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BLCK (12232)4 t P.O. BOX 1504 N o , 12232 Building 78-105 CALLE ESTADO Address 52-661 Navarro LA QUINTA, CALIFORNIA 92253 Owner Sergio Sanchez Mailing BUILDING: TYPE CONST. OCC: GRP. Address Same A.P. Number cittya Quints, CdZip92253 JTe� 64-5203 Legal Description Contractor Project Description d�2' of 4' -hash wood frame/stue; f3+ nerii3u lder 36' of 54 high wood frame/stucco fence Address City Zip Tela State Lic. City & Classif. Lic. # Sq. Ft. No. No. Dw. Arch., Engr., Size Stories Units Designer New ❑ Add ❑ Alter ❑ Repair ❑ -Demolition ❑. Address Tel. City Zip State Lic. # 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. _SIGNATURE DATE OWNER -BUILDER DECLARATION Estimated Valuation I hereby affirm that I am exempt from the Contractor's License Law for the following $563.00 reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its Issuance also _ requires the applicant /or such permit to file a signed statement that he is licensed pursuant to PERMIT AMOUNT the provisions o/ the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 or the Business and Professions Code, or that. he is exempt therefrom, and the basis /or the alleged exemption. Any violation o/ Section 7031.5 by 'any applicant for a permit Plan Chk. Dep. s�ubjecI fib applicant to a civil penalty of not more than five hundred dollars (8500). C 11 Plan owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. tJ V Professions Code: The Contractor's License Law does not apply to an owner or property 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. I/, however, the building or improvement is sold within one year o/ completion, the owner -builder will have the burden Electrical o/ proving that he did not build or Improve for the purpose o/ sale.) - ❑ I, as' owner of the property, am exclusively contracting with licensed contractors lo'con• Plumbing struct the project. (Sec. 7044, Business and Professions Code:lThe Contractor's License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for S. M. 1. such projects with a contractor(s) licensed pursuant to thefContractojs License Law.) ❑ I am exempt under Sec. B. 8 P.C. f5r this reqs°on Grading aC Driveway Enc. ;dale—Lir 1 t � dJOwner ' 1 �- mo i 1H Id, � Infrastructure 9 3 - F w � J f WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure,: ora certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800>La4or Code.) Policy No. Company ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. .- TOTAL CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit IS /or one hundred dollars (S 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 lul NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become ZONE: BY: AW T1993 subject to the Workers' Compensation provisions o/ the Labor. Code, you must forthwith MIr1lfnUm Setback Distances: i comply with such provisions or this permit shall be deemed revoked. f Front Setback from C nter3Lin Rear Setback from Re aP4 CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line f 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.) Side Setback from Property- Line 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 it 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: Date Permit 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 purposes. Validated by: Signature of applicant —Date— Mailing ateMailing Address Validation: City, State, Zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS COLL. AREA 1 ROUGH PLUMB. 2ND FL. SO. FT. HEATING (ROUGH) YARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. SO. FT. DRAINAGE PIPING WALL SQ. FT. HEATING (FINAL) DRINKING FOUNTAIN SO. FT. ® URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES FINAL INSP. WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GRADING cu. yd. $ plus x$ GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM FINAL INSP. 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 FIRE ZONE ROOFING SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1+/a c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER GAR. FIREWALL GAS PIPING PERMIT FEE LATHING ©� 3 40 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. q/ GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IEOUIP. 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 a / �!� FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING ©� 3 40 MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL