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14577 (DEMO)fie-e��d— P.O. BOX 1504 Building 78-495 CALLE TAMPICO Address $r)89() Vi. ��7qj�{ LA QUINTA, CALIFORNIA 92253 Owner Dave Wise No. 14577 Mailing BUILDING: TYPE CONST. OCC. GRP. Address Sable BS aboVe A.P. Number City Zip Tel. La Quints 92253 775-1860 Legal Description Project Description Dirit1olit"_lon nroi1r to -Contractor Melco Crsn,struci ion rE' odelin aYO eGt. Address 33•-200 Lao -Flores City . - Zip Tela 1000 Palms 192276 343-0096 1 State Lic. & Classif. 683274 City Lic. # Sq. Ft. No. No. Dw. Size Stories Units Arch., Engr., Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State Lic. # - LICENSED CONTRACTOR'S DECLARATION I hereby affirmIthat 1 am licensed under provisions of Chapter 9 (commencing with Section the Business and Professions YCode, and my license is in full force and 700e0) of DivisiorOS+ MA `esti 1 T�•f A ,�_ ;11 "w�'�+� 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 rile 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 rive hundred dollars ($500). O I, as owner of the property, or my employees with wages as their sole compensation, will d0 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 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 knprove for the purpose of sale.) Estimated Valuation `V � h�� PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. COf1St.5+ Mech. Electrical Plumbing ❑ I, 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) Pcensed pursuant to the Contractor's License Law.) ❑ I am exempt under Sec. B. & P.C. for this reason S.M.1. r Grading 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. 3900, Labor Code.) Poli y No. company 1.Copy is filed with.the city. O Certified copy is hereby furnished. TOTAL rx!) + kt U CERTIFICATE OF EXEMPTION FROM • WORKERS' COMPENSATION INSURANCE . REMARKS (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 employ any person in any manner so as to become subject to the Workers' Compensation Laws of California Date Owner NOTICE TO APPLICANT: f, 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. ZONE: BY: Minimum Setback Distances: . Front Setback from Center Line WARNING: FAILURE To SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND'Side SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000)', IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. Rear Setback from Rear Prop! Line Street Setback frO1�;Cent r Line Side Setback from Property Lirie 1N, ~ �� L' / ��—f INSPECT© permit whendefilled out, signed and validated, and is subject to This is a buildingproperty 9 1 expiration if work thereunder is suspended for 180 days. FINAL DATE 11 I certify 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. Issued by.- Validated by: Date -� L-ait f 99 �> j / Signature of applicant Date Mailing Address Validation: City, State, Zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS SLAB GRADE 2ND FL. SO. FT. BONDING YARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. SO. FT. GAS (ROUGH) DRAINAGE PIPING WALL SO. FT. OTHER APPJEOUIP. DRINKING FOUNTAIN SO. FT. ® TEMP. POLE URINAL. ESTIMATED CONSTRUCTION VALUATION $ GROUT WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SYSTEM WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY 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 SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1 I c SEWAGE DISPOSAL GAR. FIREWALL SO.FT.GAR p 3/ac HOUSE SEWER LATHING 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 INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESlINITIALS GARDEN WALL FINAL