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002759 (ELEC)Building Address 55-491 Firestcm Owner P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Mailing Address City - Zip ` Tel. . '. Int 92260 . 55&-2828 Contractor .. National MDXtXPW­and land Address No. 002759 BUILDING: TYPE CONST. OCC: GRP. A.P. Number Legal Description Project Description MW Vr.A S t' PfMgR Ill R ' City Zip - Tela State Lic. & Classif., ,��jj. ! Cityr Lic. # Sq. Ft. No. No. Dw. Size • Stories Units Arch., Engr., I Designer _ Newt Add ❑ Alter ❑, Repair ❑ Demolition ❑ j Address Tel. City Zip State -. Lic. # _ . F001 Pedestal 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.. J. l l f'ril �� j r j . i' ;s` r imer ,. : V/,/.j% .. SIGNATURE+y K-.+'• !-w L �-: /� - DATE - OWNER -BUILDER DECLARATION Estimated Valuation 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, atter, improve, demolish, or*repair any structure, prior to its. issuance also requires the applicant for such permit to rile a signed statement that he. is licensed pursuant to 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 that. he is exempt therefrom, and the basis for the Any Section -7031.5 for. Plan Chk. Dep. alleged exemption. violation of by any applicant a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). Plan Chk. Bal.. -- ❑ 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. 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. . 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 Electrical• . of proving that he ditl not build or Improve for the purpose of sale.) - - ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing - struct the project. (Sec. 7044, Business and Professions Coder The Contractor's License Law -_ does not apply to an owner of property who builds or improves thereon, and who contracts for S•M.I: - such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading ❑ I am exempt under Sec. B. & P.C. for this reason Driveway Enc. Date ' owner Infrastructure 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 714 • W 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 thip work for which this permit is issued, I shall not r employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. ` Date ' Owrier NOTICE TO APPLICANT. If, 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 Lender's Name . Lender's Address FINAL DATE INSPECTOR 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. '^ 1 I certify that I have read this application and state that the above information is correct. -� Issued by: iJ`i1�6 Date Permit I agree to comply with all city and county ordinances and slate laws relating to building ` construction, and hereby authorize representatives -of this city to enter the above- mentioned property for inspection purposes.{ r /- /_11 Validated by: Signature of applicant f t %L �' C / � Date "(% -r �� Mailing Address k' Validation: City, State, Zip t A6919 12 15 _ 225•G" CK HARD COPY T CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS SLAB GRADE ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL. SQ. FT. 0 FORMS SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® GAS (ROUGH) METER LOOP GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS GAS (FINAL) TEMP. POLE DRAINAGE PIPING CAR P. SO. FT. GROUT WATER HEATER WALL SO. FT. FINAL INSP. DRINKING FOUNTAIN SO. FT. ® WATER SYSTEM URINAL ESTIMATED CONSTRUCTION VALUATION $ _$ WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM FIRE ZONE ROOFING 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 LATHING SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1Va c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER FINISH GRADING 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 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 APPJEOUIP. REINF. STEEL 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. 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 SIGNATURES/INITIALS, GARDEN WALL FINAL