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001906 (BLCK)I i` •44 IOU P.O. BOX 1504 No 001906 r� ' rOCAddress R�� LA QUINTACALIFORNIA 92253 Owner �$X ? BUILDING: TYPE CONST. OCC: GRP. ' Mailing, " Address ��'• - tj `f� same A.P. Number f..J City Zip Tel. .. t` . .. 92253 tS19i 4442-�S373 Legal Description Contractor Project Description 144 'f. o�' f N ft. high-- by�k w. an - . Address City Zip . Tel.. State Lic. City & Classic Lic. # Sq. Ft. No. No. Dw. . Arch.,-Engr., - ...._ Size Stories Units - Designer New Ek Add ❑ Alter ❑' ' Repair ❑ Demolition ❑ Address Tel. City Zip State Lic. # • LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisionsof Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.. SIGNATURE DATE _ OWNER•BUICDER DECLARATION Estimated Valuation I hereby affirm that I am exempt from the Contractor's License Law for the following$'.3.600.00 reason:. (Sec. 7031.5,Business and Professions Code: Any city or county which requires a, permit to construct, alter, improve, demolish, or Professions, ir-any structure, pdorrto its issuance also AMOUNT requires the applicant for such permit to rile a signed statement. that he is licensed pursuant to. - ...PERMIT - - the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) ,of . r 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 Plan Chk.-Dep.. - ' subjectsthe' applicant to a civil penalty or not more than'rive hundred dollars (5500). - - Plan Chk. Bdl.p �.Gy O,.l, 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 . `COf1St. 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, McCh.. ' 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 EIBCirICal 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- Plumbing - - struct the project. . (Sec. 7044,• Business and ProfessionsCode: The Contractor's License Law _... does not apply to an owner of property who builds or. improves thereon, and who contracts for S:M.I. - • • such projects with a contractors) licensed pursuant to the Contractor's.License Law.) • - Grading .50 ❑ 1 am exempt under Sec. B. & P.C. for this reason ' j Driveway Enc. Date Owner`' ` ' ` Infrastructure pg._. _ WORKERS' COMPENSATION DECLARATION hereby affirm that I have a'certificate of consent to. self,insure,-ot 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. TOTAL 73.T CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS'COMPENSATIONINSURANCE (This section need not be completed if the' permit is for one hundred dollars (5100) 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. NOTICE TO APPLICANT: If, after making .this Certificate of Exemption'_ycu should become ZONE: BY: subject to the , Workers" Compensation provisions'! of the Labor Code, you must forthwith Minimum Setback Distances: comply with such provisions or this permit shall be deemed revoked. Front Setback from Center 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.) . 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 ordihances 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 applicantv Date Mailing Address City, State, Zip t HARD COPY Rear Setback from Rear Prop. Line_ Side Street Setback from Center Line Side Setback from -Property Line FINAL DATE INSPECTOR Issued by: Date d Permit Validated by: Validation: A3388 11 22 )39 CK' CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. @ $ 2ND FL. SO. FT. POR. SO. FT. @ GAR. SO. FT. @ CAR P. SO. FT. WALL SO. FT. @ SO. 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 LAUNDRY TRAY 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. SO. FT. @ c BATH TUB BOND BEAM SO. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID @ 11/4 c SEWAGE DISPOSAL LUMBER GR. SO.FT.GAR @ 3/4c HOUSE SEWER FRAMING 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 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 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 INSPECTOR'S SIGNATURESIINITIALS T GARDEN WALL FINAL,