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RR (003557)Building Address Owner Mailing " Address City Contractor Address... - City �• r P.O. BOX 1504 NO. 003557 78-105 CALLE ESTADO 52--840 Navarro LA QUINTA, CALIFORNIA 92253 Steve $e' BUILDING: TYPE CONST. - OCC: GRP. Zip Po 0. Box 1256 --Zip ._ • A.P. Number, 773-335-006 Tel. Legal Description Project Description Tt— Tel.' State Lic. City & Classif. � Lic. # a f c} Sq. Ft. No. No. Dw. Size, Stories Units Arch:, Engr., Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State Lic. # _ .LICENSED CONTRACTOR'S DECLARATION _ - Ihereby affirm that`( am.licensed under DSo'visions of Chapter 9 (commencing with Section 7000)�off ivision3 " °a of.the,Busine/sss andProfessions Code, and my license is in fuU3orceefand effect '1,r_r, A� 1. SC SIGNATTU'R�E�"�"^••�" - : i..i! a' ` DATE ' OWNER -BUILDER DECLARATION hereby affirm that I am exempt from the Contractor's License Law for the following Estimated Valuation C�. ��� reason: (Sec. 7031.5,Business and Professions Code: Any city or county. which requites a - _ permit to construct, after, improve, demolish, or repair any structure, prior to its issuance also - ,r requires the applicant for such permit to file a signed statement that he is licensed pursuant to PERMIT - AMOUNT- ' 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 Any Section 7031.5 'any for Plan Chk. Dep. alleged- exemption. violation of by .applicant a permit subjects the applicant to a civil penafty'of not more than five hundred dollars ($500). ;- Plan Chk. Bal. .� - ,; 0 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. Professions Code: The, Contractor's License Law does not apply to an owner of.property who$38 , 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. If, however, the building •. or improvement is sold within one year of completion, the owner -builder will have the burden Electrical of proving that he did not build or Improve for the purpose of sale.) - O 1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing strucl 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 S.M.L. such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading • ❑ Lam exempt under Sec. B. 8 P.C. for this reason rr Driveway Enc. Date owner I nf rastFuctu re WORKERS' COMPENSATION DECLARATION " 'I hereby affirm that I have a'certificate of consent to.selfinsure, or'a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company O 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 for one hundred dollars ($100) vaivation or less.)- - I certify that in the performance of tha work for which this permit is issued, I shall not r ,r•- rsn n r. . , T� n ' R " employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. ._ r ,,,.+-,a. �( t„1✓ N t'V1 W Date Owner NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become BY: ' subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. - .ZONE: .Minimum Setback Distances: ' Front Setback from Center Line Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY Side Street Setback from Center,Llne 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 AddressFINAL DATE INSPECTOR 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 tt eQ� b �� read this application and state that the above information is correct. Issued by: Date Q Permit 1 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 Address Validation: City, State, Zip HARD COPY _ CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ 2ND FL. SO. FT. qp 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 BONDING FLOOR DRAIN MECHANICAL FEES FORMS WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APP.IEOUIP. LAUNDRY TRAY AIR HANDLING UNIT CFM TEMP. POLE 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 SO.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 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 APP.IEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BONA 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 k FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL 1145FL :I VM'J blUNAI UKLWINI I1ALb. GARDEN WALL FINAL