08912 (RPL)Building
Address 79-800
TAtyl
•-4:
I , '! 4 ' `
P.O. BOX 1504 No. 0912.1
78-105 CALLE ESTADO
Street LA QUINTA, CALIFORNIA 92253 -
Owner
.?,;N. Patera
Mailing
Address
City Zip
T -A -0vt
Contractor i
Califosaia Pool.
Address -
41 -910 Roardwal,
City Zip
& Classif.
4$5102 C-53
Arch., Engr., `.
Designer
Address =' '
City lZip
POOL
BUILDING: TYPE,CONST. OCC: GRP.
A.P. Number
Tel.
Legal Description'.
Project Description 141 21d I Raiml
s Spas
d --i
Tel.' -
1a •r `;.
City
Lic. #
Sq, Ft. - ,No No. Dw
Size Stories ` Units
New Add O Alter ❑ Repair.❑ `Demolition❑
Tel. ^
State
LIC. #
/LICENSED.CONTEIACTOR'S DECLARATION
I hereby affirm that iam licens3ed unde provisions of Chapter 9 (commencing with Section
000) of DivQs on 3 o the Business an&Professions Code, and my licegse is full force and
OWNER -BUILDER DECLARATION s
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 a permit
subjects 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, 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 own 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.)
O I, as owner of the property, am exclusively contracting with licensed contractors to con-
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
such projects with a contractors) licensed pursuant to the Contractor's License Law.)
❑ 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. (Sec. 3800, Labor Code.)
P licy No, Company
Copy is filed with the city. ❑ 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 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, alter 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.
Estimated Valuation
8 040
PERMIT .: AMOUNT., .t
Plan Chk. Dep. !t g '
Plan Chk. Bal. Q
Const.
Mech. 9Ar
Electrical
Plumbing
S.M.I. - .--
Grading
Driveway Enc. _
Infrastructure
TOTAL
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
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.)
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 it work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above 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, Stale, Zip
7 tr.
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CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. SO. FT.
POR. SO. FT. ®
GAR. SO, FT. ®
CAR P. SO. FT.
WALL SO. 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
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
ROUGH WIRING
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
ROCK STORAGE
LAUNDRYTRAY
AIR HANDLING UNIT CFM
GAS(ROUGH OMETER
Zl
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
WATER HEATER
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3Ac
HOUSE SEWER
4d Lb
$
GRADING
cu. yd.
plus x$
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.
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBINJ
UNDERGROUND f/
v�
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 OMETER
Zl
LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP.1� / 1'6 C
FINAL INSP. (j
4d Lb
$
GRADING
cu. yd.
plus x$
_$
LUMBER GR.
FRAMING
ROOFING�Cj
{ z
Je
q� L p
((
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION It l 4o L
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL