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08819 (RPL)Building Address 78-7$5 i illeta Owner Paul lauckhorn Mailing Address Sams City zip ,, La Quin 92253 Contractor Western PoG" Address 43•-375 VPadison P.O. BOX 1504 No. 0-8819, 78-105 CALLE ESTADO . LA QUINTA, CALIFORNIA 92253 State Lic. City # j�.5 & Classif. 0531 34875$ 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. A C&_ .0 !A' s ... t J C, , 0 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, 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 lhat.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 pen3fty of not more than five hundred dollars ($500). ❑ I, as owner of the property, cr my employees with wages as their sole compensation, will doithe,work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Professions Code: The"Coniiactor's License Law does not apply to an .owner o/ property who ;':;builds or improves thereon and who does such work himself or through his own employees, P0 that such improvements are not intended or offered for sale. I/, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden o/ proving that he did not. build or improve /or the purpose of sale.) - ❑ 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 o/ 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. B. & P.C. for this reason r 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 O Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATIONINSURANCE (This section need not be completed if the permit is for one hundred dollars (S100) valuation or less.) ' I certify that in the performance of thq 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, alter 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 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 BUILDING: TYPE CONST. OCC: GRP. A.P. Number Legal Description Project Description A00L A� SPA Sq. Ft. No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ 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 Estimated Valuation 13d.00 INSPECTOR PERMIT Date Permit AMOUNT Plan Chk. Dep. Validation: Plan Chk. Bal. 2 93-60 Const. 144.€90 Mech. 24.00 Electrical ' 45.00 Plumbing 27.00 S.M.I. Grading Driveway Enc. Infrastructure r. t,. ,r r�.a. -• w, naraa ,s a ..: n12._,,'3A - dke -14 &A S Ei334.51 Y �v G� 01 T34 -.J1. TOTAL 3 4. 5 i REMARKS 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. SO. FT. ® $ UNITS ROUGH PLUMB. BONDING/� /�a'-�O�� % 2ND FL. S0. FT. STORAGE TANK YARD SPKLR SYSTEM SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. gQ, (T, ® GAS (ROUGH)�� %�j—�( METER LOOP HEATING (FINAL) GAR. SQ, FT. ® POWER OUTLET ROOF DRAINS DRAINAGE PIPING CAR P. SQ. FT. ® FINAL INSP. WALL SO. FT. WATER SYSTEM DRINKING FOUNTAIN. SO FT ® LUMBER GR. URINAL ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP. WA1ER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES VENTILATION 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. SQ. FT. ® c BATH TUB SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL SQ.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 ��—/�— yGl�t ll= GROUND PLUMBING j/—/ y UNDERGROUND//—/,/-- J s A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING/� /�a'-�O�� % HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH)�� %�j—�( METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL ��' /� ' jp r�� 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 // i/ �v /�n �N�� rNcA� REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. ENCE FINAL /�/ U �� INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL