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9767 (PLBG)T4ht 4 4 a" P.O. BOX 1504 No. 9767 Building 1.5-363 -Gul `arro 78-105 CALLE ESTADO Address J __ LA QUINTA, CALIFORNIA 92253 BUILDING: TYPE CONST.-OCC. GRP. Mailing Address A.P. Number City Zip Tel. 11. . ­ . JJ�1 11. -I -� "I :-, .� 1 Legal Description Project Description Sewer Llook Uo Contractor Address 192 City Zip Tel: State Lic. City & Classif. C, 41 12 ;J 011 1) 01- 1 Lic. # 3 4.'__ Sq. Ft. No. No. Dw. Size Stories Units Arch., Engr., Designer New 0 Add 0 Alter 0 Repair El Demolition El Address Tel. City Zip State I Lic. # LICENSED CONTRACTOR'S DECLARATION I It arab� affirm that I. am licensed under provisions of Chapter 9 (corn menc I no with Section 7010)of IvNion 3ofthin Business arid Professions Code, and my license Isla full fordo and UGNATL14E 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, Improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to file 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 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 subjects the applicant to a civil penalty of not more than five hundred dollars ($500). 0 1, as ciwriar of the property, or my employees with wages as their sole compensation, will do the work, and the structure Is not Intended or offered for sale. JSec. 7044. Buisness and PFOfessfans Code: The Contractors License Low does not apply la an owner of property who builds or Improves thereon and who does such work himself or through his own employees, provided that such Improvements are not intended or offered for sale. If, however, the building or Improvement is sold within one year of completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale.) Estimated Valuation PERMIT AMOUNT Plan Chk. Dep- Plan Chk. Bal. Const. Mech. Electrical Plumbing 0 1, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044, Business and Profuusfons Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contracior(s) licensed pursuant to the Contractor's License Law 0 1 am exempt under Sec.—B. & P.C. for this reason S.M.I. Grading Driveway Enc. Date —Owner Infrastructure WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) P*I1GWNo_Cnnp:1ny \C]tcrpy is filed with the city. 0 Certified copy Is hereby furnished. TOTAL U U, REMARKS CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This -section need not be completed if The parm4 is for one hundred duffars ($ 100) vafu2flon or less.) I certify that In the performance of thp 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. It, after making this Certificate of Exemption you should become subject to the Workers' Compensafim provisions of the Labor Code, you must forthwith comply with such provisions or this pearrit shall be deemed ra6vired. ZONE: BY: Minimum Setback Distances: Front Setback from Center Lin Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY Side Street Setback from Center 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) Side Setback from Property Line Lender's Name 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 it work thereunder is suspended for 180 days. I car I lify 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 of applicant —Date Mailing Address Validation: City, State, Zip Building 49-363 GuiJarro P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Owner n.I Carpenter Mailing Address City Zip Tel. La Quinta 92Z�3 Contractor Econo Sauer Services Address P. O. Box 192 Paha Desert 1 '92260 346-2793 State Lic. City & Classif. C 42 460963 Lic. # 342 Arcn., tngr., Designer Address Tel. CityI Zip I State Lic. # LICENSED CONTRACTOR'S DECLARATION it hereby affirm that I am,lidensed under Provisions of Chapter 9 (commencing with S@ction 7,000) of Division 3 Off`the'8usinede.and/Proffeessions Code, and my license IIss)n full torba and effect. SIGNATURE -,,', AY m - 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, atter, Improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to file 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 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 subjects the applicant to a cNli penally of not more than five hundred dollars (3500). ' 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 Professions Code: The Contractor's License Law does not apply to an owner of property who 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 or Improvement Is sold within one year of completion, the owner -builder will have the burden of proving that he did not build or Improve for the purpose of sale.) b 1, 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.) 0 1 am exempt under Sec. B. & P.C. for this reason Date Owner 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 O Copy is filed with the city. ❑ Certified copy Is hereby furnished. CERTIFICATE OF EXEMPTION FROM 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 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: d, alter 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. CONSTRUCTION LENDING AGENCY 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.) Lender's Name Lender's Address 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 of applicant Date Mailing Address City, State, Zip BUILDING: TYPE CONST A.P. Number Description Project Description No. 9767 OCC: GRP. - Sq. Ft. No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ -Demolition ❑ r Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. " Electrical Plumbing • S.M.I. Grading Driveway Enc. Infrastructure QV TOTAL JU • OU REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR I Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. a 2ND FL. SQ. FT. ® POR. SO. FT. ® GAR. SQ. FT. a CAR P. SQ. FT. ® WALL SQ. FT. a SQ. FT. a 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 LAUNDRYTRAY AIR HANDLING UNIT CFM 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. a c BATH TUB SQ. FT. a c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID a 1V4 c SEWAGE DISPOSAL SQ.FT.GAR a 3/ic HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE --jCONST. FEE JELECT.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 q / J7 SEWER OR SEPTIC TANK? - l� /�FIOUGH WIRING Z DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP./EQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ P1us r5 =$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION �r C CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL 71