. Issued by: Date 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. Validated by: 1 !`fin Y, Signature of applicant , t f Date r ` Mailing Address Validation: City, State, Zip A 7 2 6 5 1 30 336691 U' HARD COPY T CONSTRUCTION ESTIMATE NO. ELECTRICAL FF NO. PLUMBING FEES 1ST FL. SQ. FT. ® UNITS COLL. AREA fal/sLAB GRADE GH PLUMB. YARD SPKLR SYSTEM 2ND FL. SQ. FT. HEATING (ROUGH) STORAGE TANK POR. SQ. FT. ® MOBILEHOME SVC. BAR SINK GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS It 001/,Z.,#OUND. REINF.z . GAS (ROUGH) DRAINAGE PIPING CAR P. Q. FT. HEATING (FINAL) OTHER APP./EQUIP. WALL SQ. FT. GAS (FINAL) DRINKING FOUNTAIN TEMP. POLE URINAL SO. FT. ® WATER HEATER ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP. WATER PIPING NOTE: Not to be used as property tax valuation WATER SYSTEM FLOOR DRAIN MECHANICAL FEES GRADING cu. yd. $ plus x$ WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED 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. SQ. FT. ® c BATH TUB SPARK ARRESTOR SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/. c SEWAGE DISPOSAL SO.FT.GAR ® 3/ec HOUSE SEWER MESH GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE ri�sT. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR �ETBACK �. 3 � OUND PLUMBI �� UNDERGROUND A.C. UNIT COLL. AREA fal/sLAB GRADE GH PLUMB. �G �' BONDING HEATING (ROUGH) STORAGE TANK FORMS ER OR SE IC I UGH WIRINGG/ �O,Q� DUCT WORK ROCK STORAGE 001/,Z.,#OUND. REINF.z . GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP./EQUIP. EINF. STEELZ�� GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ _$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ez6OOFING iiJ��G� / // 06e A,A � I GG rr REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL �46THING MESH INSULATION/SOUND !� FINISH GRADING Eilotml- INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL