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003352 (SFD)Building 55-695 ����� BonAddress Owner Michael S. Bt field. Mailing Address City - Zip r ie Zip t P.O. BOX 1504 •NU,.. QU3Z ` 78-105 CALLE ESTADO _LA QUINTA, CALIFORNIA 92253 BUILDING. -TYPE CONST. - OCC: GRP.•• M . � A.P. Number PAA WPAt 769-39n-012 Tel. - ..,�� _ Legal Description Project Description Sbote State Lia City & Classif. - Lic. # Sq. Ft*�6 Size - No. • No. Dw. Stories • Units ..Arch:; Engr., - .. .... - .. _. ... New. El Add ❑ Alter ❑ Repair ❑ Demolition ❑ . '• Designer Address Tel. 1,,411 3391 City Zip State Sar 849'" _.. Lic. # 0e,^1 pout r_R:�' 7C�/�iisAzd 4n#+h C V" 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...�fKa ' + . . ... - .... ..... .._. . SIGNATURE DATE ' OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Business and Professions Code: Any city or .county which requires a - -. permit to construct, alter, fmprove, demolish, or repair any structure, prior to itsissuancealso s.. ." requires the applicant for such permit to Nle a signed statement that he is licensed pursuant to - - the provisions of the Contractor's License Law, Chapter 9 -(commencing with Section 7000) of ' "Division 30l 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 ,"subjects the applicant to a civil penalty of not more than five hundred dollars ($500).' x '. O" 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 . Professions Code: The Contractor's License Law does not apply to an.owner of.property who Estimated �/alllatlOn - $T 9 &T d , 4 qS - PERMIT' - - 'AMOUNT .r Plan Chk. Dep. • It f17 fin-• "• Plari .Chk. Bal... C04St:, 1 1914' An Mech. twig k)n 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 , "• 110 ' A. • or improvement is sold within one year'of completion, the owner -builder will have the burden • of proving that he did not build or fmprove for the purpose of sale.) - ., .. Plumbing , i<�rf•3 ❑ 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• 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.) .O I am exempt under Sec. B. & P.C. for this reason S•M.I;- Grading _ n nn _ Driveway Enc. ._ _ Date owner Infrastructure WORKERS' COMPENSATION DECLARATION 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 ..O Copy is filed with the city. O Certified copy is hereby furnished: , TOTALS iKt�F t? �!f 9f�7 Si`3 _. CERTIFICATE OF EXEMPTION FROM WORKERS'. COMPENSATION INSURANCE ; REMARKS (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 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' Compensation provisions 'of` the Labor Code, you must forthwith. comply with such provisions or this permit shall be deemed revoked. - 4a _`' "* /f✓''/)' f� rj y .- - f sr h LU'i g. t,1t z�fii;s? ii S s) -ZONE: BY: ,Minimum SetbackDistarices: ' - - Front Setback from Center Line - Rear.Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY 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 Street Setback from Center Line Side Setback from Property Line ' Lender's Name i FINAL DATE Issued by: Validated by: INSPECTOR - 'Date ��� Permit 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 ordinances and state laws relating to building construction, and, hereby authorize representatives sof this city to • enter the .above-. mentioned property for inspection purposes Signature of applicant Date Mailing Address Validation: City, State, Zip HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ 2ND FL. SO. FT. ® POR. SO. FT. ® GAR. SO. FT. ® CARP. SO. FT. WALL SO. FT. ® SO. FT. ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET f �` YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING NOTE: Not to be used as property lax valuation Z4ROUGH PLUMB—�,'�' FLOOR DRAIN MECHANICAL FEES FORMS WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APPJEQUIP. LAUNDRY TRAY AIR HANDLING UNIT CFM GAS (FINAL) 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 SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL REMARKS: SO.FT.GAR ® 3/ac 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 Z4ROUGH PLUMB—�,'�' BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SE 7 K OUGH WIRING— DUCT WORK ROCK STORAGE FOUND. REINF. AVYGs (ROUGH),Z,—� �i METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING FINAL INSP. Cu. yd. $ plus x$ _$ LUMBER GR. — / 4 �&RAMING �� V FINAL INSP. ROOFING c REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE Z — /— SPARK ARRESTOR GAR. FIREWALL LATHING MESH //C INSULATION/SOUND -- FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL