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11662 (RPL)P.O. BOX 1504 No, 11662 Building 50-'925 Calle 2,j1 `.© 78-105 CALLE ESTADO Address LA QUINTA, CALIFORNIA 92253 Owner nitil Address Sa-rzr City Zip Tel. La Quanta, CA 9^4253 Contractor Calif6inia Poo' is & Spas Address 41910 Doradwalk Awe City Zip Tel.: Pala Desert, CA 92250 340=-9000 State Lic. City & Classif. C-53 185102 Lic. # 355 Arch.; Engr:; ' Designer Address Tel. CityI Zip I State Lic. # , LICENSED CONTRACTOR'S DECLARATION I.hereby affirm that I am licensed,under provisions of Chapter 9 (commencing with Section 7000) -of. Divisign 3'of:the Business.and Professions Code, and my license is in full force and effect. --^01 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, alter, 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 of Section 7031.5 by 'any applicant for permit subjects the applicant to -a civil penalty of not more than five hundred dollars ($500). 0 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 down 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.) ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con- struct theproject., (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 for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.), O 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 Compensation Insurance, or a certified copy thereof. (Seca 3800, Labor Code.) Policy No. Company 'Copy Is filed with.the city. 0. 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 thg work for which this permit is issued, I shall not employ any person in any manner sG as to become subject,to the Workers' Compensation Laws of California. 'Date Owner NOTICE TO APPLICANT. If, 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. 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.) Lender's Name 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. . 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 LDING:• TYPE CONST. OCC: GRP.; P. Number Legal Description Project Description Poo Sq. Ft. No. No. Dw. Size Stories Units New ❑ Add'❑ Alter ❑ Repair ❑ -Demolition ❑ Estimated Valuation $10,00().00 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal.. 76 . 05 Const. 117.00 Mech. Electrical 45.00 Plumbing 27.00 S.M.I. Yi a p Grading Driveway Enc. Infrastructure TOTAL Z b b. U5 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. SQ. FT. ® CAR P. SQ. FT. ® WALL SQ. FT. ® SO. 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)` 2[ A Lt2 GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APPJEQUIP. 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 SQ. FT. ®c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL s i /� " -TI/ SQ.FT.GAR ® 3/ac HOUSE SEWER VENTILATION 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//,2t/134P UNDERGROUND/12c 13 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)` 2[ A Lt2 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. / J FRAMING FINAL INSP3 s / ,, eO ROOFING s i /� " -TI/ REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION-3/� 5 34 CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL March 10, 1993 To Whom It May Concern CITY OF LA QUINTA La Quinta, CA 92253 This is to advise that the gate on the Northside of our home will remain locked at all times and, in the event it should be open, we.relieve the City of La Quinta of all liablity. Sincerely, RAy and Ellen-Snitil ' --------------- 5- �