RPL (0207-222)44645 Marguerite Ct
0207-222
LICENSED CONTRACTOR 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
ProfessionalsQ-ode, and'my License is in full force and effect.
License # Lic. Class Exp: Date
'192661 13 0.27 FUG C5 M31103
16ate 15 , /is" -•Signature of Contractor Aj✓ ' 'a p
OWNER -BUILDER DECLA4ATI,ON,"/
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ). 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, Business & Professionals Code).
(. ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals .
Code).
() I am exempt under Section B&P.C. for this reason
Date Signature of Owner
;• 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.
(,,,K l have and will maintain workers' compensation insurance, as required by
Section 3700 of Jhe Labor Code, for the performance of the work for which this
permit is issued. My workers' compensation insurance carrier & policy no. are:
Carrier 51rAT1. FLTN1 f Policy No. 106).4..1"-02
(This section need not be completed if the permit valuation is for $100:00 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, and agree that if I should become
subject to the workers' compensation provisions of Section 370016f the Labor
Code,,,l•§h;' li,forthwith comply with"tliose`pro' isions. 14—j 1'r ,i
Warning: Failure to securerWo,rke,rs'.•Comp'ensation dove?age'is unlawful and
rl
shall subject an employer to criminal penalties and cyil'fines up to $100,000, in '
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at `
whose request and for whose benefit work is performed under or pursuanj to
any permit issued as a result of this applicaton agrees to, & shall, indemni
& hold harmless the City of La Quinta, its officers, agents and employee1h,
2. Any permit issued as a result of this application becomes null and voidwork is not commenced within 180 days from date of issuance: -of sucpermit, or cessation of work for 180 days will subject permit to cancellation
I certify that I have read -this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize=representatives of this City to enter upon
the above-mentioned property for inspection purposes
Signature (Owfie /r Agent)
PERMIT #
BUILDING PERMIT ••
40
020 9 :
DATE VALUATION - LOT TRACTJOB SITE
C'
ADDRESS 44460 MAROU M.M
APN
OWNER
I W. Y .Warill
44 -64 5MARGAM, RITE,
1.A t qlb m
USE OF PERMIT
PGCi1,.ANDADR IT'PA
CONTRACTOR
y/ DD yESSIIG NgER / ENGINEER T y.
F40 BOX 16185
CA 92253 LAQDW'XA CA 92,253
(76s))398 — Muf 01'888
0
1aOLjIRSIsF,, ! A i,. `: ° G:J i:d tow,P. C;1'd"i''',5;;. kaiat• ► 7 -, :. ..
A1.. RM,VD,A111M9 SPALL 191%1 PLACE, AT PRE. PLA : UR. P14S3PVC3.10141
k?'QLTiii>ItiIJFfi T MC;:9•C3SUM NOT 1114C:LUDIM
6 11% • IAL L 1$£'0 L -F
VALUATION
UA.''t ION 14, i3.U0 I9
.lu.eb&m"A..a.4F C(),Iri 41:1; u.O.NrSI3.A'4iM1I'6on}Od'E
Y
Mt lel;` ,1'F H 1C SUMMARY
1'1 1 CHECK PE
101-000.429-3I8
$122,03
C0pp 1ppST 4t,UC&'1pp'S'Sgldyal ;99 y11
101-00-418-000
4 ;
1'J:,C 1:iNC1FE1'• •- POOL,
101.0110-419••0011
$27,00
3 '
• i ► x:01 "1 itUC' 'F.: 9 AND PLAN ala
PERIAOXIVEIES POE How
e.
DATE BY ATE Fl L ✓ M
1810ce
INSPECTION RECORD
OPERATION DATE INSPECTOR
• BUILDING APPROVALS
Set Backs
Forr'ts & Footings
Slab Grade
Steel
Roof Deck
0. K. to Wrap
Framing
Insulation
Fireplace P.L.
Fireplace T.O.
Party Wall Insulation
Party Wall Firewall
Exterior Lath
nnAAmn _ int 12th
OPERATION l DATE I INSPECTOR
MECHANICAL APPROVALS
Underground Ducts
Ducts
Return Air
Combustion Air
Exhaust Fans
F.A.U.
Compressor
Vents
Grills
Fans & Controls
Condensate Lines
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
FinaUtility Notice
COMMENTS:
Final
Final
BLOCKWALL APPROVALS
Steel
POOLS - SPAS
— —0
Set Backs
Electric Bond
Footings •-21
Main Drain
-
—�r
Bond Beam i, /elle y
"`�
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
-
`
PLUMBING APPROVALS !
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Pinina
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
FinaUtility Notice
COMMENTS:
Building
Address
re—m
Owner
Mailing
Address
City Zip
PRIM >rt c
Contractor
S
A Zip
P.O. BOX 1504 N 0. 0833T T -
78-105 CALLE ESTADO
LA QUINTA', CALIFORNIA 92253
4x e a BUILDING: TYPE CONST: •_ - • OCC: GRP.
375 Wasbimten St. A.P. Number Tract 24208 - Phase i
Tel.
MID 34-9,-7541 Legal Description CECCtus Hower
Project Description. Pigm SBR lot 61
State Lic.
City
& Classif. 4399
Lic. # 1231
Sq. Ft. X134
No.No. Dw.
Size
Stories Units
Arch., Engr.,
Designer
New ❑ Add
❑`._ Alter ❑ Repair ❑ Demolition ❑•
Address
Tel.
? t•
City,
Zip
State
= .
Lic. #
q
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm -that I am licensed under provisions of Chapter 9 (commencing with Section '
- 7000) Division
=}
of 3 of the Business and Professions Code, and my license is in full force and
effect.
r ,;
'
• +_SIGNATURE• DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the. -following.
,jreason: (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
i.,re'quires 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 rive hundred dollars, (5500).
-1-0, 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
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,
. •.iprovided that'such improvements are not Intended or offered for sale. If, however, the -building
Estimated Valuation
- 1 -
PERMIT AMOUNT
- -
Plan Chk. Dep.
Plan Chk. Bal. , . '19
COr1St. - 6AR SO
Mech.' '
-
-'Electrical
r r
,
'
'.or. Improvement is sold within one year or completion, the owner -builder will have the burden
"'of proving that he did not build or improve for the purpose of sale.)
Plumbing -
><
-
0 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 contractor(s) licensed pursuant to the Contractor's License Law.) -
0 1 am exempt under Sec. B. & P.C. for this reason
S.M.I.
Grading
Driveway Enc.
N 00Owner._ - -
Infrastructure -
,Date.
• -
A b
A
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent'to self -insure, or a certificate of
.Worker's Compensation Insurance, ora certified copy thereof. (Sec. 3800, Labor Code.)
h
Policy No. + Company s•
0 Copy is filed with the city. 0 Certified copy is hereby furnished. ..
TOTAL
4 -384,30
CERTIFICATE OF EXEMPTION FROM • _ - _
WORKERS' COMPENSATION INSURANCE
REMARKS
•. _ _ ... _
-.-
(Thiess.section, need not be completed If. the permit is for one hundred dollars ($100) .valuation
I certify that in the performance of thg 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.
f `i fi "{' • i.. } %'
• 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.
ZONE:. BY: -
'Minimum Setback Distances:
"
Front Setback from Center Line '.
Rear Setback from Rear Prop.'Line
CONSTRUCTION LENDING AGENCY'Side
Ihereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.) •
Street Setback from Center Line
Side Setback from Property Line '
Lender's Name
FINAL DATE
INSPECTOR
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.
Issued by:
Validated by:
Date Permit
Signature of applicant Date
Mailing Address A
Validation:
City, State, Zip -
!'A, m t r , f;:..?: a. ;r e• ;i •+i,e-! -r.•4 ..tf -. i
ii ;t_ .4 : r... + > .: > 1 ~ T ' ., . c. r. - _ ,>'
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SO, FT. ®
CAR P. 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
ROUGH PLUMB.
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GAS (ROUGH)41ayU (gyp
Lc
LAUNDRYTRAY
AIR HANDLING UNIT CFM
m
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
BOND BEAM
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID @ 1+/a c
SEWAGE DISPOSAL
LUMBER GR,
SQ.FT.GAR ® 3/ac
HOUSE SEWER
FINAL INSP. v
(/
ROOFING 2llr/- ( �`�
3
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE JPL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING" ,)-r eq(-
q.3 UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE A,
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)41ayU (gyp
Lc
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 1 (,b
FRAMING 41t/
FINAL INSP. v
(/
ROOFING 2llr/- ( �`�
3
f
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LAARHING
MESH
INSULATIONISOUND 7 O CU (.
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL