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001791 (SFD)P.O. BOX 1504 Building 78-105 CALLE ESTADO Address 55~009 LA QUINTA, CALIFORNIA 92253 Owner X80 Mailing Address 75-M5 t9Xmtty Mvib Drive City Zip Tel. Palm � . 92260. • 568--28 : Contractor i`1 Lamd and MDXtQ.. Address No. 001791 t 11LDING: TYPE -CONST. OCC. GRP. P. Number _ ;gal Description oject Description Tim 10 OR City sa Zip Sam Tela same_ State Lic. & Classif. City Lic. # 32s S 2272 Sq. Ft. No. No. Dw. Size GAR - -582 Stories •1 Units - 1 Arch.; Engr.; _ Designer Whexi A1tMV A.9=6' New E Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. 2915 Red RM -Ave. #710 54O 5117 City State 00_1*a t JZip Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm,thet I am licensed under provisions of Chapter 9 (commencing withSection 7000) of Division 3 of the Business and Professions Code, and my license is iinn.full,force`and.,/ ' ' _ •, .._ - ,• _ - _ SIGNATURE "'^ r w IX DATE " OWNER -BUILDER DECLARATION ' ' I herebyaffirm that I am exempt from the Contractor's License Law for the following � P 9 reason: 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 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 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 subjects'the applicant to a civil penalty of not more than five hundred dollars (8500). ❑ I, as owner. of the property, or my employees with wages as their sole compensation, will _ do e work, and the structure is not intended, or offered for sale. (Sec. 7044, Buisness and tfi Professions Code: The Contractor's License Law does not' apply to an owner of property iwho 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:) O I, as owner of the property, am exclusively contracting with licensed contractors to con- 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 such.projects with a contractor(s) licensed pursuant to the Contractor's License Law.) O 1 am exempt under Sec. B. & P.C. for this reason 1� ��qq Estimated Valuation 144,,517.00- � �.F4 � ��. iTQ ' - - PERMIT - AMOUNT _ - - Plan Chk. Dep. Plan Chk. Bal. Y62 sv9 Ci COr1. �p r St545.50 Mech. " 55.00 Electrical 102.17 Plumbing M.50 - S.M.I. '_ 9.84 . Grading Driveway Enc. _ Date Owner Infrastructure 2y�. 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. s�y TOTAL 3.303..'N REMARKS CERTIFICATE PE EXEMPTION FROM . WORKERS' COM PENSATION-INSURANCE - (This section need not be completed if the permit is for one hundred dollars (8100) valuation or less.) 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. &W S. -A x a AN..♦; OF Purl—El 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 Side Street Setback from reenter 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 FINAL DATE INSPECTOR 11-13-85 Issued by: Date Permit Vafldated by: Validation: A 3 1 9 0 11 13, _•3S ,390 CK, 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 r? r r �_+fk :? Date�fr/ ��y ddress µ r ) Mailing Address— City, State, Zip City, f HARDCOPY CONSTRUCTION ESTIMATE `' NO. ELECTRICAL EE2j NO. PLUMBING FEES IST FL. SQ. FT. ® 2ND FL. SQ. FT. ® POR. SQ. FT. ® GAR. SQ. FT. ® CARP. SQ. 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 SLAB GRADE ! 3 FLOOR DRAIN MECHANICAL FEES BONDING WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER SEWER OR SEPTIC TANK— GARBAGE DISPOSAL FURNACE UNIT . WALL FLOOR SUSPENDED DUCT WORK LAUNDRY TRAY AIR HANDLING UNIT CFM FOUND. REINF. KITCHEN SINK ABSORPTION SYSTEM. B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR - HP POLE, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER. B.T.U. SQ. FT. ® c BATH TUB GROUT SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 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 r GROUND PLUMBINGJj,' i UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ! 3 k4 ROUGH PLUM BONDING HEATING (ROUGH STORAGE TANK FORMS a SEWER OR SEPTIC TANK— ROUGH WIRINO2 •� cJ �— DUCT WORK / ROCK STORAGE FOUND. REINF. GAS'(ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) .f / �D TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ _$ LUMBER GR. FINAL INSP. FRAMING `; / ✓ b FINAL INSP ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND3 ,, 6 FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL - INSPECTOR'S SIGNATURESIINITIALS• GARDEN WALL FINAL