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003228 (SFD)•44 Aj P.O. BOX 1504 No. 03228 Building 78-105 CALLE ESTADO Address 54-864 Inverness LA QUINTA, CALIFORNIA 92253 Owner .. ... BUILDING:" TYPE CONST. OCC: GRP. Mailing Address 75-005 Country Club Drive` A.P. Number PGA West City Zip Tel. Palm Desert -l---- 92260 568•-2828 Legal Description Contractor26 Project Description Phase s Plan2� National gortaaae Land Address. City Zip Tela State Lic. City & Classif. 288134 Lic. # 328 Sq. Ft. P"+P:"Ib%3 No. No. Dw. Arch.; Engr.,' Size 'BAR - -424 Stories Units Designer. New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. CityZip State _ Lic. # ." / LICENSED CONTRACTOR'S DECLARATION, I hereby affirm thatd 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 fulPforce ands" effect...�1 n i '`! Y%Yr1'J.�+i*'f �_% /lel- 1k _SIGNATURE i J f ' `" - DATE OWNER -BUILDER DECLARATION Estimated Valuation 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, 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 -PERMIT AMOUNT the provisions of the Contractor's License Law, Chapter9 (commencing with Section 7000) of =r Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the. basis - Plan Chk. Dep. for the alleged exemption. Any violation of Section 7031..5 'by_ "any applicant for ^-a permit • subjects the applicant to a civil penalty ofnot more than five hundred dollars ($500):' - . ❑ I, as owner of the property, or" my employees with wages as their sole compensation, will Plan Chk. Bal. 3(J4 . 65 do the work, and the structure is not intended or offered for sale. jSec. 7044, Buisness and 'Const.' 483. 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 tha( such improvements -are not intended or offered for, sale. If; however, the building 42. 00 or improvement is sold within one year of completion, the owner -builder will have the burden Electrical •� 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- Plumbing struct the project. (Sec.. 7044, Business and Professions Coder The Contractor's License -Law - 92- IDID does not apply to an owner of property who builds or improves: thereon, and who contracts for S•M•I. - -� Asuch projects with a contractor(s)-licensed pursuant to the Contractor's License Law.) - Grading " ❑ I am exempt under Sec. B. & P.C. for this reason Driveway Enc. Date Owner Infrastructure WORKERS' COMPENSATION DECLARATION I hereby'affirmthat 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.. " ❑ Certified copy is hereby furnished. -TOTAL. CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE " ' "* n -s " r "" r R '? This section need not be completed it the ( ) ?�`r`. '•�4�j�P'.�F �+'/y� 1�-�+' �'+�}t�� jty �•�^ ( P perm!('fs for one hundred dollars $100 valuation I certify that in the performance of the 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,, after making this Certificate of. Exemption you should become ZONE: - BY: ' subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Minimum Setback Distances: . comply with such provisions or this permit shall be deemed revoked. - - - 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 FINAL DATE INSPECTOR 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. Issued" by: Date719 4;197 Permit 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. Validated by: _ Signature of applicant Date Mailing Address Validation: City, State, Zip HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ 2ND FL. SQ. FT. FOR. SQ. FT. ® GAR. SO, FT, ® CAR P. SQ.,FT. WALL SQ. FT. ® SO, 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.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER AS (ROUGH) ,/ GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APP./EQUIP. 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. SQ. FT. ® c BATH TUB FRAMING /b i / SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1% c SEWAGE DISPOSAL SO.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 GROUND PLUMBI UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE 191-711r7 OUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER ORS T C A ROUGH WIRING !� �6 DUCT WORK ROCK STORAGE n FOUND. REINF. (/ AS (ROUGH) ,/ 177 METER LOOP HEATING (FINAL) OTHER APP./EQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM FINAL INSP. o FINAL INSP. % 2 % C7 $ GRADING cu. yd. plus x$ _ $ LUMBER GR. FRAMING /b i / /� ROOFING i•� VENTILATION` / !-/ 51�^4 71y 04 �� y ?/y REMARKS: FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL • LATHING (,V 2O MESH INSULATIONISOUND , t1,Z FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL