10747 (PAT)a
Q4 P4 fps
Building 79-413 Horizon Palms
Owner
Fred Recupido
Mailing
Address same
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
City LaQuinta Zip 92253 Tel. *
Cont acT31 r%Huilder
Address
No. 10747
11LDING: TYPE CONST. -OCC,. GRP. -
P. Number 604-1100-027
:gal Description
oject Description Patio Cover
CERTIFICATE OF EXEMPTION FROM f,
WORKERS' COMPENSATION iNSURANC5,-,,_---M
(This section need not be completed if the permit is for one,
h
or less.) undred dollars ($100) valuation
- .r i/
I certify that in the performance of thq'work.for which/this permit°is issued, I shall not
employ any person in -any manner sous torbecome subject to t 1Norkers',Compensation -
Laws of Califomia i B t
Date Owner ,/_
NOTICE TO APPLICANT�,f1,`afteii,maCng,:.th(s�Certifichi6-of Exemption you should- become
subject to the' Workers' Compen"sagon prooionsr o1—the Labor Code, you must forthwith
comply with such provisions or this permit shafoe. deemed revoked.'
v 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.)
Lenders Name
Lenders 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
REMARKS
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
Issued by: Date Permit -
Validated by:
Validation:
City
Zip
Tel.:
State Lic.
& Classif.
City
Lic. #
Sq. Ft. 310
Size
No. No. Dw.
Stories Units
•Arch., Engr:, - . .
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
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Busbiess and Professions Code: Any city or county which requires a
permit to construct, after, improve, demolish, or repair any structure, prior to its issuance also
_requires the app8cant for such permit to nye 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, andthe basis
for the alleged exemption. Any violation of...Section 7031.5 by 'any applicant for a pemdl�
' subjects the applicant to a civil penalty of not more than five hundred dollars.($500).
}l - 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•bnproves thereon and.who does such work himself or through his own employees,. -
- provided that' such bnprovements are not intended or offered,lor 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 bnprove for the purpose of sale.1 .. '
O I, as owner of the property, fg—tin "1'
p party, am exclusively contracting wifh licensed contractors to con-
struct the project. -(Sec. 7044, Busiriess�Rfofesslons�Ciide: The Contractor's License Law
does not apply to an owner of propertyjrJ o builds or Improves thereon, and who contracts for
• such projects with a contractor(s)7icensed pursuandto the Contractor's License'Gw.) -
O. 1 am exempt under Sec, � / �� /
B. &/P.0/forthis reason /
,��--��-s-
EStlmateti.ValUatlOn
4 D nn V
61
. PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
; •
Ct.
7�
•
Mebh. -
-
Electrical
Plumbing
S.M.I.
o �� ,
Grading
Driveway Enc.
Date owned
Infrastructure
WOrRK PS' COMPENSATION DECLARATION
" I hereby affirm thatjl have ajc6tificate of consent *to self -insure, or a certificate of "
Workers Compensatior0nsurancfe, or a certified copy thereof. (Sec. 3800. Labor Code.)
Policy No _�
,Company
O.Copy is filed with the city. O Certified copy is hereby furnished. -
-
rF r ppr' i Jt /ire a
r3'3 ' tC`Id'tl Li[ timet ` 5 , "(j
TOTAL
119.30 �
CERTIFICATE OF EXEMPTION FROM f,
WORKERS' COMPENSATION iNSURANC5,-,,_---M
(This section need not be completed if the permit is for one,
h
or less.) undred dollars ($100) valuation
- .r i/
I certify that in the performance of thq'work.for which/this permit°is issued, I shall not
employ any person in -any manner sous torbecome subject to t 1Norkers',Compensation -
Laws of Califomia i B t
Date Owner ,/_
NOTICE TO APPLICANT�,f1,`afteii,maCng,:.th(s�Certifichi6-of Exemption you should- become
subject to the' Workers' Compen"sagon prooionsr o1—the Labor Code, you must forthwith
comply with such provisions or this permit shafoe. deemed revoked.'
v 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.)
Lenders Name
Lenders 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
REMARKS
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
Issued by: Date Permit -
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SO. FT. @
GAR. SO. FT. ®
CAR P. SQ. FT.
WALL SQ. 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 APPJEOUIP.
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1% c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/.c
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 APPJEOUIP.
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 Ilk ?x
VV
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