13871 (RPL)Building 54-280 Riviera
-Address
Owner
Mike Fry
Address same
City ip
La Qui 92253
Contractor
California Pobls a Spas
I dIrE1410 Boardwaik A-2
'Ohim Desert,,, CIA' 92211
State Lic. C_5
& Classif. 3 185102
Arch., Engr.
'Designer.,
Address
71 4�OP.O. BOX 1504,:A�,-,1.r-1r1`i No. 138
.:,P_�8-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Tel.
340-9000
City
Lic. # 355'
el.
I __7i p I -
City 77 State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby-,affirmt"_t,I _�am llcen�pd-under-provisions of Chapter 9 (commencing with Section
700C�)'of�Divi,sionr3l-of.'the,-B-G—sili -
1, 6,,, �14rofAlsions_Code, and my license is in full force and
_.C,_
effect.
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affi(m 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, I 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
Divi ston 3 of the Business and Professions Code. or that. he is exempt thereii0m, 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 ($500f.
__0 1, as owner of the property, or my employees with wages as their sole compensation, will
boft.-e work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
r�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 improvbment 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.)
0 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
klehereby affirm that I have a certificate of consent to self -insure, or a certificate of
Wor r's Compensation Insurance, ora certified cop/
Polic C _,therey. (Sec. 3800, La6or Code.)
YJNO..Company �� X I- _ .
0*4`bop�y is filed with the city. 0 Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This se�tfon need not be completed if the permit is for one hundred dollars ($100) valuation
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' 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, Zi
—BUILDING: TYPE CONST. OCC'. GRP.
A.P. Number
Legal Description
Project Description 61 and, Spa
Minimum Setback Distances:
Front Setback from Center Line
Rear=S6tback,friom-Rear-PFop—Cine--I
Sq. Ft.
Size
N 0. No. Dw.
Stories Units
FINALDATE
New 0 Add 0 Al ter 0 Repair 0
-Demolition 0
Issued by:
Date Permit
IBY/'-'
Validated by:_�
'Validation:
Estimated Valuation
$14t200.00
PERMIT
AMOUNT'
Plan Chk. Dep -
Plan Chk. Bal.
105.30
'Const.
162.00
Mech.
24A0_
Electrical
45.00
Plumbing
27.00
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL 363.30
REMARKS
ZONE: — — — — — -- �._BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear=S6tback,friom-Rear-PFop—Cine--I
0, N,k � 11 r-,\ I
from Center Line
�1.rAj L". \A C-1 1; 1
lde Setba k from Property ILI in e
—SiaalStreet'Setback
FINALDATE
A11r, GIASOM
T6R
Issued by:
Date Permit
IBY/'-'
Validated by:_�
'Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. @ $
UNITS
SLAB GRADE
ROUGH PLUMB.
j
YARD SPKLR SYSTEM
2ND FL. SO. FT. @
FORMS
SEWER OR SEPTIC TANK
FOR. SO. FT. @
MOBILEHOME SVC.
-
BAR SINK
GAR. SQ. FT. @
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
OTHER APPJEQUIP.
DRAINAGE PIPING
CAR P. I SO. FT. @
TEMP. POLE
WALL SQ. FT. @
GROUT
DRINKING FOUNTAIN
SO. FT. a
FINAL INSP.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
WATER PIPING
NOTE: Not to be used as property tax valuation
I FLOORbRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
VENTILATION
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
GAR. FIREWALL
SQ. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR @ 3/4c
HOU E SEWER
GAS PIPING
PERMIT FEE
PERM FEE
PERMIT FEE
DBL
TOTAL FEES
I
MICRO FEE
I
MECH.FEE PL.CK.FEE
CONST. FEE ELECT.FEE
I
SMIFEE FEE
PLUMB.
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 APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BONDBEAM
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.
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES11NITIALS
GARDEN WALL FINAL 71