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002186 (RPL)P.O. BOX 1504 N o. 002186 Building 78-105 CALLE ESTADO '• Address 90-35-5 ]Z BB=h LA QUINTA, CALIFORNIA 92253 Owner Mailing* ' Address 75-005 Cbuntw Club D.. City Zip Tel. ftsert 92260. 568-!-282V,,, Contractor Address 68-465 Femz RDad ' City ...... _ Zip , • Tel.' _ State Lic. I City & Classif. 275796 Lic. # 69— Arch., Arch., Engr:, Designer' Address Tel. BUILDING: TYPE CONST. OCC: GRP: ' A.P. Number Legal Description Project Description Vim C 1 20.x 30 .. _ spa ID X 10 Sq. Ft. No. No. Dw. Size Stories Units New ❑t . Add ❑ Alter ❑ 'Repair ❑ Demolition ❑ ..... POOL A City Zip State ... Lic. #F :F;' ENCE LICENSED CONTRACTOR'S DECLARATION • I hereby affirm that I am -licensed under Provisions of Chapter 9 (commencing with'Section 00) • 70of Division 3 of.Uie Businessyannd Professions Codeand my license is in full force ander - AL effect. +�` ,/. *; ,,,i • i -Y'. civ'' r`..• r �•+.,.::.•-._..j.,.i t' SIGNATURE DATE _ OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's. License Law for the following Estimated Valuation .9 reason: (Sec. 7031.5,Business and Professions Code: Any city. or .county •which requires, a permit to construct, alter, improve, demolish, of repair any structure, prior to its issuance also -' - M-.•. " 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, .Chapter 9.(commencing with Section 7000) of - _ "Division 3 or the'Susiness and Professions Code, or"that. he isexempttherefrom,- and the basis•.. for. the alleged exemption. Any Section 7031.5 by 'any -applicant for -a ._ -' Chk.. Dep.• violation of • permit subjects the applicant to a'civil penalty of not more lhan'live hundred dollars ($500). ' .. :Plan _ -. . .. Plan Chk. Bal. 0 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 Const. `34}s.i7i Professions Code: The Contractor's License Law does not apply. to an owner of•properly, who builds. or Improves thereon and who does such work himself 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 14. " of proving that he did not, build or improve for the purpose or sale.) , . - _ - .. .•V ' 0 1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing • �iG struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law - does not apply to an owner of who builds or improves thereon, for S.M:I. 14 properly and. who contracts • such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) - . . + - '0 Grading 1 am exempt under Sec. B.-& P.C. for this reason _ 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 0 Copy is filed with the city. . 0 Certified.copy is.hereby furnished. _-' , TOTAL 3iU •? CERTIFICATE OF EXEMPTION FROM REMARKS • 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 thg work for which this permit is issued, I shall not - - - employ any parson 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 or Exemption you should become ZONE: BY: subject to the 'Workers' C6thperisation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. .Minimum Setback Distances:- 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.) - , „ - - ine Side Setback from.Property Line— Lender's 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. certify I have this : • ^ . . �� "' .I .that read application and state that the above information is .correct. ' I agree .'Issued by: Date, Permit 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. ,, f Validated by: Signature of applicant t r Date �' Mailing Address - f. Validation: City, State, Zip A4%..98. 3 17.y. 5...60.26 S1• - ' HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SQ. FT. ® $ 2ND FL. SQ. FT. ® POR. SO. 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.000L HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APP.IEQUIP. LAUNDRY TRAY AIR HANDLING UNIT CFM TEMP. POLE 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. SO. FT. @ c BATH TUB SQ. FT. ®c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL SO.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 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 APP.IEQUIP. 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 SIGNATURES/INITIALS GARDEN WALL FINAL :1