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003222 (SFD)ti 4 P.O. BOX 1504 No. 003222 Building 78-105 CALLE ESTADO Address 54--824 InVerrsesss LA QUINTA, CALIFORNIA 92253 Owner ...... Mailing Address City 1pd _. x .halm Desert 92260 Contractor .1 . National Mort4a Address BUILDING: TYPE CONST.:OCC: GRP.. .►,.. , t... A.P. Number PGA Tiest �"- Legal Description ' Project Description rr�ase 266 Plan !.MRfit lir&n- HARD COPY City Zip Tela State Lic. & Classif. .. 208130 City Lic. # Sq. Ft. DWa 16.27 No. No. Dw. Size - G -424 • Stories • Units Arch:; Engr., .. Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State - Lic. # A 'i 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.;fc% 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,,' after, improve, demolish, or repair any structure, prior to its issuance also requires the:applicanutor 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 b/'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): • ❑ 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 contractor's License Law does not apply to an owner of property who Estimated Valuation. � .� ,. Ail PERMIT AMOUNT ,a Plan Cihk. Dep. Plan Chk. Bal. 38044 • Const. ��.� • builds or improves thereon and who does such work himself or through his own employees, provided that such improvements, are not intended,or of/eyed./or 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.) Mech. - •'�� • Electrical -I +y `�# ,. 41 , Plumbing 87. 50 ❑ 1, 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 orimprove8 thereon, and who contracts for such projects -with a contractor(s) licensed pursuant to the Contractor's License Law.) O [am exempt under Sec. • B. 8 P.C. for this reason . . S:M.I.• t> C.A 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. 3800, Labor Code.) Policy No: . Company O Copy is filed with the city. q Certified,copy is hereby furnished. TOTAL $2,751 .21 - _ � CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed i/ the permit is for one hundred dollars ($100) valuation .. or less.) . .. - - •. -ty 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. REMARKS • 2 _ (`j t`j�y�i_�i? ,rj.%� Cic,+,}rti. b—ry^spy ,� •){ � i+HJ CI 2 y v e rv� -. Date' Owner NOTICE TO APPLICANT: If, 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 Rear Setback from Rear Prop. Line 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 Side Street Setback from Center Line Side Setback from Prope.rty.Line Lender's Address FINAL DATE INSPECTOR Issued by: Date .15 8%Permit Validated by: 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 ciy 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 Validation: City, State, Zip HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. 50. FT. ® $ 2ND FL., SO. FT. POR. SO. FT. ® GAR. SO. FT. ® CAR P. SO. FT. WALL SO. 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 COLL. AREA FLOOR DRAIN MECHANICAL FEES ROUGH PLUMB. WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASIAER(AUTO)(DISH) APPLIANCE DRYER FORMS GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED ROUGH WIRING LAUNDRY TRAY AIR HANDLING UNIT CFM DUCT WORK 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. SO. FT. ®c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1114 c SEWAGE DISPOSAL WATER HEATER SO.FT.GAR p 3/4c HOUSE SEWER FINAL INSP. GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FE PPL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK Of GROUND MB NG~NDERGROUND ;j2 A.C. UNIT COLL. AREA SLAB GRADE (tl/r"609z ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS 01 SEWER ORS PTI TANK k ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REI NF. / e5l aAS(ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM '$"plus GRADING yd. x$ _$ LUMBER GR. /D ;0 FINAL INSP. IV/04 FRAMING /v '�� ®� INAL INSP. ROOFING /dL S /vl Z � �� �J (/• �� J . /C/ dl, 2, REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING 4- V/L,/ ® MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS, GARDEN WALL FINAL