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9603-0030 (SFD) Revision 1
IIIIIII VIII III VIII IIII 38 , IE P.O.BOX 1504 No. 15680*. Building �°3 78-495 CALLE TAMPICO Address 79 380 Arb©la Circle LA QUINTA,CALIFORNIA 92253 .. Owner snelle.nberge: & Associates - Mailing BUILDING: TYPE CONST.____..__OCC.OCC.GRP. R-'-3 Address 41-865 3oardl�allt, Ste. 604-271-005 A.P.Number G31'.l. Desert, Ap 92211 116e',,) 777-77£9 Legal Description Lot .74 Tract 23313 Prase Y Contractor Project Description plat'' 4 sajr& Address Quinter.ra City Zip Tel.: State Lic. City &Classif.. B 488234 Lic.# 1858 Sq.Ft. No. No.Dw. Arch.,Engr., Size 2593 Stories Units Designer Ciar�es D. Garland New ❑ Add ❑ Alter❑ 1 Repair❑ Demolition ❑ A e_p,63 Cathedral Cyn Dr. Tia 191% 770-7025 Ctyathedra3 CitF ;p CA 92234 u�t# LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm that I am licensed upder provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and:Pr6fes ions Code,and my license is infull forceand effect. � r .� +'"'�"ofr 1Ksr SIGNATURE'-'W ••r" DATE OWNEWBUIL ER DECLARATION Estimated Valuation I hereby affirm $153,652 .00 that I am exempt from the Contractors License Law for the following 2 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 rile 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 Professkms Code, or that.he is exempt therefrom, and the basis e for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit Plan Chk. Dep. t �i/�y. B Q subjects the applicant to a cion penalty of not more than rive hundred dollars($500). Plan Chk. Bal. - !�r G p ❑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 COr1St. .�Lrt 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, •'Mech. 89.50 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 166.18 of proving that he did not build or improve for the purpose of sale.) ❑I,as owner of the property,am exclusively contracting with licensed contractors to con- Plumbing 180.00 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 S.M.I. 15.37 such projects with a contractor(s)[rcensed pursuant to the Contractor's License Law.) Grading 20.00 ❑1 am exempt under Sec_ a•&P.C.for this reason Driveway Enc. .00 Date Owner - Infrastructure 3,430.83 Arts- in Pubic Places 134.13 WORKERS'COMPENSATION DECLARATION 1 hereby affirm that I have a certificate of consent to,self-insure, or a certificate of Worker's Compensation Insurance,or a certified copy the reo�f•1( ec.3800,Labor Code.) Policy No. company 7 ❑Copy Is filed with the city. O Certified copy is hereby furnished. TOTAL 5,567.39 CERTIFICATE OF EXEMPTION FROM REMARKS 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 the work for which this permit is issued,I shall not employ any pperson in any manner so as to become subject to the Workers'Compensation laws of California. Date Owner NOTICE TO APPLICANT: H, after making this Certificate of Exemption you should become ZONE: 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. Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop.Line WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL,AND Side Street Setback from Center Line SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE j/_) HUNDRED THOUSAND DOLLARS($100,000),IN ADDITION TO THE COST OF COMPENSATION, Side Setback from Property Llne*.� DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND %%�j ATTORNEYS FEES. FINAL DATE INSPECTOR �. This is a building permit when properly filled out,signed and validated,and is subject to r �/ .r expiration if work thereunder is suspended for 160 days. /I I certify that I have read this application and state that the above information is,correct. Issued by: Date/ �"�f=Perrnit nom. 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-. I/ mentioned property for inspection purposes. Validated by:-. ,q��- y� Signature of applicant -Date- Mailing ate Mailing Address Validation: City, State, Zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBINU FEES 1ST FL. SO.FT.® $ UNITS 2ND FL. SO.FT. YARD SPKLR SYSTEM POR. SO.FT.® MOBILEHOME SVC. BAR SINK GAR. SO.FT.® POWER OUTLET ROOF DRAINS CAR P. SO.FT.® DRAINAGE PIPING WALL SO.FT. DRINKING FOUNTAIN SO.FT.® URINAL ESTIMATED CONSTRUCTION VALUATION $ 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.U. SO.FT.®c BATH TUB SO.FT.®c WATER HEATER MAX.HEATER OUTPUT,B.T.U. SO.FT.RESID®1+/4 c SEWAGE DISPOSAL 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 PLU UNDERGROUND A.C.UNIT COLL.AREA SLAB GRADE ROUGH PLUMP 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 APPJEOUIP. REINF.STEEL GAS(FINAL) TEMP.POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING LUMBER GR. FINAL INSP/ cu.yd. FRAMING D f10V FINAL INSP. $ - plus x$ =$ ROOFING LK,r REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING 7 MESH L Jr INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. 6N FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL