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07255 (SFD)T4t�t 4 4 Q" Buildin Address 78-350 Vi Deane His Mailing Address 15 Agusta Drive City Zip Tel. �4 c ;� 9 r Zip 92270 ' Contractor Same . Address State Lic. I City & Classif. 509208 Lic. # Arch., Engr., Designer Address I Tel. P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 CityI Zip I State I Lic. # q� LICENSED CONTRACTOR'S DECLARATION I herb affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of�Division 3 of the Business:and•Professi ns Code, and my licA se, is•in fuIl•foCce and I. �l t l! L_. �n G�,a2 ;` SLGNATUR•EL�.J�. \1 If G! DATE OWNMBUILDEJi DECLAFIATION 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 Me 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, o1 not more than fve hundred dallars ($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 Contractors 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 corrmletion, the owner -builder will have the burden of proving that he did not build or ertprove for the purpose of sale.) O 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.) ❑ 1 am exempt under Sec. a, & 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 Js 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 thg work for which this permit is issued, I shall not =any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date owner NOTICE TO APPLICANT: ff, 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 shag be deemed revoked. CONSTRUCTION LENDING AGENCY 1 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.) Lenders Name Lender's Address 'This is a building permit when property filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. 1 certity 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. Signature of applicant Date Mailing Address City,. State, Zip No. 07255 BUILDING: TYPE CONST. 'OCC: GRP. A.P. Number 613-492-004. 009. 010 Legal Description Tent. Tr. Na. 23971 Project Description Phasel A Lot .17 . Sq. Ft. Size 2i�0 No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation i�1=927 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. 286.62 Const. .681.50 Mech. 66. 60 Electrical 118.36 Plumbing ieu, S.M.I. / Grading Driveway Enc. Infrastructure A • ti TOTAL REMARKS .f. •7 'tr✓'3 L+. 1w37 i��.�i,i.F1�� VL IJ �.y�� 1. Lf 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 2/26/90 Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ UNITS COLL. AREA SLAB GRADE YARD SPKLR SYSTEM 2ND FL. SO. FT. HEATING (ROUGH) STORAGE TANK FORMS MOBILEHOME SVC. BAR SINK POR. SD. FT. ® DUCT WORK ROCK STORAGE FOUND. REINF. POWER OUTLET ROOF DRAINS GAR. SO. FT. ® HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL DRAINAGE PIPING CAR P. SO. FT. @ WALL SO. FT. DRINKING FOUNTAIN. FINAL INSP. URINAL SO. FT. WATER SYSTEM ESTIMATED CONSTRUCTION VALUATION $ GRADING cu. yd. $ -Plus-X$-=$ WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. Q [ O Z FLOOR DRAIN MECHANICAL FEES ROOFING /V ! �//2 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 ® 11/4 c SEWAGE DISPOSAL SO.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) c 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. Q [ O Z FRAMING ? �� FINAL INSP. ROOFING /V ! �//2 JTF w` S_ Pre� ��4ta eP ��FIRE REMARKS: VENTILATION ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. �FI(REWALL LA IRG (_q MESH INSULATION/SOUND 2 FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL - INSPECTOR'S SIGNATURES11NITIALS GARDEN WALL FINAL I