15559 (RPL)P.O. BOX 1504
No. 15559
Building 78-495 CALLE TAMPICO
Address 44-355 Camino Lava»da LA QUINTA, CALIFORNIA 92253
Owner Otte/Flartin
Mailinn BUILDING: TYPE CONST. OCC. GRP.
Address rime as above
City ' rzlpTel. "
La Qtiifr'1'r'a 92253
Contractor
Aaaress 68-805 Pere; Road geaite F'-9.
Cathedral pity 9.2234 324--1232
State Lic- City
& Classif. 574127 Lic. # 1044
Arch., Engr.,
Designer
Address Tel.
City lZip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
000) of Division 3�gof the Business and Professions Code; and myHcen a is in full force and
effect. t t -t E4 ± ^
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,Business and Professions Code: Any city or county which requires a
permit to construct, atter, 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 or 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
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 knprove 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
i 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
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Co pensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Polic No. Company
Cdpy 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 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: It, after making this Certificate of 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.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND
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,
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
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. '
A.P. Number
Legal Description
Project Description Pool and Spa
FINAL DATE
Issued by: Date
Validated by:
Signature of applicant Date
Mailing Address Validation:
City, State, Zip
r
INSPECTOR
Sq. Ft.
Size
No. No. Dw.
Stories Units
New Com] Add ❑
Alter ❑ Repair ❑
Demolition ❑
Estimated Valuation
1
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal
99.45
Const.
153.00
Mech.
24.00
Electrical
A5_0111
Plumbing
27.00
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
348 45
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
Issued by: Date
Validated by:
Signature of applicant Date
Mailing Address Validation:
City, State, Zip
r
INSPECTOR
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW FEES
1ST FL. SO. FT. @ $
UNITS
A.C. UNIT
2ND FL. SO. FT.
SLAB GRADE '
YARD SPKLR SYSTEM
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
STORAGE TANK
FORMS
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
DUCT WORK
ROCK STORAGE
DRAINAGE PIPING
CAR P. I SO. FT.
METER LOOP
WALL SO. FT.
OTHER APP./EOUIP.
DRINKING FOUNTAIN
SO. FT. ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING i
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
LUMBER GR.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FINAL INSP.
LAUNDRY TRAY
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/e c
SEWAGE DISPOSAL
MESH
SO.FT.GAR ® 3/ac
HOUSE SEWER
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
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 _d ELECTRICAL _ j HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROU D
A.C. UNIT
COLL. AREA
SLAB GRADE '
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC
ANK
ROUGH WIRI
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EOUIP.
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
00,
I I
�0
/Ay
0
I, -
4a
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
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q
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ACCZESS Poo
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beach gra. i g
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BWXUAFETY DERRTMI ENT
x SU JECT TO INSTALL -TI.;OAS PEfi ,
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ARID ALL AF'PLIC BIBLE CODES
BY
SIZE Lq1?_ 3Px3,4Sgft SIZE 16 Y 32 AREA 438
RAISED +6- "
DEPTH -3'6-' to -S'
UTE 100 11'A7—S
SI-APEor-aMLPERPELE.. 86
TRI LEVEL SEATS vcs
-'L SIZc ��op 3 1jtdam '
22' 24" 27'•
TL_ C-:PL4;. AR 91 scigrwf �ruut
C'Al./.YlAL- WIDTH 6
i R41SE 6EAm
SP LL'IlAY S(LE 1F 'r
'Pi CCIF'IhG cantilever 100'
-C 1tiE'J
CAPAC-Y —I-FJI 34 GALS
-GIMP CA=AC Y ti0 aPM
JETS.# s -_
ht -TCR i -P STA MA.X 2 aP 1.5
FILTER S YST'E19 3 300 -Q -
FIS 3-040
=P%t
! TUP.NCVFR 3 HK:S i
LR-'JR1V LIKES. YES
MAIN rRAIN YF -S-
-.S KIMI.,F;
LtiSIr1MMF; MODEL DUMA'OUT
--IECK %!A-VrF4jR SPA
E',TER L;ARS SIZE -5O 40(i F37UL
=(A- LIGHT 44KI —_
PA U& 1-f l NOW
CL -C -ICK 2411ORi210V �
ELE::TFCRY-S.D.C.
ELE.-TIRKA'- z-OP-0INS BY�S.D,C.
TI -E At Cl COOING SD.0
rEC;;I1.G S�D�C. S1� SQFT'
C00LDFC7( K(- 93 (15"STLPS,
CQ.VTRA.%`IGR -mo-
r'espons 9'lity f• -r da -nage to 1
c`-jrbG. s .iewa&s, driveways,
cerre v slabs, sawers
lawns,- --es. fences, retuning :j
walla sorirlders. tee..hone Ines
o- s -rubs. When access is -nade
th-cugh a neighbor's property t is
undeq--tozd that you, Yne owner,
have nei--hzo-s permission
and'aaucn_ full resporsibilly.
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A:A44355`Cam. Lavanda
-4. La Qwi nta, Ca.
dson�,
SHOW ROCPA
F+ /
66-805-A PERE_? RD.'STE. E-9
CATHEr3F-:AL CITY C -A- 92234 "+