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06935 (SFD)T4bf 4 4 a" P.O. BOX 1504 Building 76-595 via Ct9rrido7&105 CALLE ESTADO Address LA OUINTA, CALIFORNIA 92253 BARCON DEVELOP14ENT Address 68-713 Perez Road, #1 CiityCathedral City Zip 92234 Te,173-9024 Contractor 5AHL ress City Zip &tCla. City ssif. 337077 I Lic. # 1219 Arch., Engr., Designer Address Tel. City Zip State Lic. # J LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed underorovisions of Chapter 9 (commencing with Section 7000) of Divis'ion,3roffethe Business and Professions Code, and my license is in full force and offect / //.etre%,+' • /�9% ,�i �lrf I 11 �✓�i= !� 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, pnor 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 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). ❑ 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 Contractor's License Law does not apply to an owner of properly 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. ff. however, the building orimprovement is sold within one year of completion, the owner -budder will have the burden of proving that he did not build or improve for the purpose of sale.) ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to torr 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. & 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 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. CERTIFICATE OF EXEMPTION FROM 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 the work for which this permit is issued, I shall not employ any pperson in any manner so as to become subject to the Workers' Compensation Laws of Catifomia Date Owner NOTICE TO APPLICANT. h, 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. 1 agree to comply with all city and county and 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. x}6935 BUILDING: TYPE CONST. OCC: GRP. Tract #21555.5, Phase V A.P. Number Legal Description Project Descriptio PARC LA QUINTA € tan 2222 (D). Lot #6 Sq. Ft. 2222 Size No. Stories No. Dw. Units New[X Add ❑ Alter ❑ Repair ❑ 'Demolition ❑ Estimated Valuation X112,161 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. 5 ou Const. Mech. W. U0 Electrical lZ0.79 Plumbing S.M.I. 7.91 Grading Driveway Enc. Infrastructure ?_0!6Z3. b3 , • TOTAL 4� 1..3 '� REMARKS •) +11.775 ZONE: BY: Minimum Setback Distances: Front Setback from Center. Line Rear Setback from Rear Prop. Line Side Street Setback from Centel Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ UNITS SLAB GRADE ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2NQ FL SO. FT. FORMS d SEWER OR SEPTIC TANKj( q0 Q ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SO. FT. ® GAS (ROUGH) �q T d �(� I l GAR. SO. FT. ® POWER OUTLET ROOF DRAINS REINF. STEEL GAS (FINAL) DRAINAGE PIPING CAR P. SO. FT. ® GROUT WALL SO. FT. SERVICE DRINKING FOUNTAIN. BOND BEAM URINAL SO FT ® GRADING yd - $ -plus-x$-=$ ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP.—3r—ggL 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 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 ® 1+/4 c SEWAGE DISPOSAL J p INSULATIONISOUND l SO.FT.GAR ® 3/4c 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 GOND. SOLAR SETBACK GROUND PLUMBING ` 1V) {7 M1 UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS d SEWER OR SEPTIC TANKj( q0 Q ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) �q T d �(� I l METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING yd - $ -plus-x$-=$ LUMBER GR. FINAL INSP. C I'c 0 Q0&,_cu. c FRAMING FRAMING 2 �,, ,Y1Q0 - FINAL INSP.—3r—ggL ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING q13 -1,j 1 `C �✓�— MESH J p INSULATIONISOUND l FINISH GRADING FINAL INSPECTION [ '3 w' _ l qj CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL:d 1