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05655 (BLCK)T4'yl 4 f�'.GN,rGv P.O. BOX 1504 No. 05655 Building 54-421 INVERNESS78-105 CALLE ESTADO Address LA QUINTA, CALIFORNIA 92253 Owner ,S"t3MS't3 CO. MailingY ��,.• t BUILDING: TYPE CONST. OCC: GRP. Address . , PGA WEST A.P. Number City Zip Tel. P -WE 29h PAW �� 922606��-^� Y9%�7i6 Legal Description Contractor Project Description 414 L.P. OF 6—PbOT HIGPI 2i�I6Ll�L 1 Address .. - , e w City Zip Tel { State Lic. City 1£ Classif. 288130 Lic. # 398.. , , Sq. Ft. No. No. Dw. Arch., Engr., Size Stories Units Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing withSection 7000) of Division 3 of,the,Business and Professions.Code„ nd my license i5 in full and effect. �l SLGNATURE ? .N Ai . 17 At'.rk✓r �- j��-' f DATE OWNER -BUILDER DECLARATION / Estimated Valuation $10,350.00 I hereby aHirin that 1 am exempt from the Contractors License Law for the following reason: (Sec. 7031.5,13bsioess 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 lie a signed statement that he is licensed pursuant to PERMIT AMOUNT the provisions of the Conbx[ors 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 Plan Chk. Dep. subjects the applicant to a ciW pena9y of rat more than rive hundred dollars ($500). Plan Chk. Bal. ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. 120.00 Professions Code: The Contractor's license Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees, Mech. Provided that such irpmvomenlS are not intended or offered for sale. If, however, the building or improvement is sold w& m ow year of completion, the owner -builder will have the burden Electrical of proving that he did not bui d or irprove for the purpose of sale.) ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to tort• Plumbing struct the project (Sec. 7044, dress and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractors) licensed pursuant to the Contractor's License Law.) Grading .7-7 11I am exempt under Sec a- & P.C. for this reason G Driveway Enc. Date Owner Infrastructure WORKERS' COMPENSATION DECLARATION -- 1 hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. company O Copy is filed with the city. ❑ Certified copy is hereby furnished. TOTAL WOR�KERSFl COMPEFNSSAETIION INSURAON NCE REMARKS! TiRI -110 i63i1WA1'A4Q'') -:0M, 2A - 771ID (This section need not be completed it the permit is for one hundred dollars ($ 100) valuation or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any pers ornion in any manner so as to become subject to the Workers' Compensation Laws of Califa Date owner NOTICE TO APPLICANT f, after maldV this Certificate of Exemption you should become ZONE: BY: subject to the Workers' Conpensation provisions of the Labor Code, you must forthwith comply with Such Provisions ormispemmaShall bedeemed revoked. Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line 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.) Side Setback from Property Line Lender's Name Lender's Address This is a buildingFINAL DATE INSPECTOR permit when properly filled out signed and validated, and is subject to 4120/89 T20/8 `^ expiration if work thereunder is suspended for 180 days �5 7 1 certify that I have read this application and state that the above information is correct. Issued by: Date Permit I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorae representatives of this city to enter the above-. mentioned property for inspection purposes. Validated by: Signature of applicant Date Mailing Address Validation: City, State, Zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SQ. FT. ® $ UNITS SLAB GRADE 2ND FL SQ. FT. BONDING YARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SQ. FT. ® POWER OUTLET I ROOF DRAINS FOUND. REINF. GAS (ROUGH) DRAINAGE PIPING CAR P. SQ. FT. ® OTHER APPJEQUIP. REINF. STEEL WALL SQ. FT. TEMP. POLE DRINKING FOUNTAIN. SQ FT ® GROUT URINAL ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP. WATER PIPING NOTE: Not to be used as property tax valuation WATER SYSTEM 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, TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SQ. FT. ® c BATH TUB SPARK ARRESTOR SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1% c SEWAGE DISPOSAL LATHING SQ.FT.GAR ® 3/ic 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 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 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 PEfiT OCC. CE FINAL 7INSPECTOR'S SIGNATURESIINITIALS r GARDEN WALL FINA \