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05498 (SFD)Building 48-121 Vista Cielo P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 -f-- --- Abe 6 Thelma Grow mna Mailing Address 9010 Corbin Ave. 8.3 City Zip Tel. Northridge 91324 8181349-5594 Contractor James C. CasIman 73-200 Itivams eta Pali Desert I 922€0 1 6191345-5430 State Lic. I City &+Classif. 8 195333 Lic. # 260 Arch., Engr.; Dm esigner Address Tel. e. City Zip State Lic. # I LICENSED CONTRACTOR'S DECLARATION I herebyy.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 SIGNATURE -z DATE { OWNER -BUILDER DECLARATION . `1 I, hereby affirm that I am exempt from the Contractor's License Law for the following reasoh: ••(Sec. 7031.5,8rrsiness 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 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 oW 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 Contractors License Law does not apply to an owner of property who builds or improves thereon arid 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.) 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 contraotor(s) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec B. & P.C. for this reason Date Owner I WORKERS' COMPENSATION DECLARATION j I hereby affirm that 1 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 I' z Copy is filed with the city- ❑ Certified copy is hereby furnished. ! CERTIFICATE OF EXEMPTION FROM n WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less.) • I I certify that in the Performance of thr. 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: fl, after making this Certificate of Exemption you should become subjectto the Workers' Compensation provisions of the Labor Code, you must forthwith comply with Such provisions or this permit sha8 be deemed revoked. r j CONSTRUCTION LENDING AGENCY I 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. 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 I No. 05498 BUILDING: TYPE CONST. OCC: GRP.. A.P. Number 617-444-047 Legal Description Lot 47 Project Description Pira 3 Sq. Ft. 1852 Size - No. No. Dw. Stories Units New Add ❑ Alter ❑ Repair ❑ -Demolition ❑ Estimated Valuation �1�2,22ti•t1 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. 45.4: Const. Mech. ��• Electricali- �' .• 1 Plumbing « S.M.I. 7.21 Grading Driveway Enc. Infrastructure f+3 •�' Fringe -toed TOTAL REMARKS �• .. s�rsrsrahl, . t -i- nn ts3 •iaabrV Yew>rns>�Y-t [a . � ..✓.a'uY�ITU.tS .a "1-iSltl," �"' f.1Y_�IV+�.IJr ZONE: BY: Minimum Setback Distances: . Front Setback�fiom Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR 3114189 Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS �< ROUGH PLUMB. BONDING 2ND FL. SO. FT. STORAGE TANK YARD SPKLR SYSTEM SEWER OR SEPTIC TANK ROUGH WIRING. MOBILEHOME SVC. BAR SINK POR. SO. FT. ® AS (ROUGH)49 METER LOOP ! HEATING (FINAL) GAR. SO. FT. ® POWER OUTLET ROOF DRAINS DRAINAGE PIPING CAR P. SO. FT. ® FINAL INSP. WALL SO. FT. WATER SYSTEM DRINKING FOUNTAIN. SO FT ® LUMBER GR. INAL INSP. - o URINAL ESTIMATED CONSTRUCTION VALUATION $ d �� L��• Q v - WATER PIPING NOTE: Not to be used as property tax valuation 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, 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+/a c SEWAGE DISPOSAL SO.FT.GAR ® 3/ac HOUSE SEWER 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 I. 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. /A GG AS (ROUGH)49 METER LOOP ! HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL 01L GAS (FINAL) •(7 TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ =$ LUMBER GR. INAL INSP. - o FRAMING FINAL INSP. ROOFING �� VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING -i/ got MESH INSULATIONISOUNDUg FINISH GRADING FINAL INSPECTION CERT. OCC. d �� L��• Q v - REMARKS: - GNSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL