RPL (14286)51005 Mandarina
14286
'BOX 1504
Building 51.-005 Man*darina 78-495 CALLE P.O. TAMPIC,O
Address "-r s a 1 A Z LA OUINTA, CALIFORNIA 92253
Owner Neely
i .
BUILDING: TYPE CONST. OCC. GRP.
Mailing Same
Address
A.P. Number
City Zip Tel.
La Quinta,. 'C 92.253 Legal Description
Contractor Pool and Spa
California Pools & Spas Project Description
Address
41-910 Boardwalk Suite A2
CLtyP'alm Desert, 1,.ZAP 92260 Tela 340.9000
State Lic. C53 185102 City 355
& Classif. Lic. # Sq. Ft. No. No. Dw.
Arch., Engr.,
Size Stories Units
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm I atrl'am.JIiEensed finder provisions of Chapter 9 (commencing with Section '
7000) 01 Division oVt e'Busings90and Professions Code, and my license is in full force and
effect.
SIGNATURE a DATE
OWNER -BUILDER DECLARATION Estimated Valuation$12,000.00
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 PERMIT AMOUNT
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or thathe is exempt therefrom, and the basis
for the alleged exemption. Any violation of 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 (5500).7 •
1, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. _
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and 1 J, • L'
Professions Code: The Contractor's License Law does not apply to an owner of property no Const.
builds or improves thereon ,and who does such work himself or through his own employees, Mech. 4 r V
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 burdenEIBCtrICal %5 •
of proving that he did not build or 'reprove for the purpose of sale.)
C 1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing "r • V
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.
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
C. I am exempt under Sec. B. 8 P.C. for this reason
Driveway Enc.
Date Owner Infrastructure
WORKERS' COMPENSATION DECLARATION
I hereby aff}rmrthatlt have a certificate of consent to self -insure, or a certificate of
Worker's Comp nsa on Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy%Company
_ opy is fi ed with the city. O Certified copy is hereby furnished. r
TOTAL
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed If the permit is for one hundred dollars (5100) valuation
Of less.)
I certify that in the performance of thV 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 I I
Laws of California.
Date Owner O O
NOTICE TO APPLICANT. d, 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 fro Qenter Line
Rear Setback froFRrep. bine _
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
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION'TO THE COST OF COMPENSATION, Side Setback from Property Line
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
This is a building permit when properly filled out, signed and validated, and is subject to FINAL DATE INSPECTOR
expiration it work thereunder is suspended for 180 days.
1 certify that I have read this application and state that the above information is correct. Issued by: Date_Permit
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. Validated by:
Signature of applicant -Date-
Mailing
ateMailing Address Validation:
City, State. Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES #
1ST FL. SO. FT. @ $
2ND FL. SO. FT. ®
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. SO. FT. ®
WALL SO. FT. ®
SO. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEOUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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 ® 11/2 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/4c
HOUSE SEWER
REMARKS:
VENTILATION
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
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 APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
c$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION l f'C/,
CERT. OCC.
FENCE FINAL
IN,YCI:I uN"J Juan I UKLUINI I IALS
GARDEN WALL FINAL