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RPL (4211)54190 Avenida Martinez 04211 P.O. BOX 1504 Building r — Z LA QUINTA CALIFORNIA 92253 Address Jai .g I ,"` .13C3 , Owner Mailing A BUILDING: TYPE CONST. OCC. GRP. Address S&xmo A.P. Number 774-222-000 City Zip Tel. TA Quinti 92253 56d_yIf, 6 Legal Description ContractorProject Description Pool and «han4a of service z ficail iar. Address to underground City Zip Tel. State Lic. City & Classif. Lic. # Sq. Ft. No. No. Dw. . Arch., Engr., Size Stories Units Designer New El Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State 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 effect. SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,auslness 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) o/ 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 (5500). ❑ 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, provided that such Improvements are not intended or offered for sale. If, however, the building or improvement is sold wfthJn one year o/ 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. 8 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 ❑ Copy is filed with the city. O Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed i1 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 on PERMIT I I AMOUNT Plan Chk. Dep. Plan Chk. Bal. S40.62 t Const. 62.50 Mech. Electrical 32.511) Plumbing 12.00 S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS 141 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 6/28/39 Issued by: Date Permit Validated by: Validation: WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE STRUCTURE PLUMBING ELECTRICAL HEATING 8 AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEE tS1 FL 2ND FL POR GAR CAR P. WALL ESTIMATED CONSTRUCTION SO FT i UNITS HEATING (ROUGH) Qt FT. YARD SPKLR SYSTEM SO gr MOBILEHOME SVC. FT. BAR SINK SO ttt POWER OUTLET FT. ROOF DRAINS SO. IG SO FT. ra DRAINAGE PIPING SO. FT., DRINKING FOUNTAIN SO. FT. (d URINAL VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation TEMP. POLE FLOOR DRAIN MECHANICAL FEES GROUT WATER SOFTENER /ENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTONDISHI 4PPLIANCE DRYER BOND BEAM GARBAGE DISPOSAL "URNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY SIR HANDLING UNIT CFM LUMBER GR. KITCHEN SINK 4BSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET :OMPRESSORHP POLE,TEMIPERM LAVATORY AEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER 301LER B.T.U. SO. FT. ®c BATH TUB SO FT @ c WATER HEATER NAX. HEATER OUTPUT. B.T.U. SO. FT, RESID 1'A c SEWAGE DISPOSAL SO.FT.GAR >i c HOUSE SEWER SPARK ARRESTOR GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL I TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE I CONST. FEE ELECT. FEE SMI FEE PLUMB FEE STRUCTURE PLUMBING ELECTRICAL HEATING 8 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 APP.IEOUIP. ' REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING CU. yd. $plUs xS =E LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING cl J J - If LL REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATUREWINITIALS GARDEN WALL FINAL �h F s CITY OF LA OUI NTA DEPARTMENT OF PLANNING & DEVELOPMENT BUILDING DIVISION 5642246 24-HOUR NOTICE FOR INSPECTIONS Owner Thomas Bower Contractor Same Permit Number 4 211 POST ON JOB IN CONSPICUOUS PLACE INSPECTOR MUST SIGN ALL APPLICABLE SPACES JOB ADDRESS 54-190 Martinez "Pool & change of service to TYPE OF INSPECTION DATE INSP. FOUNDATION & SETBACK FOOTING STEEL MAIN GROUND SYSTEM GROUND PLUMBIN PRE-GUNITE r DO NOT POUR C E UNTIL ABOV HAS BEEN SIGN CONCRETE SLAB JOISTS & GIRDERS ELECTRICAL GROUND WORK DO NOT POUR CONCRETE UNTIL ABOVE HAS BEEN SIGNED ROUGH PLUMBING ROUGH GAS & GAS TEST HEATING & VENT -A/C FIREPLACE ROOF BOND BEAM O.K. TO WRAP GROUT ❑ 4' ❑ 8' FRAMING INSULATION PRE -ROOF COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED DRYWALL INTERIOR EXTERIOR LATH POOL PRE PLASTER POOL FENCE & GATE SEWER SEPTIC TANK FINALS ELECTRICAL PLUMBING FINAL GAS TEST HEATING - A/C HOUSE NUMBERS JOB COMPLETED Trun nr�rri ABOVE APPROVALS DO NOT INCLUDE RIGHT TO TURN ON UTILITIES OR OCCUPY BUILDING 4/88