13858 (RPL)• 4 4 "
P.O. BOX 1504 N o .
Wilding 49-125 Paso Tempo Lama 78-105 CALLE ESTADO
kddress LA QUINTA, CALIFORNIA 92253
13858
JWIICf .D, b1eserE. Development
BUILDING: TYPE CONST.
A.P. Number
OCC: GRP..
Aailing
kddress p.0. Box 1716
;ity
Zip
Tel.
La Quinta., dA
92253
1 771-Z941
Legal Description
Project Description
;ontractorPa®1
California Pools $ Spas
dd 4s—9110I. Boardwalk, A-2
;ity
Palm Desert&
,
Zi
92260
Tel.'
340-9000
(tate Lic.., �.F�J� 0
L Classif.
City �i3rJ.
Lic. #
Sq. Ft.
No. No. Dw.
Size
Stories Units
►rch., Engr.,
)esigner
New ❑ Add ❑
Alter. ❑ Repair ❑ Demolition ❑
kddress
Tel.
;ity
Zip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed.under provisions of Chapter 9 (commencing with Section
70000f DNis'om3;ohthe'Business a d rofessions Code, and my license is in full force and
LGNATURE DATE
- OWNER•BUILDERDECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
myon: (Sec.. 7031.5,Business and Professions Code: Any city or county which requires a
ermit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also
squires the applicant for such permit to rile a signed statement that he is licensed pursuant to
)e 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
)r the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit
ubjecls 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, willp�
o the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
'rofessions Code: The Contractor's License Law does not apply to an owner of property who
wilds or improves thereon and who does such work himself or through his own employees,
rovided that• such improvements are not intended or offered for sale. If, however, the building
r improvement is sold within one year of completion, the owner -builder will have the burden
proving that he did not build or improve for the purpose of sale.)
J 1, asowner of the property, am exclusively contracting with licensed contractors to con-
itruct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
foes not apply to an owner of property who builds or improves thereon, and who contracts for
;uch projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
] I am exempt under Sec. B. & P.C. for this reason
Estimated Valuation
$11,000.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
81.90
Const.
�.1,6. V i�
s♦
Mech.
.0
Electrical
45.00I
Plumbing
27.06
S. M. 1.
Grading
Driveway Enc.
ate owner
Infrastructure
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. (Sec..300, Labor Code.J
Policy No. Company Win.- C_ t:1 r-^1
OfCopy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL
303.90
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
REMARKS
'This section need not be completed if the permit is for one hundred dollars ($100) valuation
)r less.)
I certify that in the performance of thg work for which this permit is issued, I shall not
:mploy any person in any manner so as to become subject to the Workers' Compensation
_aws 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
,omply with such provisions or this permit shall be deemed revoked.
ZONE: BY:
Minimum Setback Distances:
Front Setbackro(n Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
cork for which this permit is issued. (Sec. 3097, Civil Code.)
Side Street Setback from Center Line
Side Setback from Property Line
ender's Name
FINAL DATE
Issued by:
Validated by:
INSPECTOR ~ _
-) %
Date r.Permlt�• r ``
/
/
ender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
xpiration if work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.
agree to comply with all city and county ordinances and state laws relating to building
:onstruction, and hereby authorize representatives -of this city to enter the above
mentioned property for inspection purposes.
�ignalure of applicant Date
$ailing Address
Validation:
�� UZ 2 /
Sp�j� l r
J ��
_ <.li
My, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
i
2ND FL. SO. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. I 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
---
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN _
WASHER(AUTO)(DISH)
APPLIANCE DRYER
ROCK STORAGE
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
OTHER APPJEQUIP.
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
WATER SYSTEM
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/nc
HOUSE SEWER
FINAL INSP.
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 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.
FRAMING
FINAL INSP.
ROOFING
/
v �/
/
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