003849 (RPL)4
P.O. BOX 1504 ., :- NO. 0 0 3 4 9
Building 78-105 CALLE-ESTADO
Address 53-730 Paxairea LA QUINTA, CALIFORNIA 92253
'Owner
Ted Freitas
BUILDING: TYPE CONST. -OCC: GRP.
Mailing
Address
A.P. Number 77A_i 27—ni 1
City —
Zip
Tel.
Lar Ouin
92253
564 -46 12 ,
Legal Description
Contractor
Project Description 1 •
California Pools A Sha
.Address . .
�7.e.� 6?�r9atn 3?rinari
City
Tel
Cathedral Wy
[Zip
92234
i323� 3Q3 _ _
State Lic..
City
& Classif.
Lic. #
Sq. Ft. No. No. Dw.
Size Stories Units '
Arch:, Engr.. .
Designer
New' ❑ Add ❑ Alter ❑' Repair ❑ Demolition ❑
Address
Tel.
City/` "'
Zip i
State
Lic: #
LICENSED CONTRAGTOR;S DECLARATION ---77—) '
_
hereby affirrrethat I am}licensed under g)rovisi on of Chapter 9 (commencing with Sec It on
7000) of Divisiddn 3 of the Business and Professions -Code, and my license is in full'force and
effect. yy}} % ter/ .
�Yk
SIGNATURE �- ... y..•. ._ .._.__.._ DATE
.. .. .
OWNER>BUILDER DECLARATION'
Estimated: Valuation
I hereby affirm that I am`exempt from the Contractor's License Law for the following
4G
reason_ (Sec. 7031.5,Business and Professions Code:. -Any' city or county whicA requires a
-ppermit'io.
-sio a
-
construct, alter, iinprove, demolish, or repair any structure, prior to, its issuance also
requires the applicant /or 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'
Any Section 7031.5 by 'any /or
. 'Plan Chk. De• -
p -
- '
for the alleged exemption. violation of applicant a permit
' subjects the'applicant to a civil penalty of not more than -five hundred dollars`($500). - '
. -
Plan Chk. Bal.
❑ I, as owner of the'property, or my employees with.wages,as their sole compensation, wilt,';,
do the work, and the structure is not intended or offered for sale. (Sec:•7044, Buisness and'
Const. $125. W0 '
. Professions 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. '
provided that such improvements are not, Intended, or offered ./or, sale. I/„ however, the, building
or improvement is sold within one year of completion,' the owner -builder will have the -burden
Electrical, 4 . 1
' of proving that he did not build, or improve /or the, purpose of sale.)
..
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con-
y� �g�,
Plumbing 14! o QY -
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 /or
S.M.I.
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) - - -
-
Grading
❑ I am exempt under Sec. - B. & P.C. for this reason -
Driveway Enc.
Date Owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
' I hereby affirm' that I have'a certificate of consent to self -insure, or a certificate of:-
f>Worker's
Worker'sCompensation Insurance, 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.
TOTAL
CERTIFICATE OF EXEMPTION FROM+
REMARKS
WORKERS' COMPENSATION INSURANCE
be
�::.
- 7 s py{ !,'Ali f
(This section need not completed it the permit is /or one hundred dollars ($100) valuation
- or less.)
certify that in 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 o/ Exemption you should become
ZONE: ' BY:
' subject to the Worke& 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 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.)
Side Setback from Property Line '
Lender's Name
Lender's Address
FINAL DATE INSPECTOR
' This is a building permit when properly filled out, signed and validated, and is subject to
expiration it 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:. Date4 11 & 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
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO.. PLUMBING FEES
IST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SQ. 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 APP./EGUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
1KITCHEN 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.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
-
Per: -
SQ.FT.GAR ® 3/ac
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
i 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 APP./EGUIP.
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
-
Per: -
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INW-LU I UK'* WUNAI UNt511N111ALb.
GARDEN WALL FINAL