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14145 (AR)uG� A • P.O. BOX 1504 N o . 14145 Building78-105 CALLE ESTADO Address 8--908 Mountain Viet Lan L-A QUINTA, CALIFORNIA 92253 Owner Oswald Lellinter U1141 BUILDING: TYPE CONST.' OCC. GRP. -R3 Address Sarie A.P. Number City Zip Tel. La Quinta, CA 92253 Legal Description Contractor Project Description Sae Room -0Wr*0V4,BU4 0r Onyx Construction Inc. Address j6--448 F©rber Dr. CityZip Tel Rancho Mirage, �A 92270 322--4551 State Lic. City & Classif. B 594739 Lic. # 3390 sq. Ft. No. No. Dw. Arch., Engr., Size 998 Stories Units Designer Forge Septiew New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Ad.U: Box 3287 Tel. Cit Zi State Valu Springs,[&92263 Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section fe0)t f Division 3 of the Business an Professions Code, and my license is in fo �e�nd "SIGNATURE DATE OWNER -BUILDER DECLARATION Estimated Valuation ;53 757.Oti I hereby affirm that I am exempt from the Contractor's License Law for the following t reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a permit to thconstruct, alter, improve, demolish, or repair any structure, prior to its issuance also AMOUNT requires e 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 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. subjects the applicant to a civil penalty of not more than five hundred dollars ($500). Plan Chk. Bal. • ❑ 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. 432 • �U Professions Code: The Contractor's License Law does not apply to an owner of property who 7_. builds or improves thereon and who does such work himself or through his own employees, Mech. % • 11�J provided that such improvements are not intended or offered for sale. Ir, however, the building t`)+ CC or improvement is sold within one year or completion, the owner -builder will have the burden Electrical 7. M 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 63. U8 struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner or property who builds or improves thereon, and who contracts for S,M.I, 5. 3U such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading ❑ I 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 ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. TOTAL b d •b IS 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 thi's permit is issued, I shall not employ any person in any manner so as to become subjedit,to the Workers' Compensation haws of California. / (� f,. (Date � �' !%1 Owner / l• ITNOTICE'TO APPLICANT: If, after making this Certificate of Exemption you 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 C n, e Re rom ar P o .Line CONSTRUCTION LENDING AGENCY a Str tback om t r 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.) I e S ack from Propert L' Lender's Name CC���� Lender's Address FINAL DATE �j44TO 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. Issued by: DaiB Per It I agree to comply with all city and county ordinances and state laws relating to building If construction, and hereby authorize representatives -of this city to enter the above- mentioned property for inspection purposes. Validated by: v1 Signature of applicant Date Mailing Address Validation: ' City, State, Zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS SLAB GRADE 2ND FL. SO. FT. BONDING YARD SPKLR SYSTEM STORAGE TANK MOBILEHOME SVC. BAR SINK POR. S0. FT. ® DUCT WORK ROCK STORAGE GAR. SO. FT. ® POWER OUTLET ROOF DRAINS HEATING (FINAL) OTHER APPJEOUIP. DRAINAGE PIPING CAR P. I SO. FT. TEMP. POLE WALL SO. FT. ® GROUT DRINKING FOUNTAIN SO. FT. ® FINAL INSP. URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER SYSTEM WATER PIPING NOTE: Not to be used as property tax v'al'uation _$ FLOOR DRAIN MECHANICAL FEES FRAMING WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER REMARKS: GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM 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 SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL MESH SO.FT.GAR ® 3/ac HOUSE SEWER INSULATIONISOUND 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 6 AIR COND. SOLAR SETBACK AAROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK J OUGH WIRING/f� lCT DUCT WORK ROCK STORAGE FOUND. REINF + ��, L v� GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM FINAL INSP. GRADING cu. yd. $ plus x$ _$ LUMBER GR. 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 GARDEN WALL FINAL