14706 (RPL)414
P.O. BOX 1504 :. N o . 14706..
Building 78 -995 --River Rock 78-495 CALLE TAMPICO
Address LA QUINTA, CALIFORNIA 92253
Owner kinistrelli Construction _
BUILDING: TYPE CONST. = OCC: GRP.
Address
Mailing 50 , 445 Mountain shadow's' y
A.P. Number
LI Q1183id �� ZIp 9 "t25� .. Tel. -
Legal Description "
Poo and S;aRI&tLrATtor'e- P�1S -
& Spas, Project Description
. dd ass .
.t .. �.•� 1792.....
may. Quin a-., CA Zip 2253' .TV427'3522.
State Lic.City
& Classif.- :. x 53 •'614621 Lic. # 1945 Sq. Ft. No. No. Dw.
Engr., .. _ .
Size .. •• - • ..Stories -'Units'
Designer-. New 0 Add ❑ ^ • -• ' Alter❑ Repair ❑ Demolition 0
Address Tel.
City Zip _ State
Lic: #
LICENSED,CONTRACTOR'S DECLARATION
I hereby affirm that I;a'm licensed under provisions of Chapter 9 (commencing with Section '
7000) of Divisio" 3 o_f , Busine/ss,an.,d� P Tessio Code, and my license Is in full force and
effect. ;'�:.:)' fF ��1 ✓± rt^�
�LGNATURE - DATE
OWNER -BUILDER DECLARATION on ' .
I hereby affirm that I am exempt from the Contractor's License Law for -the following Estimated Valuati
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 - - – -.
requlres the applicant for such.permlt to file a signed statement.that he is -licensed pursuant to .r PERMIT- - • •AMOUNT ••' .
the provisions of the Contractor's License Law, Chapter 9 (commencing wfth,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. -
subjects the applicant to a civil penalty of not more than rove hundred dollars ($500). ^ - • . -
- -- ❑ I,.as,owner of the property, or my employees with wages as their sole compensation, will
Plan Chk. Bal. is • 0
do the work, and the structure is not intended or offered for sale. .(Sec. 7044, Buisness and COnSt1 ! s
Professions Code: The Contractor's License Law does not app•y to. an owner, of property who '
builds or improves thereon and who does. such work himself or through his own ;employees,Mech. - - d • U
provided that such Improvements are not Intended or 'offered for sale.. if, however,. the building
or improvement is sold within one year of complation,.the owner -builder will have'the burden Electrical - " - S. "
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 • `
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..
• such projects with a contractors) jmcensed pursuant to the Contractor's License Law.).
Grading
❑ 1 am exempt under Sec ` B. & P.C.- for this reason
Driveway Enc.
Date owner Infrastructure
* WORKERS' COMPENSATION DECLARATION
' I hereby�eMrm that I have a certificate of. consent to self -insure, or a. certificate of -
Worker spensatlon Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) ,
Poli�cy�o. —Co
mpany
Xcipy is filed with the city. . ❑ Certified copy is hereby furnished. _
TOTAL • ��
CERTIFICATE OF EXEMPTION FROMREMARKS
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.1s issued, I shall not
employ any parson in any manner so as to become subject to the Workers' Compensation
Laws of Cal ifornla s
"bite Owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become ZONE:
subject to the Workers' Compensation provisions of . the Labor Code; you must forthwith- -
comply with such provisions or this permit shall be deemed revoked. - - Minimum'Setback Distances: '
Front Setback from Center Linger.
Rear Setback from Rear Prop /fij�ie�
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE ISUNLAWF.UL;AND - •SIde:Street Setback ff0/m C er Lined°
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; Side Setback. from Pr 9 y Lite
DAMAGES AS PROVIDED FOR IN..SECTION 3706 OF THE -LABOR CODE, INTEREST, AND / /C
ATTORNEY'S FEES. •
Ttiis*is a'building permit when properly filled out, Signed and validated,'and is subject to FINAL DATE INS yCTOR
expiration It work thereunder is suspended for 1110 days.
I certify that I have read this application and state that -the above information is correct. Issued by: Date ._Permit
' a
–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. 9� AT,
Validated by: -�
Signature of applicant— Date U
Mailing Address Validation: !�
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
2ND FL. SD. 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 APPJEOUIP.
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
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
t FINAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
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 ® 11/4 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 APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
t FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
40�F NAL INSPECTION32?!-? j
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIONATURESIINITIALS
GARDEN WALL FINAL