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07579 (SFD)414 a9ba. P.O. BOX 1504 Building 78-105 CALLE ESTADO Address 488-539 Via Encanto LA QUINTA, CALIFORNIA 92253 Owner Abe A Thelma Grossman Mailin Address 9010 C04in AVenlue, S-3 City Zip Tel. Northridge 1 91324 1 818-349-5894 Regal Homes** Inc. Address 3184 Airmy Avenue City Zip Tela• Costa i 92526 State Lic. City i£ Classif. 446687 Lic. # Arch., Engr., Designer Address 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 the Business and Professions Code, and my license is in full force and effect. SIGNATURE 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 thathe 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 applytoan 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.) 0 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.) O 1 am exempt under Sec. B. & P.C. for this reason Date *f',.Y 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 ($100) valuation or less.) .1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. - CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration it work thereunder is suspended for 180 days. I certify that'l have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives -of this city to enter the above- mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip No. LDING: TYPE CONST. • I OCC: GRP.: P. Number 07579 Legal Description Tract, 2nnsp .Ra Q]aa IS Project Description Lot 11 ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property.Line FINAL DATE INSPECTOR Issued by: Date 4/19/9ermit Validated by: Validation: Sq. Ft. Size 1$ No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation 410a22 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. US 4113 Const. Mech. Electrical Plumbing 5 S.M.I. 2 Grading Driveway Enc. Infrastructure TOTAL REMARKS nrsex a ie/��t�a�p nk syna�nt�.�g> -_ rs ,rsCA� a yt7rlva 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 4/19/9ermit Validated by: Validation: t I CONSTRUCTION ESTIMATE 4 NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS COLL. AREA 2ND FL. SQ. FT. ® s' ROUGH PLUMB. YARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. Sq, FT. ® POWER OUTLET ROOF DRAINS t CARP. SQ. FT. DUCT WORK DRAINAGE PIPING 3 �AS (ROUGH)GJ_ METER LOOP WALL SQ. FT. ® HEATING (FINAL) DRINKING FOUNTAIN. ° Sq, FT. ® GAS (FINAL) URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation WATER HEATER FLOOR DRAIN MECHANICAL FEES FINAL INSP. WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GRADING cu. yd. plus x$ GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FINAL INSP. LAUNDRYTRAY AIR HANDLING UNIT CFM 946ROOFING -7-11-20 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 SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR ® Vic HOUSE SEWER 66ATHING GAS PIPING PERMIT FEE MIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE FPL.CK.FEEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK ROUND PLUMBIN2S UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS WER OR SEPTI ROUGH WIRING DUCT WORK ROCK STORAGE 4 FOUND. REINF. /� �AS (ROUGH)GJ_ METER LOOP HEATING (FINAL) OTHER APPIEOUIP. i REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. i BOND BEAM WATER SYSTEM $ GRADING cu. yd. plus x$ -$ LUMBER GR. FINAL INSP. RAMING %� /�j/ FINAL INSP. 946ROOFING -7-11-20 Ql> T o G✓�n� _ / Gs✓ �G� � V R/• i/v /�i-(/Cl / �V REMARKS: VENTILATION FIRE ZONE ROOFING' FIREPLACE SPARK ARRESTOR GAR. FIREWALL 66ATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. a FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL