Loading...
002231 (SFD)Building Address 54-940 1nVC=M s ' Owner sum -i m Oil ' Mailing ` Address 75—M COMA Club City Zip P—Desert 92260 Contractor 14ttl mxtffilm and L _Address , 4"im-mo City Zip State Lic. & Classif. 288130 Arch., Engr.;' - Designer 4 P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 No. 23.4 BUILDING: TYPE CONST. OCC: GRP.- A.P.-Number RP.A.P.Number el. 568-2828 Legal Description Project Descriptiont` PIM 40. 7B, ... City' VIM3142 Lic. # 328 S4 Ft. No. Size • b'* • 589- -Stories New CJ. ,,. Add ❑ Alter ❑ No. Dw. Units Repair ❑ Demolition ❑. Address Tel. Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line ' CityZip State _ Lic. # Issued by: Date 4,!,7*"0,6 Permit r _• LICENSED CONTRACTOR'S DECLARATION _. I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) ' S++ A51 -1Z of.Division 3 of the Business and.Professions Code, and my'license is in full force and effect ,SIGNATURE' •SIGNATURE' '; 'Y �•' .+'r• "- `--�—..+' W DATE f/ J r '�JOWNER•BUILDER DECLARATION _ I hereby affi m that I am exempt from the Contractor's. License Law for the following 7031.5,Business Code: Any Estimated Valuation ; try q A reason: (Sec. and Professions ,city or.county,which requiress-a permit to construct. atter, improve, demolish, or repair any structure, prior. to its issuance also I J .0 the. applicant, for such permit to file a signed. statement that he is licensed pursuant to PERMIT • r AMOUNT the provisions of the Contractor's 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. violation Section 7031.5 by 'any for Plan Chk. Dep. alleged exemption. .Any of .applicant a. permit subjects the applicant to a civil penalty of not more than Five 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 Coflst. 18. 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 workhimself or through his own employees, - ' Mech._ ©� - 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 ' Electrical. •' • " $2€3.fi of proving that he did not build or unprove for the purpose of sale.) _ ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-. Plumbing 140.50 • slruct the 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 S.M.I. 13.83 such 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 2*000.00 WORKERS' COMPENSATION DECLARATION 4 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. 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 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 _ 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 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 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. ;', / • 1 Signature of applicant ; 1 - rl.., _ Date Mailing Address City, State, Zip J, L! ` r l HARD COPY TOTAL 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 4,!,7*"0,6 Permit r Validated by: Validation: A51 -1Z 4 8 58C 17 U