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002862 (3&4)Building 55-423 tC3M Address Owner Mailing - Address y City ' Contractor Address . - Sam City State Lic. & Classif.• 288130 Arch., Engr., Designer Address P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Zip Tel. 92260 515R 2282 Zip Tel. City Lic. # M Tel. City Zip State - 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 theBusiness and Professions Code, and my license is in full force and. effect. . vF ... r• SIGNATURE d a LFr- * "- DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following 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 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) of Division 3 of the Business and Professions Code, or that.he is exempt therefrom, and the basis I 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): •" ❑ 1, as owner of the property,, or my employees with wages as their sole compensation, will do the work, and the structure isnot 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 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 build or improve for the.purpose of sale.) O 1, 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.) - 0 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that Ihave a certificate of consenttoself-insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. ' Company O Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for'one hundred dollars (5100) 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: If, 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, Civil Code.) ' Lender's Name Lender's 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. ir �. „ . Signature of applicant e .r a'•—� Date Mailing Address (-sL City, State, Zip No. 002862 BUILDING:. TYPE CONST. OCC. GRP. A.P. Number Legal Description Project Description Pte. I PHAM 14 B PM 20 OR 5096? Sq. Ft. 2- No. No. Dw. Size _577Stories Units New ® Add ❑ Alter ❑' Repair ❑ Demolition ❑ Estimated Valuation $ 17991318.04 PERMIT Plan Chk. Dep. Plan Chk..Bal. Const.. Mech. HARD COPY T Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS AMOUNT 525.1 633.00 555.A00 .7,-.5.-.7 .06 I 132.50 12.5 2,000.00 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 1-27-87 Permit Validated by: Validation: A 7 2 1 3 1 30 547123 Ch CONSTRUCTION ESTIMATE NO. ELECTRICAL FFA& NO. PLUMBING FEES IST FL. SO. FT. ® UNITS COLL. AREA t,�AeSLAB GRADE Z �O —�1 UGH PLUMBC/-7�a /—O 7 YARD SPKLR SYSTEM 2ND FL. SO. FT. HEATING (ROUGH) STORAGE TANK FORMS MOBILEHOME SVC. BAR SINK POR. SO. FT. ® DUCT WORK ROCK STORAGE GAR. S0. FT. ® POWER OUTLET ROOF DRAINS HEATING (FINAL) DRAINAGE PIPING CAR P. I SO. FT. ® GAS (FINAL) TEMP. POLE WALL SO, FT. DRINKING FOUNTAIN SO. FT. ® WATER HEATER URINAL 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 WASHER(AUTO)(DISH) APPLIANCE DRYER INAL INSP. „� GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED �—lo �!.`e U (N�''��/ L�—� Q lI ,�JaGC r1/✓� • ( L� 31J—.i% LAUNDRY TRAY AIR HANDLING UNIT CFM 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 SPARK ARRESTOR SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL e4lCf-ATHING C.�-�t✓-- , SO.FT.GAR ® 3/ac HOUSE SEWER MESH GAS PIPING PERMIT FEE &INSULATION/SOUNDLI PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE TNST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR 6,��WETBACK —a'� 6—ri ROUND PLUMBAG UNDERGROUND A.C. UNIT COLL. AREA t,�AeSLAB GRADE Z �O —�1 UGH PLUMBC/-7�a /—O 7 BONDING HEATING (ROUGH) STORAGE TANK FORMS EWER OR SE5 �K UGH WIRING/ /—" ' DUCT WORK ROCK STORAGE OLIND. REINF.� _�i^ �7 GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IEOUIP. ✓� EINF. STEEL2 —�� %�/ GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM $ GRADING —cu. yd. plus x$ _$ LUMBER GR. ONAL INSP. JeRAMING ('/ �(—S/ INAL INSP. „� Fi00FICJrI/C 3� �—lo �!.`e U (N�''��/ L�—� Q lI ,�JaGC r1/✓� • ( L� 31J—.i% REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL e4lCf-ATHING C.�-�t✓-- , MESH &INSULATION/SOUNDLI FINISH GRADING eZ.&MMAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS, GARDEN WALL FINAL