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003250 (SFD)6 44 0 . - . I.. .- . . .,.. .. - . . I . 1�.. P.O. BOX 1504 No. 0 0 3, 2 5 Building 78-105 CALLE ESTADO f Address 54-829 In ernean LA QUINTA, CALIFORNIA 92253 Owner • 2'F%nV-J ecus C0fn•w's4!t1t Mailing Address 75-•005 Country Cries Drive, City Zip Tel. Contractor _ izs11�, iI �naL 1 A✓ti�alr��f�lr�€fs & T�� :.. Address ' City MID Tel: BUILDING: TYPE CONST. OCC..GRP. A.P. Number PGA West Legal Description Project Description Phase 23B, Hart 300 State Lic. & Classif. 288130 City Lic. # 328 Sq. Ft.. DWG 2825 Size.'fz.a- • 9;r%R No. -, No. Dw. • Stories Units Arch., Engr., • -- .. -- Designer New ❑ Add ❑ - Alter ❑ Repair ❑ Demolition ❑ Address Tel. Side Setback from Property Line City Zip State Lic. #- Issued by: Date? 11A 101 Permit Validated by: y 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. ,;.R, �� /.e. 1` .t' mitis ^•l`� i f;1 Validation: r �w _ SIGNATURE- DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following .reason: reason: (Sec. 7031.5,Business and Professions Code: Any city or county .which requires a to construct, alter, 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 th Division 3 of e Business and Professions Code, or thathe 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 builds or improves thereon and 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.) - ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-. struct-4he 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 contractor(s) licensed pursuant to the Contractor's License Law.) ❑ I.am exempt under Sec. B. 8 P.C. for this reason EStlmated Valuation � * OCW) -An -PERMIT AMOUNT •..Plan Chk. Dep. - -_ - Plan Chk. Bal. COf1St .. 4711 Q - Mech. Electrical - 1f o m '71 Plumbing 1 74 + n S.M.I.. 4 42 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 ❑ Copy is filed with the city. O Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation orless.) - - - I certify that in the performance of thg work for which this permit is issued, l shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Dt ' TOTAL C< gq9 Alf REMARKS - - nna a 0- N.Aiyo,> 2�7 "' .u..rfi])i i tr'` a e. 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. CONSTRUCTION LENDING AGENCY Ihereby 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, Slate, Zip HARD COPY 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? 11A 101 Permit Validated by: Validation: �w CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. . SQ: FT. p $ 2ND FL. SQ..FT. ® POR. I ( SQ. FT. ® GAR. SQ. FT, ® CAR P. Q. 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. LAUNDRY TRAY AIR HANDLING UNIT CFM TEMP. POLE 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 SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1+/4 c SEWAGE DISPOSAL SQ.FT.GAR Q Y4c 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 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 INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT: OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL 4 DAVE STEAVENS , Inspection Services PROJECT ADDRESS T 1elf q BLDG. PERMIT # ENGINEER �� cAQ0 �� i�,✓c INSPECTION TYPE Page % of I PROJECT # do 0 3- 0 q CLIENT4•-1 Z:> Pt ` DATE :S- ll,)A `( �'t;�o-3 ARCHITECT 6;0(-61,q A ik C Fl CONTRACTOR'I C- (- M A iZ '- INSPECTION REPORT 'IAILS -- YA h'i'-,-7- L-�O`!5 kA1t—iAJ(—- r , ie, t L 70t,-7 r 7Fl�t» 7-L�! r , 1 � �. � r2 CERTIFICATION OF COMPLIANCE: To the best of our knowledge, all of the reported work, unless otherwise noted, substantially complies with approved plans, specifications and applicable sections,of. the building codes. This report covers ,✓ he locations of the iniA inspected only and does not constitute, engineering opinion & project control. NO. T. ®7�)� y ..,c�,,„ y INSPECTOR NAME • aj (� � tit,. AJ CJ 5 CER ,y� �q �/ ON p (Prini leery) DATE Sf�r/Y ! a'1.,c° o 3 f t ) INSPECTOR SIGN ATUR pit ;c t. JE ,