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05961 (SFD)Tihf 4 P.O. BOX 1504 No. 05961 Building �� 3�i38t8 7&105 CALLE ESTADO Address •LA QUINTA,..CALIFORNIA 92253, Owner Barcon Dev. Mailing . «.. Address 68-e7I3 Peres 11d. # 1 CityZip Tel. Cat city 92234 1 773-9024 Contractor Address ity lZip JTel.' State Lic. City 8Classif. 337€77 Lic- # 1219 Arch., Engr., .: Designer Address Tel. City(Zip I State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Divisio ofle BusinessandProfessions Code, and my license is imtfull force and SIGNATURE ^'• DATE OWNEWBUILDER DECLARATION I hereby affirm that I am exempt from the Contractors License Law for the following reason: (Sec..7031.5,Business and Professions "Code: Any City or county which requires a permit to construct, after, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to Me a signed statement that hes licensed pursuant to the provisions of the Contractor's License Law, Chapter 9(conxnenchif with Section 7000) of Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the bass for the alleged exemption. Any violation of Section 7031.5 Dy arty applicant for a permit subjects the applicant to a civil penally 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 appy 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. ff, however, the building or improvement is sold within one year of completion, the owner -budder wig 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 con• struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not appy to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors 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 pennif 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 =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 rift 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 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 • ILDING: TYPE CONST. OCC: GRP.- '.Number RP.'.Number Legal Description Project Description Phaae III TLOt 23 Plata 1740 Pear T>1n fhT "tn Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Sq. Ft. 1740 Size No. Stories No. Dw. Units NeWF❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Issued by: Date Permit Validated by: :,Validation: Estimated Valuation 88,574.00 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. yy• Const.• Mech. • Electrical ' Plumbing igt3• S. M.I. Grading Driveway Enc. Infrastructure 1992.92 TOTAL 3373.00"5 fr ":5, Z' J. REMARKS 171*; `H $.'�sM7'.'e .ft•.ws..s: +jii al �.'kl� 'h . 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 Permit Validated by: :,Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS SLAB GRADE �D ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL. SQ. FT. FORMS SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. Sp. FT. ® (ROUGH) METER LOOP HEATING (FINAL) POWER OUTLET ROOF DRAINS GAR. SO. FT. ® GROUT DRAINAGE PIPING CAR P. SQ. FT. ® FINAL INSP. BOND BEAM WATER SYSTEM DRINKING FOUNTAIN. WALL SD. FT. =$ LUMBER GR. // 6NJAL INSP. -12 FRAMING URINAL SQ. FT. O — C?.s7 ESTIMATED CONSTRUCTION VALUATION $ REMARKS WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES FIRE ZONE ROOFING: 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, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER. B.T.U. SO. FT. ® c BATH TUB SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1 Vi c SEWAGE DISPOSAL SO.FT.GAR ® 3/<c HOUSE SEWER FENCE FINAL 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 PLUMBIN UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE �D ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. !_ l� (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ =$ LUMBER GR. // 6NJAL INSP. -12 FRAMING FINAL INSP. ROOFINGN VENTILATION O — C?.s7 REMARKS FIRE ZONE ROOFING: FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING 2- j G MESH Ok4NSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL 1