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14903 (BLCK)r� • Qum& / �av P.O. BOX 1504 Building a 78-495 CALLE TAMPICO Address LA QUINTA, CALIFORNIA 92253 Mailing Address 254 ,g DESERT FALLS City Zip Tel. 92260 340-3522 UM DESSIrl Contractor 'S AM Address. SADM Zip State Lic. & Class if.. 4975104' C--29 City Lic. # 3607 Arch.; Engr., • ' Designer Address Tel. . City lZip State Lic: # LICENSED CONTRACTOR'S DECLARATION . . I hereby affir%vat I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Divisi n of 'Busrress and Professions Code, and my license is in full force and effect. No. 14903 BUILDING: TYPE CONST. VA" -OCC.' GRP. A.P. Number ' Legal Description C'ARDEN WALL Project Description. BLOCK' VALL BY . HOUSE Sq. Ft. No. Size Stories New O Add O Alter ❑ 143' X `5 • HIGH 201 X`--4 GNATUR - - DATE V OWNEWBUILDER DECLARATION I hereby affirm that I am exempt from the.Contractors License Law for the following reason: (Sec. 7031.5,Business and Professions Code: Any city or county .which ,requires a Estimated Valuation rr permit to construct, after, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to rile a signed statement that he Is licensed pursuant to PERMIT - the provlsions or the Contractor's License Law, Chapter 9 -(commencing with Section 7000) or 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 rive hundred dollars ($500). O 1, 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 . The Contractor's.Ltcense Law does not apply to an owner or property who Plan Chk. Bal Const. Mech. . builds 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 Electrical or Improvement 'is sold within one year of completion, the owner -builder will have the burden. of proving that he did not build or bnprove for the purpose of sale.) Plumbing O I, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044, Business and.Professions Code: The Contractor's License Law • S. M. I. .. 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.) • ❑ 1 am exempt under Sec B: & P.C. for this reason Grading Driveway Enc. Validated by: 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. O Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM . WORKERS' COMPENSATION INSURANCE (This section need -not be completed !f .the permit Is for one, hundred dollars ($100) valuation or less.) ' I certify that in the performance of thg 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' Compensefion provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION -COVERAGE IS UNLAWFUL,,AND' SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION .3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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: 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.- Signature urposes.Signature of applicant - Date' Mailing Address City, State, Zip of , TOTAL 540 NO. DW.- Units Repair ❑,;-,.,, 'Demolition ❑ , REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center e Rear.Setback from Rear L e Side Street Setback fr9 nter LI " FINAL DATE Side Setback from Pr" y Lin 1 'ECT _Issued by: Date Pen yet Validated by: { � e CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. @ 2ND FL. SO. FT. @ POR SO. FT. @ GAR. SO. FT. @ CARP. SQ. FT @ WALL SO. FT. 0 SQ. FT. @ ESTIMATED CONSTRUCTION VALUATION $ UNITS YARD SPKLR SYSTEM MOBILEHOME SVC. BAR SINK POWER OUTLET ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL $ WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD :SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER 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.0 SQ. FT. @ c BATH TUB SQ. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR @ 3/ic HOUSE SEWER 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 ROCKSTORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM 3 �� WATER SYSTEM GRADING cu. yd. $ plus x$ =$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING rJ REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INRIII ATInKlMnIINn FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL GARDEN WALL FINAL INSPECTOR'S