RPL (10425)4k
P.O. BOX 1504 N o , 10425
78-105 CALLE ESTADO
Building 54-065 MENDOZA LA QUINTA, CALIFORNIA 92253
Address
Owner
WM. ENRIGHT
Mailing BUILDING: TYPE CONST. OCC. GRP.
Address SAME
A.P. Number
City Zip Tel.
LA QUINTA 192253 1 566-0446 Legal Description
Contractor Project Description SHIMMING POOL
OWNER BUILDER
Address
City Zip Tela
State Lic. City
& 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 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 Estimated Valuation
I hereby affirm that I am exempt from the Contractors 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 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.
`ubecis the applicant to a civil penalty of not more than live hundred dollars ($500). Plan Chk- Bal.
as owner of the property, or my employees with wages as their sole compensation, will$81.90
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and t
ns. 126.00
Professions Code: The Contractor's License Law does not apply to an owner of property who Co
builds or Improves thereon and who does such work himself or through his own employees, Mech. 24.00
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 45.00
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,_contraclors to con- Plumbing 27.00
struct the project. (Sec. 7044, Business and Professions Code: The �Eo`ntr'�ctor`s Licen§e Law
does not apply to an owner of property who bufldsror Improves,thereon, and who cont r cis for $,M,l, � . (i
such projects with a contractor(s) licensed pursuantifo he Contra tor'§ License Law`)
/ / y �^» Gradin
❑ 1 am exempt under Sec. / ,_B ,
B. &/P,C. for this,reason !� / g
/° /1.1 / / Ill,". . ,P/i l / / Il+! . - Driveway Enc.
1< Date y Zf ;owner � � /414 S LIU Infrastructure
WORKERS' COMPENSATION DECLARATION
1 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 i 1
❑ Copy is filed with the city. 0 Certified copy is hereby furnished.
TOTAL 4 3 (i S • U0
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
employ
I of
that in the performance of the work for which this permit is issued, I shall not . h��i)� T"T,'t`1.f f a-T►j`�t i�7! "' : }•: ,!1 j
y 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 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 from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line
I=
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
This is a building permit when properly filled out, signed and validated, and is subject to FINAL DATE INSPECTOR
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
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING 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 S '
R PKLSYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN.
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
r �n
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
L
LAUNDRYTRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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
BOND BEAM
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/. c
SEWAGE DISPOSAL
LUMBER GR.
SO.FT.GAR ® 3/ac
HOUSE SEWER
FINAL INSP./dam/—�p�n
(
ROOFING
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
r �n
h ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
Jl/ y '
SEWER OR SEPTIC TANK
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
L
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL Yx
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP.
y
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FRAMING
FINAL INSP./dam/—�p�n
(
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