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002099 (RPL)Building 55-045 %�S Address Owner ut3II�.�E' Mailing Address 7C.—MR fV7k, sf' Irl', i 0 44 0 tyl d4 P.O. BOX 1504 No. 002099 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 City Zip " Tel. •D t 92960 • 328-2681 Contractor , el.H. Pbol MnstM Address , BUILDING: TYPE CONST. OCC: GRP. -r- A.P. Number _ Legal, Description Project Description 8x14 ' City cat city Zlp 92234 Tel. 328-2681 State Lic. City & Classif._ 275796 Lic. # 69 Sq. Ft. Size No. No. Dw. ..Stories Units -Arch., Engr.; Designer New 1i Add ❑ Alter ❑. Repair ❑ Demolition ❑ Address Tel. City Zip State Lic. # - LICENSED CONTRACTOR'S,D_ECLARATION I hereby,affirm that,l-am licensed under provisions of Chapter 9,(comniencing with Section 7000) of Division 3 of'the Business and Professions•Code, and rimy,lfcense is in full force and' effects /�'� y�/y�� r/j/ �•si.e-. _ SIGNATURE' DATE i 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 io construct, atter, 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'be 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). -- O 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 yorf t�h d� • a:= 10.000.00 PERMIT . x , ' AMOUNT De Plan�Chk. p., - - Plan Chk. Bdl. - 56.22 COr1St . �/� 8 ooz�• .5G - Mech. - - s wl.f� /� .50 builds or imp roves 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.) Electrical �. Plumbing � ��i{i 0 I, 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 of property who builds or improves. thereon, and who contracts for 1 • such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) ❑ I am.exempt under Sec. B. & P.C. for this reason S.M.I. ^ Grading Driveway Enc. Date Owner Infrastructure WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to setf•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. O Certified copy is hereby furnished.' TOTAL REMARKS CERTIFICATE OF EXEMPTION FROM WORKERS'. COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) 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. Date Owrier 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 shell 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.) .. Side Street Setback from.Center Line Side Setback' from Property Line ' Lender's .Name FINAL DATE Issued by: Validated by: Validation: A4-537. INSPECTOR Date"" Permit 3 5_. X8622 CK Lenders Address This is a building permit when properly filled out, sighed and'validated; and is subject to expiration it 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"oity to -enter the above• mentioned property for inspection purposes% ._ _ ,y Signature of applicant-,-_« Date Mailing Address City, State, Zip HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SQ. FT. @ $ 2ND FL. SO. FT. @ FOR. SO. FT. @ GAR. SO. FT. @ CAR P.. SQ. 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 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 APPJEOUIP. 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 SO. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID @ 11/a c SEWAGE DISPOSAL ' SQ.FT.GAR @ 3/ac 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 SETBAgK 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 ROCKSTORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. 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 INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL I V 1f4 wumA I V MCDIIrm I IALA, GARDEN WALL FINAL