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RPL (12492)Building .57-301 H6rion Address Owner ',• Btkr2'iett Mailing Address .._-. Seme P.O.-BOX 1504 N o . 124,92 • 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 City' t Zip Ii, .• - I. I La Qi1'-a,,CA 92253 _ .771-2325 Contractor Cali; oi'n :a P©1o16 and Spas,-_ Ad�d�re= 1"4 336a�rdwalk A-2 . cValm, DPs$rt, t �p 92221 Te State Lic-: Ci' 340-9040 & Classif: -'::. C453 185102 Lic. # 355 -Arch., Endr;,--,'* Designer Address {.7:. .,• x;.r Tel. ' Pyy a City '�; Zip State Lic. # -" LICENSED CONTRACTOR'S DECLARATION I hereby affirm that l am licensed.undeL:provisions of Chapter 9 (commencing with Section 000)CoF Division•3 of-the•Business'ari P.r,O essidrts,Code, and my license is in full force and Aeffect. r �Y - _SIGNATURE DATE ,OWNER -BUILDER DECLARATION j 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 orlcounty 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). ❑ 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, Buisness and Professions Code: The Contractor's License Law does not apply to an owner of property who bullds'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 or 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 contractor(s) licensed pursuant to the Contractor's. License Law.) ❑ 1 am exempt under sec.`• B. & P.C'for this reason Date Owner ' t 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 MQdpy 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 iri 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 or 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 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.) 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 BUILDING: TYPE CONST. OCC: GRP. A.P. Number Legal Description Project Description Pool and spa Sq. Ft. Size No. Stories, No. Dw. E' Unjts New ❑ Add O -Alter ED- -Repair p Demolition`O , L , tstfmatea valuation $17 t 3500. 0-3 `PERMIT AMOUNT , „ Plan Chk. Dep. Plan Chk. Bal. COr1St. - - -•6f a Vii - 4e.0 Mech. m ^ Electrical �� • +�i+ Plumbing i • "� .S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS ZONE: BY: MinimumSetbackDistances: _ Front Setback from Center Line Rear Setback from Rear Prop. Line •Side Street Setback from Center Line - Side,.SAack.from Property Line `* FINAL DATE INSPECTOR Issued by: Date Validated by: s -Validation: ;:� ;NO ,l 0 ,199 CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS SLAB GRADE 2ND FL. SQ. FT. ®' BONDING YARD SPKLR SYSTEM STORAGE TANK MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® DUCT WORK ROCKSTORAGE GAR. SO. FT. ® POWER OUTLET ROOF DRAINS HEATING (FINAL) OTHER APPJEQUIP. DRAINAGE PIPING CAR P. SQ. FT. TEMP. POLE WALL SQ. FT. GROUT DRINKING FOUNTAIN SO. FT. ® FINAL INSP. URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER SYSTEM WATER PIPING NOTE: Not to be used as property tax valuation -$ FLOOR DRAIN MECHANICAL FEES FINAL INSP. WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM VENTILATION 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 GAR. FIREWALL SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEIE CONST. FEE JELECT.FEE SMI FEE rFEE 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 ROCKSTORAGE 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 INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESJINITIALS GARDEN WALL FINAL