RPL (10573)A
N,',ip IS
i
• Building
• Address 52-710 NAVARRO
+1f , JON SCHOLLESNBBRGBR
Mailing
Address P. O, BOX 59
City Zip
LA QUINTA 92253
Contractor
GENERAL CONTRACT MGM
Address
SABER
City . izip
7,7W P.O. BOX 1504 No, .10573
78-105 CALLE ESTADO'
LA QUINTA, CALIFORNIA 92253,, l,�)
BUILDING: TYPE CONST: OCC: GRP. -
A.P. Number
Tel.
554-1486 Legal Description
Project Description POOL AND SPA
�» • -_,;� sr�, :rw.�:•�, :.ori: ,
Tel..
State Lic.
City.
,
& Classjf. 524-325
Lic. # 1235
Sq. Ft. No. No. Dw.
Size _ Stories Units •.
Arch., Engr.,
New ❑ Add ❑ Alter ❑ Repair ❑ "Demolition ❑
,;Designer.
Address
Tel.
City
Zip
State
'
Lic. # ;
4
LICENSED CONTRACTOR'S DECLARATION
w
' I hereby affirm that I am licensed under provisions of_Chap'ter 9 (commencing with Section
ess
7000) of Division 3 of the Business and Profions Code.and my license is in full force and
-'effect. . . - - - >
-DATE
SIG .. - 8 DATE
.<
s OWNER•BUILDER DECLARATION
k`a — e �-
t i 1 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, "or to its issuance also
,requires the applicant for such permit to life a signed statement that he is .licensed pursuant lo''
the provisions of the Contractor's Ucense Law, Chapter 9. (commencing with Section 20.00) o/
(.'Division 3 0l the Business and Pro/esslons'Code,-or that.h-e is exempt therelom, and,thetbasis
for the alleged exemption .•Any'•violatlon of•Sectlon 7031.5 by 'any applicant• for a -permit
' ."subjects the applicant to a civil penalty of not more than live hundred dollers.($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 o/ 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.)
Estimated Valuation '$8 Q O
- ( !
-• '
.. PERMITS. - :AMOUNT
.,. '
PIan.Chk Dep;- -
_ -
Plan Chk. Bal.
1.COf1St. . ' Y 6 4 .35
�.
VMech.� ,. � , 9 '00- pa7 n - •-
- 79 9
~
EI2CtfICal - 24 :00
- '
Plumbing. rj Q�
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
• • strucl the project. (Sec. 7044, Business and Professions -Code: Th/Contractor's License Law
does not apply to an owner o/ 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'
- ❑ 1 am exempt under Sec. ,r"' B'8 P.C. for this reason
-
_ - Asf
S.M.I. •'t1 27.00 '
'
Gradin 80
9 •
Driveway Enc.
Date 'owner J
Infrastructure
WORKERS' COMPENSATION DECLARATION
'
I hereby affirm that I have a certificate of consent to self=insure; or a certificate of
Worker.'s.Co_ mpensation Insurance, ora certified copy thereof. (Sec. 3800; Labor Code.) . •'
,
' - ' '
Policy No. .Company
❑ Copy is filed with the city. • O Certified copy is hereby furnished:
,• . ,,,
TOTAL` '$260.15
'
CERTIFICATE OF EXEMPTION FROM,
WORKERS' COMPENSATION INSURANCE '
(ThisIsection roeetl not be completed 11 the permit is /or one hundred dollars � ($100) valuation
or less.):- • 1
I certify that in the performance of the work for which this permit is issued, I shall not
employ anyp ersonin any manner so as to become subject -to the Workers' Compensation -
Laws of California.
y "
REMARKS
_
f
,
'- Date Owner '
•_ NOTICE TO APPLICANT: If, after .making this Certificate o/ Exemption youhould become
s
'subject to the Workers' Compensation provisions o/ the Labor. Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
r -
ZONE: BY:
Mlnlmum Setback Distances:
t
Front Setback from. Center. Line
_
Rear Setback from Rear Prop. Line
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.)
Side Street Setback.from Center.Llne
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. r
I cerlily that I have read this application and stale that the above information is coriect:
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 4• Permit
�-
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. SQ. FT. ®
GAR. SQ. FT. ®
CAR P. SQ. FT.
WALL SO. FT. ®
SQ FJ ®
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
SLAB GRADE
FLOOR DRAIN
MECHANICAL FEES
BONDING
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
SEWER OR SEPTIC TANK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
DUCT WORK
LAUNDRYTRAY
AIR HANDLING UNIT CFM
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1% c
SEWAGE DISPOSAL
BOND BEAM
SQ.FT.GAR ® 3Y.c
HOUSE SEWER
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
o UNDERGROUNDL
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. /� /Y1
ROOFING
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REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND +
FINISH GRADING
FINAL INSPECTION? 9 3
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL