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10965 (SOTB)4 P.O. BOX 1504 f No. 10965 Building q 7 7&105 CALLE ESTADO Address -428-2 9 V5.1; bib De I�3opal LA OUINTA, CALIFORNIA 922555333 Owner (:r . M William Ginny Houze Mailing BUILDING: TYPE CONST. OCC. GRP Address Same City Zip Tel. { L -a Quints 92253 564-6400 Contractor O er/Buildej: Address I State Lic.. City &IClassif. Lic. # Arch., Engr., Designer Address c ity I Zip I State Lic. # LICENSED CONTRACTOR'S DECLARATION I' hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section c''7D00) of Division 3 of the Business and Professions Coand my license is in full force and effect de, .SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractors License Law for.the following reason: (Sec. 7031.5,Bustness and Professions Lode: 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 lite a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing ng 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 five hundred dollars ($500). CyI, 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 untended or offered for sate. If, however, the building or l 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.) - ❑ I I, as owner of the property, am exclusively contracting with licensed contractors to con - stfuct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property -who bndds or iproves thereon, and who contracts for . such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) - r 0'1 am exempt under Sec. w, & P -C_ for this reason -- - Date OwneiJ `�"--�"^ WORKERS' COMPENSATION DECLARATION kehereby affirm that I have a certifieate'of consent to self -insure, ora certificate of Worr's.Compensation Insurance,ora certified copy thereof. (Sec. 3800, Labor Code.): Policy No. Company ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. a 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.) - 1 I certify that in the performance of thprwork^for'whish this permi{is issued, I shall not employ any person in any manner-so`as to, become subject to the Workers' Compensation Laws of California. Yr G=,� •> Date Owner NOTICE TO APPLICANT'y after makbg this Cerfificate-of Exemption you ,should become subject to the Workers' Compensation' provisions of the' Labor Code, you must - forthwith comply with such provisions or this pem* shag be deemed revoked. ' 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, Chd Code.) Lender's 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. I certify that I have read this application and state that the above information is correct. I agreeto 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. r Signature of applicant Date Malling Address City, State, Zip A.P. Number Legal Description Project Description Sun Porch Enclosure Sq. Ft. Size No. No. Dw. Stories- Units New ❑ Add ❑ Alter ❑ Repair ❑ -Demolition ❑ NUTS: Not to be conditioned Space Estimated Valuation 200.00 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. 30.00 Mech. Electrical, ' Plumbing S.M.I. Grading t ' Driveway Enc. Infrastructure TOTAL $3��;�0t}h13' `fes `41j R `� :...4.•tt+,y 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. ® $ 2ND FL SQ. FT. POR. SQ. FT. ® GAR. SQ. FT. ® CAR P. SQ. FT. WALL SQ. FT. ® SQ FT ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK _ ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN. URINAL WATER PIPING NOTE: Not to be used as property tax valuation BONDING FLOOR DRAIN MECHANICAL FEES FORMS WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APPJEQUIP. LAUNDRYTRAY . AIR HANDLING UNIT CFM TEMP. POLE 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 ® 11/4 c . SEWAGE DISPOSAL SO.FT.GAR ® V4c HOUSE SEWER REMARKS: 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 c� /� FOUND. REINF.� I) _ ry2— ����//// ✓ [ GAS (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. 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 SIGNATURESIINITIALS GARDEN WALL FINAL &War�uzs ©c MANAGEMFJYT GROUP and approval from the City, of La `quinta. Pleasesubmit copies-of::permitsuoon- receint frnm thA REGIONAL OFFICES hvine . • Rancho Cucamonga i San Clemente 9 SouV' Bay 9 Coachella Valley 9 San Diego Unit Date O .y fV z '�[ q Street Address. [,r Local.Phone 76 O 71 Other Phone To the Architectural Committee: We, the undersigned owners, request your approval of the modifications..proposed on the reverse side of this form. Attached are drawings of the work to .be done; types of material to be used .are indicated an the drawings. We understand tnat building permits for home improvements are I{, required by theCity of La Quinta and that the cost of the' permits an.d.responsibility of obtaining permits and subsequent inspections will,be borne by -us. Ji We ackowledge that all approved changes in the original design will be at our expense; that any damage to or "relocation of existing sprinkler systems, underground utilitiesr building structure an d exterior lendsca in P 9 0r other damage .resulting from construction of these permitted improvements will beatour expense; and that maintenance' of the permitted improvements will be at our expense. SYgnature of all owners: