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10011 (RPL)4 P.O. BOX 1504 N o . 10011 I Building 78-105 CALLE ESTADO Address 44-095 Carman Place LA QUINTA, CALIFORNIA 92253 Owner BAY BUILDING: TYPE CONST. OCC: GRP. ! Mailing Address eame A.P. Number City Zip Tel. LaQi rota 92253 Legal Description Contractor Project Description Bice ftuntai€r. Pools POOL AND SPA Address 73111 HWY 111 CityZip Tel.: Palm Desert 9225€ 3455535 State Ljc. CitLic.# 1.402 S & Classif. fr53 331356 q. Ft. No. No. Dw. Size Stories Units Arch., Engr., Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. I City Zip State Lic. # ! LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensedunr der provisions of Chapter 9 (commencing with Section 7000) of tAisidn 3 oftheB`ubine'ss andrPPr fessions Code, and my license is i�j�ff;ll force and effect.'•,/ y�.C.f _ 4...�4 7/%,✓ ' XGNATUIIE. L EDATE OWNER-BUIR DECLARATION - Estimated Valuation I hereby affirm that I am exempt from the Contractor's License Law' for the following9 E� C, © fl 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 rile 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 for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit Plan Chk. Dep.•' 1.26 81.90 fI e9 V e� . subjects the applicant to a civil penalty of not more than five hundred dollars (5500). Plan Chk. BBI. O ❑ I, as owner of the property, or my employees with wages as their sole compensation, will 9g qt 9 do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. . • 00 Professions Code: The Contractor's License Law does not apply to an owner of property who r+ V n builds or improves thereon and who does such work himself or through his own employees, Mech. d, provided that such improvements are not intended or offered for sale. If, however, the building �ryf• G 0 or improvement is sold within one year of completion, the owner -builder will have the burden Electrical 45. 00 of proving that he did not build or improve for the purpose of sale.) . ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 27.00 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.I. 1 • i 0 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 Worker's Compensation Insurance, or certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company 6"6py is filed with the city.. ❑ Certified copy is hereby furnished. TOTAL- 305. 00 CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE t (This section need not be completed if the permit is for one hundred dollars ($100) valuation - .1 41 tf }, k00- t 4W Al 07— r1 1 —104`7 116 10 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: 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 Minimum Setback Distances: comply with such provisions or this permit shall be deemed revoked. 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 This is a building permit when properly filled out, signed and validated, and is subject to FINAL DATE INSPECTOR expiration if work thereunder is suspended for 180 days. I certify that I have read this application and state that theabove information is correct. Issued by: Date 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 CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SQ. FT. ® $ UNITS COLL. AREA SLAB GRADE YARD SPKLR SYSTEM 2ND FL. SQ. FT. HEATING (ROUGH) STORAGE TANK POR. SQ. FT. ® MOBILEHOME SVC. BAR SINK GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS CAR P. I SQ. FT. ® DRAINAGE PIPING WALL SQ. FT. HEATING (FINAL) DRINKING FOUNTAIN. SQ FT ® URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES FINAL INSP. WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GRADING cu. yd. $ plus x$ GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FRAMING LAUNDRY TRAY AIR HANDLING UNIT CFM (j1/`���)a } l'/� C I U ' 0( led/q < b qM 11 !/ 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 GAR. FIREWALL SQ.FT.GAR ® V4c 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 2 ICONDERGROUND 23 ��� 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)7l-2?/ ih 666666 ��l��lll % METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM FINAL INSP. 1Q ( U ql L 111 FINAL INSP.'S G%� c�� GRADING cu. yd. $ plus x$ _$ LUMBER GR. FRAMING ROOFING (j1/`���)a } l'/� C I U ' 0( led/q < b qM 11 !/ REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION- �L CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL :d