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002936 (RPL)Building Address Mailing Address 75-05 City Zip ...�"t Contractor S.I. Pool Address P.O. BOX 1504 NO. 002936 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 BUILDING: TYPE CONST: OCC: GRP. Club Glx ive A.P. Number Tel. 92260 55g_2,g29 Legal Description PIZ Project `M i3= 2. C Y . P.O. B= 399 . City Zip Tel: ' -- (!at - X 23 State Lic. City & Class.if.. 275796 Lic. # 69 Sq. Ft. No. No. Dw. - Size Stories Units Arch., Engr., - Designer. New Add ❑ Alter ❑ Repair ❑." Demolition ❑ Address Tel. City Zip State Lic. # . Spa LICENSED CONT.RACTOR'S DECLARATION i, I hereby affirm that I am licensed.under provisioris of Chapter•9,(com encing with Section 7000) of Division -Sof the Business and Professions Code„and•my-license.is.in full force and ' effect. SIGNATURE DATE _ - OWNER -BUILDER DECLARATION Estimated Valuation . I hereby affirm that I am exempt from the Contractor's License Law for the following $ 101000.001 . reason: (Sec. 7031.5, Business and Professions Code: Any city ,or county. which requires _a 9 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 pursuantto., 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 for Any Section 7031.5 'any for Plan Chk: Dep. ' the alleged exemption. violation of by 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, will do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and COfYSt. ��.{� 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.- �d 6.10 " 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 Electrical Q of proving that he did not build or improve for the purpose of sale.) " , " n O I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 12.00 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 for S. M. 1. -' such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading O I am exempt under Sec..B. 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 Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company ❑ Copy is filed with the city. .❑ Certified copy is hereby furnished. TOTAL 182.72 CERTIFICATE OF EXEMPTION FROM REMARKS 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. NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become ZONE: BY: 'subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Setback Distances: comply with such provisions or this permit shall be deemed revoked _ Minimum 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 if work thereunder is suspended for 180 days.q I ify p ©�� 18 Permit certthat I have read this application and state that the above information is correct, Issued by: Date " 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. y .� 1 . ;-= Validated by: Signature of applicant l' �' --Date Mailing Address Validation: City, State, Zip HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. @ $ UNITS SLAB GRADE 2ND FL. '' SO. FT. BONDING YARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. @ POWER OUTLET ROOF DRAINS CAR P. SO. FT. GAS (ROUGH) DRAINAGE PIPING WALL SO. FT. OTHER APP.IEOUIP. DRINKING FOUNTAIN SO. FT. @ TEMP. POLE URINAL ESTIMATED CONSTRUCTION VALUATION $ GROUT WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SYSTEM WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM KITCHEN SINK ABSORPTION SYSTEM. B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE,TEMIPERM 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 @ 11/4 c SEWAGE DISPOSAL GAR. FIREWALL SO.FT.GAR @ 3/ac HOUSE SEWER LATHING 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 APP.IEOUIP. 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 INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL