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002230 (SATT)* 4 . 44.. 0 hf Qgk&.- P.O. BOX 1504 Building 80-388� Address LA QUINTA, CALIFORNIA 92253 Mailing Address*7 CA 4fflm _S"h � _ City Zip - Tel. Det 922£0 .55,68-4828 Contractor watl aqe and Land Address No.. 002230 11LDING: TYPE CONST: OCC: GRP., P. Number !gal Description oject Description PIA TOM MAN 40 0 4Q 7 D NOTICE TO APPLICANT: If, alter 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 inspectionCCp�urposes. Yr _ !i✓��li J , Signature of applicant t _ Date f .� Mailing Address City, State, Zip (' / HARD COPY 1 ZONE: BY: Minimum Setback Distances: City a Zip Tel. Rear Setback from Rear Prop. Line State Lic. & Classif. 288130 City Lic. # 32$ UC 3142 Sq. Ft. M 5$9 Size No. 1 No. Dw. Stories - Units Arch., Engr., Designer New Ik Add ❑ Alter ❑. Repair ❑ Demolition ❑ Address Tel. 4 City Zip State Lic. # 4 8 3580.17 CK - • LICENSED CONTRACTOR'S DECLARA.IfON . I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 70 130) of Division 3 of the Business and Professions Code, and my license is infullforce and effect. y SIGNATURE it + + ✓ a+_ a DATE 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 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 byeny applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ' 01 , 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 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.) , . . ❑ 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 • such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) 0 I am exempt. under Sec. B. & P.C. for this reason Estimated Valuation �y {�/� d.�l�F.i's9�Li1i I 49 Wi IW PERMIT-• -' AMOUNT - • PIan.Chk. Dep. - - Plan Chk. Bal. 419 CO11St.' fa„ 678.00 Mech. . �i'"�..ifi _ '.Electrical �y (y C - 1wCCDs 7 128.65 Plumbing A ^ 140.5! S.M.I. �y 33&83: Grading Driveway Enc. Date Owner Infrastructure h 2,000.00 WORKERS' COMPENSATION DECLARATION 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 ❑ 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 or less.) I certify that in the performance of thg 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' " TOTAL .. r� REMARKS ' NOTICE TO APPLICANT: If, alter 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 inspectionCCp�urposes. Yr _ !i✓��li J , Signature of applicant t _ Date f .� Mailing Address City, State, Zip (' / HARD COPY 1 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'°'86 Permit Validated by: Validation: A5111 4 8 3580.17 CK CONSTRUCTION ESTIMATE AdlkkNO. ELECTRICAL Fr-gdlkk NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ 2ND FL. SQ. FT. POR. SO. FT. ® GAR. SO. FT. ® CAR P. SQ. FT. WALL SO. FT. ® SO. FT. ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET I 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 AS (ROUGH) jn :C GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APP./EQUIP. LAUNDRYTRAY 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. SQ. FT. ® c BATH TUB SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 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 SETBACK f4obROUND PLUMBING � UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE &ZOUGH PLUMB BONDING HEATING (ROUGH) STORAGE TANK FORMS f,,JSEWER OR SdT5PTA K CROUGH WIRINCa01 Q �/ ( to DUCT WORK ROCK STORAGE FOUND. REINF. O GC AS (ROUGH) jn :C METER LOOP HEATING (FINAL) OTHER APP./EQUIP. �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. Z(_eF AMING OI O �/n (,�INAL INSP// PKEIOOFING O%CSG �. rr VENTILATION - REMARKS: FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR FIREWALL //GAR. LI(Ck:ATHING �Lr MESH INSULATION/SOUND / FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL GARDEN WALL FINAL Ott INSPEU OX'S SIGNAI URE511NITIALS.