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002234 (SATT)P.O. BOX 1504 No.. Building 80-444 Pebble Beach78-105 CALLE ESTADO Address LA QUINTA, CALIFORNIA 92253 Owner Mailing Address 7 � IL's 3b � A City JZip _ Tel. 568-2828 DeSel 92260 Contractor . Pr Address 11�38lilL City Zip Tela 00223' UILDING: TYPE CONST. OCC: GRP. P. Number Le Description oject Description FM HIM PLM 20 0 X733 State Lic. & Classif. 2.88130 City Lic. # 328 MC 2596 Sq. Ft. No. Size GAR... 577 Stories No. Dw. Units • ' Arch:, Engr., Designer New QC Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. Side Street Setback from Center Line City - Zip State Lic. # INSPECTOR Issued by: _- 1k-7 $6 Permit Date Validated by: LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is, in full. force•and effect. y� •. ^ Validation: _ SIGNATURE / !` t 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 by 'any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ❑ 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 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.) - - ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044, Business and Professions Code:dThe 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.) .. ❑ I am exempt under Sec: B. & P.C. for this reason Estimated Valuation �' �� ' ' •N ' PERMIT , AMOUNT ' _ - Plan Chk: Dep. Plan Chk. Bal. 495.15 Const. «} Mech.,-e0 Electrical ,�� IS Plumbing 132.50 S.M.I. ,� 9 +� 11 Grading Driveway Enc. Date owner Infrastructure 21,000.00 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 ❑ Copy is filed with the city. O Certified copy is hereby furnished. - TOTAL 3,394, 95 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 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 purpose/s. 5 i Signature of applicant Date Mailing Address C s r City, State, Zip HARD COPY 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: _- 1k-7 $6 Permit Date Validated by: Validation: A5079 4 8 3394.95 U CONSTRUCTION ESTIMATE NO. ELECTRICAL FEE NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ 2ND FL. SQ. FT. POR. SO. FT. ® GAR. SO. FT. ® CAR P. 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 FLOOR DRAIN MECHANICAL FEES HEATING (ROUGH) WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER DUCT WORK GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED G LAUNDRYTRAY AIR HANDLING UNIT CFM HEATING (FINAL) 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 BOND BEAM SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/a c SEWAGE DISPOSAL LUMBER GR. SQ.FT.GAR ® 3/ac HOUSE SEWER vQ&RAMING FINAL INSP. 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 5 UNDERGROUND A.C. UNIT COLL. AREA �A. SLAB GRADEROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK OUGH WIRINGg n� o� DUCT WORK ROCK STORAGE QLIeFOUND. REINF. G /GAS (ROUGH) 67, :2 C/O t3 � METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL /U 0 ,GGAS (FINAL) TEMP. POLE 4 GROUT WATER HEATER SERVICE 64&INAL INSP. j/ BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ =$ LUMBER GR. ueINAL INSP!. //. vQ&RAMING FINAL INSP. it /, ROOFING Q, 2 Q / W REMARKS: c� VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL G[LLATHING 8re MESH I N SU LATIONISOUN D FINISH GRADING L�LFINAL INSPECTION CERT. OCC. FENCE FINAL N5Pt;I VH'b SIUNA l UHtWINI I IALS GARDEN WALL FINAL pt r) ot./ i„InC L q, �'I Y7 Ip,