BSPN2015-0005 + RPL (14864)44585 Marguerite Ct
BSPN2015-0005
14864
y: 0' r Quittrcv
78-495 CALLE TAMPICO
LA QUINTA, .CALIFORNIA 92253 r COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BSPN2015-0005
Property Address:
APN:
Application Description: SPECIAL INSPECTION TO DEMO POOL
Property Zoning:
Application Valuation: (}
Applicant:
Ff"nuut
PAUL& RAMON MARQUIS 2 9 2015
44585 MARGUERITE CT
LA QUINTA, CA 92253 OFLAGUINTA
VELOPMENT DEPARTMENT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
License Class: License No.:
Date:
Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
city or county that requires a permit to construct, alter, improve, demolish, or repair
any structure, prior to its issuance, also requires the applicant for the permit to file a
signed statement that he or she is licensed pursuant to the provisions of the
Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3
of the Business and Professions Code) or that he or she is exempt therefrom and the
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for
permit subjects the applicant to a civil penalty of not more than five hundred dollars
1'4 as owner of the property, or my employees with wages as their sole
co pensation, will do the work, and the structure is not intended or offered for sale.
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
apply to an owner of property who builds or improves thereon, and who does the work
himself or herself through his or her own employees,, provided that the 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 or she did not build or improve for the purpose of sale.).
(_) I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project. (Sec. 7044, Business and Professions Code: The Contractors'
State License Law does not apply to an owner of property who builds or improves
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
the Contractors' State License Law.).
(_) I am exempt under Sec. B.8 .C. for this reason
ate: - — Ownel-4a 4')A fiA —
.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for
the performance of the work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's
Lender's Address:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/29/2015
Owner:
PAUL & RAMONA MARQUIS
44585 MARGUERITE CT
LA QUINTA, CA 92253
Contractor:
Llc. No.:
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations
_ I have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by Section 3700 of the Labor Code, for the performance
of the work for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Section 3700 of the Labor Code, for the performance of the work for which this permit
is issued. My workers' compensation insurance carrier and policy number are:
Carrier: _ Policy Number:
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, and agree that, if I should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
Date: r ! Applican .
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS NLAWFUL,
AND 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, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
the conditions and restrictions set forth on this application. '
1. Each person upon whose behalf this application is made, each person at whose
request and for whose benefit work is performed under or pursuant to any permit
issued as a result of this application , the owner, and the applicant, each agrees to, and
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
employees for any act or omission related to the work being performed under or
following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is
not commenced within 180 days from date of issuance of such permit, or cessation of
work for 180 days will subject permit to cancellation.
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 o enter upon the above•
mentioned property for inspection purposes.
Date: / ` / Signature (Applicant or Agen r
Property Detail Report
Property Detail Report for:
44585 MARGUERITE CT, LA QUINTA, CA, 92253-4832
Owner Information:
Page 1 of 1
DIGITAL MAP ecyonatmpprrg
PROOUCTS
Owner Name:
MARQUIS, PAUL N MARQUIS, RAMONA
Assessed Value:
Mailing Address:
44585 MARGUERITE CT, LA QUINTA, CA,
92253-4832
Est Market Val: $348,500
Land Value:
Vesting Code:
HUSBAND AND WIFE
$3,937
Phone Number:
Improvement Value:
Location Information:
Improvement %:
75
Legal Description:
LOT 59 MB 223/022 TR 24208
Tax Exemption:
CA HOMEOWNER
County:
RIVERSIDE FIPS Code:
06065
Census Trct/Blk:
045215/1
APN:
604-252-039 Alternative APN:
Zoning:
Map Ref:
J7-819
Twnshp-Rnge-Sect:
- - Legal Book/Page:
No of Buildings:
Tract No:
24208
Legal Lot:
59 Legal Block:
Res/Comm Units:
1
County Use Code: R1
Subdivison:
0.2063
Sewer Type:
Last Market Sale Information:
-.
Water Type:
Sale Date:
7121/2000 Sale Price:
$229,500
1st Mtg Amount:
$218,025
Sale Doc No:
2000-281480 Price Per SgFt:
$97
1st Mtg Int Type:
ADJ
Transfer Doc. Na
Price Per Acre:
$1,275,000
2nd Mtg Amount:
$
1st Mtg Doc No:
2000-281481
2nd Mtg Int Type:
Sale Type:
FULL AMOUNT COMPUTED
Deed Type:
GRANT DEED/DEED OF TRUST
Title Company;
FIDELITY NATIONAL TITLE CO
Lender:
WASHINGTON MUTUAL BANK FA
Seller Name:
, EVANS WILLIAM L & VALERIE J
Property Characteristics:
Building Area:
2,378 Total Rooms:
Construction:
Living Area:
2,378 Bedrooms:
4
Heat Type:
CENTRAL
Garage Area:
Baths:
3
Air Cond:
CENTRAL
Basement Area:
Fireplace:
Roof Type:
Parking Type:
No of Stories:
1
Roof Material:
TILE
Yr Built/Effective:
1990/. Qualitys
Style:
Pool Code:
Tax and Value Information:
Assessed Value:
$282,088
Assessed Year:
2014
Est Market Val: $348,500
Land Value:
$70,518
Property Tax:
$3,937
Assessor AppdVal:
Improvement Value:
$211,570
Improvement %:
75
Total Taxable Value:
Tax Exemption:
CA HOMEOWNER
Site Information:
Assessor Acres:
0.18
Zoning:
Land Use Code: 163
Assessor Lot SgFt:
7,841
No of Buildings:
Land Use Desc: SFR
Lot W/D:
I
Res/Comm Units:
1
County Use Code: R1
Calculated Acres:
0.2063
Sewer Type:
Calculated Lot SgFt:
8,986
Water Type:
http://dc1.parcelstream.com/GetByKey.aspk?dataSource=%24%28ACCOUNT NAME%2...1/29/2015
*. Y.,? ;^
.c HGTg-06 _HAIR "EYES•:
3106 .l
n
t
r
1t r
T- - , d4t. 4 -4 Q ",
P.O. BOX 1504
LA QUINTA, CALIFORNIA 92247-1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
PROPERTY OWNER'S PACKAGE
(760)777-7012
FAX (760) 777-7011
Disclosures & Forms for Owner -Builders Applying for Construction Permits
IMPORTANT! NOTICE TO PROPERTY OWNER
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as. the builder of the property
improvements specified at
We are providing you with an Owner -Builder Acknowledgment and Information Verification Form to make you aware of your
responsibilities and possible risk you may incur by having this permit issued in your name as the .
Owner -Builder. We will not issue a building permit until you have read, initialed your understanding of each provision,•
signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice
unless you, the property owner, obtain the prior approval of the permitting authority.
OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION
DIRECTIONS: Read and initial each statement below to signify you understand or verify this information.
c
1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder"
building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as
an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person
and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those
injuries. I am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers
on my property.
24. I understand building permits are not required to be signed by property owners unless they are responsible for the
construction and are not hiring a licensed Contractor to assume this responsibility.
C 3. I understand as an "Owner -Builder" I am. the responsible party of record on the permit. I understand that I may protect
myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my.
own.
I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on
ernuts and contracts.
. I understand if I employ or otherwise engage any persons other than California licensed Contractors, and the total value
of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered. an "employer"
der state and federal law.
. I understand if I am considered an "employer" under state and fed r
e al.law, I must register with the state and federal
government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment
compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial
r'1
+ ' 7. I understand under California Contractors State License Law, an Owner -Builder who builds single-family residential
structures cannot legally build them with the intent to offer them for 'sale, unless all work is performed by licensed
subcontractors and the number of structures does not exceed f6ur, within any calendar year, or all of the work is performed
under contract with a licensed general building Contractor.
`8. I understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any
financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the
workmanship or materials.
1"l9. I understand'I may obtain more information regarding my obligations as an "employer" from the Internal Revenue
Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California
Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-
00-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors.
10. 1 am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that -I am the
party legally and. financially responsible for proposed construction activity at the following address:
► "'irl. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all
applicable laws and requirements that govern Owner -Builders as well as employers.
a(42. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I
have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with
someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss
you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also
important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working
on your property, you may be held liable for damages. If you obtain a permit as Owner -Builder and wish to hire Contractors,
you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers'
compensation insurance coverage.
Before a building permit can be issued, this form must be completed and signed by the property owner and returned to
the agency responsible for issuing the permit. Note: A copy of the property owner's driver's license, form notarization, or
other verification. acceptable'to agency is required to be presented when the permit is issued to verify the property
owner's signature.
Signature of property owner L144 Date:
Note: The following Authorization Form is required to be completed by the property owner only when designating
an agent of the property owner to apply for a construction permit for the Owner -Builder.
AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF
Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize
the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner -Builder
Permit for my project.
Scope of Construction Project (or Description of Work):
Project Location or Address:
Name of Authorized Agent:
Address of Authorized Agent:
Tel No
I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above
information and certify its accuracy. Note: A copy of the owner's driver's license, form notarization, or other verification
acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature.
Property Owner's Signature: Date:
; !' Y - .
_
f
• , • r
f
, • S
.. a
•
- '
a
a
+
` - -
..
—.
...
'
a
a
, ,
+.
a
.
..
i ; ..
t
,
r
i) M
_
a , t.
' ).
Description: SPECIAL INSPECTION TO DEMO POOL
Type: SPECIAL INSPECTION
Subtype:
Status: UNDER REVIEW
Applied: 1/29/2015 PJU
Approved:
Parcel No: Site Address: ,
Subdivision:
Block:
Lot:
Issued:
Lot Scl Ft: 0
Building Scl Ft: 0
Zoning:
Finaled:
Valuation: $0.00
Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0
No. Stories: 0
No. Unites: 0
APPLICANT
Details: SPECIAL INSPECTION TO DEMO POOL WILL DRILL HOLES PER APPROVED PLAN APPROVED PER B.H.
CHRONOLOGY
Printed: Thursday, January 29, 2015 5:11:33 PM 1 of 2 C
SYSTEMS
CONTACTS
NAME TYPE
` ' NAME `:
ADDRESSl'" ;
0. ``CITY .' :
STATE
' _ ZIP,z
• PHONE' -'
FAX-
EMAI "
APPLICANT
PAUL & RAMON MARQUIS
44585 MARGUERITE CT
LA QUINTA
CA
92253
(760)200-0218
OWNER
PAUL & RAMONA MARQUIS
44585 MARGUERITE CT
LA QUINTA
CA
92253
(760)200-0218
OWNER 1
PAUL & RAMONA MARQUIS
.44585 MARGUERITE CT
LA QUINTA
CA
92253
(760)200-0218
Printed: Thursday, January 29, 2015 5:11:33 PM 1 of 2 C
SYSTEMS
Printed: Thursday, January 29, 2015 5:11:33 PM 2 of 2 C§TWSYSTEMS
INSPECTIONS
SEQID' -INSPECTION TYRE ?.-I S PE R
SCHEDULED,
COMPLETE`REMARKS
DATE -
4,.,,DATE ,
FINAL"
Printed: Thursday, January 29, 2015 5:11:33 PM 2 of 2 C§TWSYSTEMS
Bin fl , .
Permit ##
Project Address: 1-- 4-5S'
City of La Quin to .
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico .
La Quinta, CA 92253 - {760) 777-7012-
Building Permit Application and Tracking Sheet
T U -,I - Owner's Nam c: a,4. /Y114(L( Akj S
A. P. Number:
Address:► 4'5 8S CY-arv ere 'f e, ('
Legal Description:
City, ST, Zip: ( ,L' t C ft a j
Contractor:. TJ WAb1G
Q bl
Telephone-1 .DU ACU (
aim=,
Address:
Project.Description:
City, ST, Zip:.
Telephone:
State Lie. # :
City Lie.
Arch., Engr., Designer:
Address: .
City., ST, Zip:
Telephone:
:
aneY
Construction. Type: Occupancy:
•
State Lie. #:
Project type (circle one): New Add'n Alter. Repair Demo
Name of Contact Person:
Sq. Ft.:
#'Stories:
# Units:
Telephone # of.Contact Person:
Estimated Value,of Project:
#/ Submittal Rcq'd
APPLICANT: DO NOT WRITE BELOW THIS LINE
Rcc'd TRACMIG PERMIT FEES
Plan Sets
Plan Check submitted
Iteni
Amount
Structural Calcs.
Revic-,Ycd, ready for corrections
Plan Check Deposit
Truss Cafes.
Called Contact Person
Plan Check Balance.
Title'24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical.
Grading plan
2" Rcvicw, ready for corrcctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up.
S.M.I.
Ii.O.A. Approval
Plans resubmitted
Grading
IN IiOUSE:-
'`0 Revicw, ready for corrcctionsfissuc
Developer Impact Fee
Planning Approval.Called
Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permIt issue
School Fccs
Total Permit Fees
. CV'- -
--tr on
s 85 rna.r,o u e
m P-2 ;s
n •':' i1 P.O. BOX 1504 N o . 14 8 6 4 •
Building ? 78-495 CALLE TAMPICO
Address 44-585 XargUer i.te ct . LA QUINTA, CALIFORNIA 92253
Owner.
Evans
g•._ n
BUILDING: TYPE CONST. - OCC: GRP.
Mailing --' :
Address i
A.P. Number
"CI& Q nta:" ZIp 92253 Tel360-i5 Legal Description
Project Description tion Pool ana Spi3
.` .o1r• csrnxa Pdols & Spas p
Address -93 .. of 6 ° high gaixden block wall
4x' -glt9 'Boardwalk A-2
City __..-. .. Zip Tel.:
Palm, desert, fA 9,2260 3614--1645
State LIc - City ;
& Classff ... C53 . 656128 Lic: # 35_5 Sq. Ft. No. No. Dw.
Arch., fngr., "
Size ; -
Stories..
Units •:
Designer New ❑ Add, 04 Alter.❑ Repair ❑ Demolition ❑. "
Address Tel. #
.City Zip State
Lic. #
ii LICENSED.CONTRACTOR'S,DECLARATION
I hereby affirm that I amrlicensed under provisions of Chapter 9 (commencing with Section
7000) of Divissionr3`oftthe,Business.5nd Professions,Code, and my license is in4ull force and
effect. 3- !-
SIGNATURE ! 3' D' DATE _ $13j200-.00- Pool]?
r OWNER -BUILDER DECLARATION - ~
Estimated Valuationf I !t t
I hereby affirm that I am exempt from the contractor's License Law for the following ,.21✓25". W11Vail -
reason: (Sec. 7031.5,8uslness and Professions Code: Anycity or county which requires a -
permit to construct,. after, 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 too PERMIT' • •s .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 that. he Is exempt therefrom, and the basis
-for the all ad. exemption- Any violation of section 703.1.5 by 'any applicant for:a,permit "Plan Chk. Dep. " " . e r '
subjects the applicant to a civil penalty of not more than five hundred dollars (8500). - _ . . _ ,• .ya i
O..I, as owner of the property, or. my employees with wages as their sole compensation, wil Plan Chk. Bal.
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
CiOf1St
Professions Code:, The Contractor's License Law does not apply to an owner, o/ property who . _ - • _
. builds or Improves ves 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 ' 4 5 0
of proving that he did not build or bnprove for the purpose of sale.)
l7 1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing. , '27. 00.! " f
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. i •- ,
such projects wlh'a contractors) Pcensed pursuant to the Contractor's License Law.) . .
Grading `
O 1 am -exempt under Sec B. & P.C. for this reason
Driveway Enc. .tet
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.)
" Policy No , Company
CV6opy.is filed -with the city, . ❑ Certified copy is hereby furnished.
TOTAL 402.45
` 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 person in any manner so as to become subject to the Workers' Compensation
Laws of California
Date Owner
NOTICE TO APPLICANT:-ff. after making this Certificate of Exemption you; should become ZONE: -
subject to 'the l Workers' Compensation provisions of the Labor Code, you must forthwith -
complywithsuchprovisionsorthispermitshahbedeemedrevoked. .. Minimum Setback Distances:
Front Setback from"Center Line
Rear Setback from Rear Prop: Line
WARNING: FAILURE TO SECURE WORKERS'COMPENSATIONCOVERAGE ISUNLAWFUL. 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 builAmg permit when properly filled out, signed and validated; and is subject to FINAL DATE INSPECTOR
expiration it work thereunder is suspended for 180 days. " • : •• " `
A. I certify that I have read this.application and state that. the above information is correct.."., lssued by: • Date Per • i
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives •of'. thin city , to • enter the, above•..
mentioned property for inspection purposes: Validated by: jI
Signature of applicant Date;MAR 1 3 1995
Mailing, Address . Validation: 1
City, State, Zip: }
;' QV;
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING; FEES
1ST FL. SO. FT. ® $
2ND FL. SO. FT. p
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
SLAB GRADE
FLOOR DRAIN
MECHANICAL FEES
BONDING
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
DUCT WORK
LAUNDRYTRAY
AIR HANDLING UNIT CFM
GAS (ROUGH)
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
WATER HEATER
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1% c
SEWAGE DISPOSAL
BOND BEAM
SO.FT.GAR ® V4c
HOUSE SEWER
$
GRADING
cu.Y d.
plus x$
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 L 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 SE K
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND((. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
EINF. TEEL 1
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
$
GRADING
cu.Y d.
plus x$
=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
`
- lJ
III
l/ /
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
T, A 70
P.O. BOX 1504 No. 08355
Building 78-105 CALLE ESTADO .
Address ter.• "-485 vafi'verite,i oust LA QUINTA, CALIFORNIA 92253
Owner
BUILDING: TYPE CONST..'.. • OCC. GRP
Mailing ._ mss._ .. -
Address'
A ",*951122Cry A.P. Number 'i'meat Wfin - TAt 59
City Zip Tel. ,
Legal Description !`Cotta FIMmAr
Contractor Project Description ,PW.Q Lent K(
Address •
City Zip Tel.: y
State Lic. City '
& Classif. -• Lic. # Sq. Ft.No. No. Dw.
'Arch., Engr.,
Sizej:$.. Stories Units 019 1231,
Designer New ❑ Add.❑• . Alter ❑ Repair ❑ Demolition❑.,
.Address Tel.
City'- ` Zip State t 1r
Lic. # '
LICENSED CONTRACTOR'S DECLARATION ' +
.I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section _ -
7000) of Division 3 of the Business and Professions Code, and my license is in full force and -j `
effect.
+ ,SIGNATURE- - DATE
OWNER-BUILDER DECLARATION Estimated Valuation
.Thereby affirm .that I am exempt from the Contractor's License Law for the following 124,470,00
.
reason: '(Sec. 7031.5,Business and Professions 'Code: Any city or county which requires a 1sA,
permit to construct, atter, improve, demolish, or repair any structure, prior to its issuance also ,
requires tha,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 that. he 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 live hundred dollars ($500). b
01, 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 COr1St' ti.. .• .'
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, • - • rMech. - '
-provided that such improvements-are not intended or offered for sale. If, .however, the building 53q
or'.Improvement is sold within one year of completion, the owner-builder will have the burden Electrical 4. '
of proving that he did not build or improve for the.purpose of sale.)..' - - - •
O ],'as owner of the property, am exclusively contracting with I icensed 'contractors to con ! ; Plumbing . • 167.50
strucl 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. • yiS '
such projects with a contractors) licensed pursuant to the Contractor's License Law.)
Grading
O 1 am exempt under Sec. B. & P:C. for this reason
Driveway Enc.
Date nes Infrastructure
mt-In Public taces 61.18
WORKERS' COMPENSATION DECLARATION -
_ I hereby affirmthat'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
t ❑ Co s filed with the city.' ❑ Certified co
_ Copy iy py is hereby furnished: .
TOTAL 4,574.25
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one .hundred dollars (S 100) valuations +
`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 • a
Laws of California.
Date Owner:.
NOTICE • TO APPLICANT: If, after making this Certificate of . Exemption you should become ZONE: - BY:
subject to the Workers' Compensation provisions 'of the Labor Code, you•must forthwith Minimum Setback Distances: '
comply with such provisions or this permit shall be deemed revoked.
Front Setback from Center Line
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
Lender's Address FINAL DATE INSPECTOR
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. "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 Address Validation:
City, State, Zip +
t i.. -; -+ 4. i > t ..rE -k 1 _ e '; ^ .:K `S..`' , 1 y 4 t. 'i •1.,n-. ..^' .. i
t y r. "ti' 'F ..l ,t n - .:t `2s'.•- -r. e t t'u
.f, r. es w •t. `- . .. .e1..r ! ^i 1" ..a +:{. jy ,is, tii_,:••. .., i •.' . '4• "'. „ L: t + -Y t•. - .. .. _ .
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. SQ. FT.
POR. SO. FT. ®
GAR. SQ. FT. ®
CAR P. I SQ. FT.
WALL SQ. FT. ®
SQ 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
COLL. AREA
FLOOR DRAIN
MECHANICAL FEES
ROUGH PLUMB.
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FORMS
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
DUCT WORK
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.
SQ. FT. ® c
BATH TUB
TEMP. POLE
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/. c
SEWAGE DISPOSAL
WATER HEATER
SO.FT.GAR ® Vhc
HOUSE SEWER
FINAL INSP.
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/ s.5
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
If
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. r
GAS (ROUGH) 3 Q L
/
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
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. L ( W
FRAMING !
FINAL INSP.
ROOFING 3
/2S2
9(p
L/ // q /
G N
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR.
FIIREWALL
LA HING T --
MESH
INSULATIONISOUND l jqlV
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL