14969 (RPL)r� " s �11Cr1Y7 V� z
« _ 4
% •-
r No..1496� .
' `+ P.O. BOX 1504 � '
Building 78-495 CALLE TAMPICO-
Address 51-245 Aye. Rub 16 LA QUINTA, CALIFORNIA 92253 ,
Owner Pall Quill
Mailing BUILDING: - TYPE CONST. OCC: GRP.
Address Sate
A.P. Number
City Zip JTel.
La-..i1311t3:. 92253 Legal Description
Contractor _ -ool and Spa
Pa In Desert Peva const. _ Project Description
-334 Desert Dr:
CityZip Tel.:
Ran> hd Hiragv a 9-2270 568-0060
State Lic. City t,
& Classif.•. c53 402959 Lic. # Sq. Ft. No.
Arch 'Engr Size ,Stories
No. Dw.
Units -
Designer.. New ❑ Add ❑, '_'Alter ❑ Repair ❑
Address Tel.
CityZiP State
.Lic: # i
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section .
�) of Division 3 of the Business and/Professions. Code, and any license is 'n full fprce aQQr_—I - • - '.r .'
'"PUeCL-Rl�.-,r .a dei J �-i+, sf�tw-0--w'-1 -1 -9 �^'g�', /h.`L .
Demolition ❑
�LGNATURE` F DATE
'
OWNER -BUILDER DECLARATION = g
I herebyaffirm that I am exempt from the Contractor's License Law foi.the'followin
Estimated Valuation$12,000.00
reason: (Sec. 7031.5,Buslness and Professions Code: Any city 'or county ,which requires 'a
'
Permit to construct, after, improve, demoltsh, .or repair any structure, prior to its issuance also
requires the applicant for such permit to rile a signed statement that he is licensed pursuant to
- PERMIT. 4,- - `•
the. provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of -
- ..AMOUNT
Division 3 of the Bustness end Professions Code, • or that. he is exempt therefrom, and the 'basis
for the alleged exemption. Any violation Section 7031.5 by -any for
. .
Plan. Chk. Dep.
of applicant a. permit
subjects the applicant to a civil penalty of not more than rove hundred dollars ($500).
Plan Chk. Bal. 1B7.75
❑ 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
Const. �3✓ _
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,Mech.
- ,qq 01AD
!provided that such, Improvements are not intended or offered for sale. d, however,, the building
-;:z+ orTimprovement,is-sold within one year of completion, the owner -builder will have the burden
-did
- •2'f y V
Electrical • `z' 1� 45 00
of proving that he not build or Improve for the purpose or sale.) _
- r
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing ` 27.00-
struct the project.' (Sec.. 7044, Business and •Professions Code: The Contractor's License Law
i
does not apply to an owner, of property who builds or improves thereon, and who contracts for
'such projects with a contractors) #tensed pursuant to the Contractor's License Law.) -
S.M-I,
Grading
❑ 1 am exempt under Sec. B. 8 P.C. for this reason
Driveway Enc.
' Date Owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
+
I hereb#affirm that I have'a certificate of consent to self -insure, or a certificate of
Worker's��°,y�npensation.lnsurance, or a certitred copyAlyeof. (Sec 3800, Labor'Code.)
v 'i 1.
_
Policy 3.ompany
' LCopy Is filed with the city, . ❑ Certified copy is hereby furnished.
' ' A.
TOTAL V 318.75---
18.075--CERTIFICATE
CERTIFICATEOF EXEMPTION FROM
-
REMARKS - `
WORKERS' COMPENSATION INSURANCE'; -
(This section need not be, completed• if the permit is for one hundred dollars (5100) valuation
_ �� • �':a - j �` ����°tiv/'j'
�.
' or less.) ! ... ,..
I certify. that in the performs ce of th ork for which this permit is issued, I shall not
i p
-
employ any person in any'man rso as to ecom s act to the Workers' Compensation
Laws ofx Ifornia ;
Date c wrsei
NOTICE-
OTICE TO APPLICANT. d, aft& makingthis Certificate of Exemption you. should become •
'
ZONE: •BY: '
subject to the Workers' C
Compensation . provisions of the labor Code, you must loRhwifh
comply with such provisions or this permit shall be deemed revoked.
/. M1 .✓
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
WARNING: FAILURE TO SECURE WORKERS'COMPENSATIONCOVERAGE-IS UNLAWFUL. AND
Side Street Setback ffOm Center -Line '
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION;.
Side Setback from, Property Line
DAMAGES AS PROVIDED FOR IN SECTION 3706'OF THE LABOR CODE, INTEREST, AND
ATTORNEYS FEES.
' This is a building permit when property 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
N0. pLUM9iNi�:.�&
1ST FL. S0. FT. $
UNITS
COLL. AREA
2ND FL. SO. FT.
ROUGH PLUMB.
YARD SPKLR SYSTEM
POR. SO. FT. 0
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. 0
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT. 0
DUCT WORK
DRAINAGE PIPING
WALL SO. FT. 0
GAS (ROUGH) /f
DRINKING FOUNTAIN
SO. FT. 0
HEATING (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GAS (FINAL)
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER HEATER
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
WATER SYSTEM
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GRADING
Cu. yd.
$ plus x$
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. 0 c
BATH TUB
SO. FT. 0 c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID 0 11A c
SEWAGE DISPOSAL
SO.FT.GAR 0 3/ec
HOUSE SEWER
SPARK ARRESTOR
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 8 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) /f
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
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