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07814 (SFD)J I IIIIIII IIID III VIII (III 06 IE Building 78-M Alden C#rci P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Mailing Address 1021 W. Bastanchury Raod City Zip Tel. - .. Fullerton 92633 714-9924880 Contractor' City jZip j Tel. State Lic. I City & Classif.,Lic. # Arch., Engr., Designer Address Tfel. City( Zip ( State I Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirmothlat I am licensed under provisions of Chapter 9 (commencing with Section 7000) of D,ivislion 3 of the B Sines ,{and Professions Code, and'my license is in full force and effect. -i'r/�d`.+1) .!�"' .Ir,..e"�.e 0, SIGNATLMr;N-" `" -` -' ' F DATE OWNER -BUILDER DECLARATION 11 by 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). 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 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.) ❑ 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 contractors) licensed pursuant to the Contractor's License Law.) ❑ 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 - I4opy 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 the 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. 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 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 -of this city to enter the above-. mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip No. 47818 BUILDING: TYPE CONST. OCC. GRP. A.P. Number Acacia HMO Legal Description 'fit326Q Map 2 A-2 R~psi �T 6f . C L C Project Description Lot til Sq. Ft. Size • 1362 No. No. Dw. Stories . Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT ' AMOUNT Plan Chk. Dep: - Plan Chk. Bal. P1.34 Const. 827.00 Mech. 47.00 Electrical - 90.61 Plumbing 120.9 S.M.I. 5.25 Grading Driveway Enc. Infrastructure 1673,19 TOTAL 2,910.89 - REMARKS `� 4 r r� ♦ •�. q :.�'..tl����.dl�.•R tf}(}n�3r"ti7"�y1,RA t�a'f �G 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 Issued by: Date 5/4/90 Permit Validated by: Validation: CCNSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SQ. FT. ® $ UNITS SLAB GRADE 3 2ND FL. SQ. FT. BONDING YARD SPKLR SYSTEM FOR. SQ. FT. ® MOBILEHOME SVC. BAR SINK GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS CAR P. SQ. FT. AS (ROUGH) 0 DRAINAGE PIPING WALL SQ. FT. OTHER APP./EQUIP. DRINKING FOUNTAIN SQ FT ® TEMP. POLE URINAL ESTIMATED CONSTRUCTION VALUATION $ GROUT WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SYSTEM WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FRAMINGDO L,{� Z GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED �f�l LAUNDRYTRAY AIR HANDLING UNIT CFM REMARKS: 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 SPARK ARRESTOR SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11% c SEWAGE DISPOSAL LATHING SQ.FT.GAR ® 3/ic HOUSE SEWER MESH 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 3 ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. AS (ROUGH) 0 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. $ plus x$ _$ LUMBER GR. FINAL INSP.�a P� FRAMINGDO L,{� Z FINAL INSP.//�j / /t�1 ll��!/ ROOFING&/,,i 7/_q s�QO VENTILATION � �f�l _ _z? qa REMARKS: FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION v/ CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL IIIIIII VIII III VIII (III 07 IE ; Building Address 4 P.O. BOX 1504 ­=Ao. 9933 78-665 ALDEN CIR , 7P -Ins; CALLS CALIFORNIA9 9� �� LA QUINTA, RNIA 225 Ownerr' TONY TOMAS Mailing ' Address SAME City Zip LA QUINTA 92253 340-2373 Contractor UNIQUE POOLS BY CARMINE Aaaress 74-818 'VELBIE WAY 01. City' Zip PALL DESERT 1 8$260 State Lic. & Classif. 520432 C53 Arch:, Engr., , Designer Address 346-63"35 City - Lic. # ,, 1366 . Tel. City (Zip (State I -� Lic. #., 4 that (ram licensed 3 of`the Business r 9 (commencing with Section my licengiaNs,fn full fcrce•and BUILDING: TYPE CONST. OCC: GRP.- A.P. Number Legal Description Project Description POOL AND SPA Y Sq. Ft. No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ OWNER -BUILDER DECLARATION l 1 / Estimated Valuation I hereby affirm that I am exempt from the Contractors License Law for the following reason: (Sec. 7031.5,Buslness 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 the provisions 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 or Section 7031.5 by 'any applicant for a permit Plan Chk. Dep subjects the applicant to a civil penalty of not more than five hundred dollars.($500). Plan Chk. Bal. ❑ 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 Const. 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. 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 or 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 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•1- such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading ❑ 1 am exempt under Sec. B. & P.C. for this reason Driveway Enc. Date Owner s 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 6i '' A 1, 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 the work for which this permit is issued, I shall not employ anyperson in any manner so as to become subject to the Workers' Compensation Laws of California - Date Owner NOTICE TO APPLICANT., If, 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 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 -of this city to enter the above•. mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip Infrastructure TOTAL c ` $8,080 AMOUNT ,ff6 4. 3 S 99.00 24.00 45.00 27.000 .80 0.15 REMARKS, AIVRsr't`) 40 11.11 013—iA--91 - 1U LI—WX11 1 10111i'lL 1 401:1. LJ 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 Issued by: Date J , - Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SQ. FT. ® $ UNITS '. COLL. AREA 2ND Fl. SQ. FT. ROUGH PLUMB. YARD SPKLR SYSTEM POR. SQ. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. SQ. FT. "u •. DRAINAGE PIPING WALL SQ. FT. GAS (ROUGH) `$l� a( �� DRINKING FOUNTAIN. SQ FT ® : URINAL ESTIMATED CONSTRUCTION VALUATION $ GAS (FINAL) WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER HEATER WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER WATER SYSTEM GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED x$ 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. SQ. FT. ® c BATH TUB FIRE ZONE ROOFINGCc SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ..FT. RESID ® 1+/a c SEWAGE DISPOSAL SPARK ARRESTOR SO.FT.GAR ® 3/ac HOUSE SEWER > GAS PIPING PERMIT FEE PERMIT FEE PERMITfEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE I FEE PLUMB. FEE INSULATION/SOUND FINISH GRADING STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING$ OUNDERGROUND 0-15rqan A.C. UNIT :..1 '. COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) :; STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING. DUCT WORK "u •. ROCK STORAGE FOUND. REINF. GAS (ROUGH) `$l� a( �� METER LOOP HEATING (FINAL){ : , +!!:,OTHER APPJEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE F GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM FINAL INSP.' GRADING cu. yd. $ plus x$ =$ LUMBER GR. FRAMING FINAL INSP. Gf G/ / 1 t ROOFING (7I r� u �✓ 01( w REMARKS: VENTILATION FIRE ZONE ROOFINGCc FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION - CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL