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RPL (11256)Buildin Addressg 53-580 MENDOZA • Owner BILL FLEMING Mailing Address SANE City LA QVINTA, Z192253 . HG*HTR$8-P®91 S . Contractor MCINTYRE POOLS Address 46-301 ROUDEL •LAIIE Cit /ANQUI'NTA 2152253 State Lic. & Classif.. C53=614611 •°Arch., Engr.,.' • • - ' ' Designer P.O. BOX 1504, NO.-ALIZ56 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253. ' BUILDING: TYPE CONST. OCC: GRP. A.P. Number Legal Description erat5i..,'4� �r�s'hiy�7:s<��9>��ti -447" . Project Description POOL ONLY TeS42—'352 i City Lic. # 1945, Sq. Ft. No. No. Dw. Size w - Stories- ' Units •- New ❑ Add`❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. ' 4 City Zip State _ _ Lic. # ' _ LICENSED CONTRACTOR'S DECLARATION _ c 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''' - ' - -• SIGNATURE DATE ' OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's Lirense Law for the following, reason: (Sec. 7031.5,Business and Professions Code: .Any city or.county which the. 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 provlslon1 o/ 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, aitd the basis - • :.for the alleged 'exemption. Any violation o/ Section 7031.5 by 'any applicant for a permit 7 subjects the applicant to a'civi penalty of not more than rive hundred dollars .($500). • ' - • ❑ a; as owner of the property, or my employees with wages as their sole compensation; will.. `ado the work, and the structure is not intended or offered for sale. (Sec. 7044; Buisness and SA.Pro/essJons Code; The Contractor's License Lawdoes'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 burden _ of proving that he did not build or improve for the purpose of sale.) _ Estimated V81UfltlOn j $10,000 - - , PERMIT AMOUNT" - e Plan Chk: Dep. .. .. ••- Plan Chk. Bal. 76.05 Const: 11-77-00 - - -`• 2�S .(% -a0 Electrical - 4500 ,• Plumbing 27.00 O 1, 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 swho builds or improves thereon, and who contracts for • such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) . - -17.1 am exempt under Sec.. ' B. 8 P.C. for this reason S.M.I.- - 1 . 00 - Grading - " Driveway Enc. Date owner Infrastructure WORKERS' COMPENSATION DECLARATION. I hereby affirm that.l 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., ❑ Certified copy is hereby furnished. TOTAL CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE,• ' REMARKS (This section need not be completed if the permit is for one hundred dollars . (S f 00) valuation or less.) .. _ 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. .. - .- 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. , ZONE: - BY:_17 Minimum Setback Distances: I.. Front Setback from. Center. Line Rear Setback from Rear Prop, Line 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 Side Street Setback from Center Line -Side Setback from Property Line Lender's Address FINAL DATE y :INSPECTOR - This is a building permit when properly filled out, signed and validated, and is'subject to expiration it work I areunderis 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:, Date Permit - Validated by: Signature of applicant Date Mailing Address Validation: � City, State, Zip M CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ 2ND FL. SQ. FT. POR. SQ. FT. ® GAR. SQ. FT. ® CAR P. SQ. FT. WALL SO. 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 BONDING FLOOR DRAIN MECHANICAL FEES FORMS WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APPJEQUIP. 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. SQ. FT. ® c BATH TUB SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID @ 11/. c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ic HOUSE SEWER REMARKS: 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 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. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL Building e Address c - Owner Mailifig Addres City Contractor Address ty Zip . ITel. State Lic. City & Classif. Lic. # Arch., Engr., Designer Address Tel. CityI Zip I State Lic. # P.O. BOX 1504 APPLICATION ONLY 78-105 CALLE ESTADO _LA QUINTA, CALIFORNIA 92253 LICENTRACTOR' CLARATION 1 here (firm that I am ed nder provis' of Chapter 9 (commencing with Section 000) itn 3�I the usi s nd Profe Code, and my license is in full force and OWNER -BUILDER DECLARATION 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 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). ' 1-1 I, as ownerof 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 v 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.) 1 1 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. 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 0 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 thg work for which this permit is issued, 1 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: 8, 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,l have read this application and state that the above information is correct. 1 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 BUILDING: TYPE CONST. OCC. GRP. A.P. Number Legal Description_ Project Description Sq. Ft. No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ r ;timated Valuation PERMIT AMOUNT Plan Chk. Dep. . Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS i ZONE:w 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 Permit Validated by: ' Validation: FINANC.F I - �11.