13453 (RPL)P.O. BOX 1504
Building 78-860 5anita Drive78-105 CALLE ESTADO
ArlrirPcc LA QUINTA, CALIFORNIA 92253
Owner
Mr. & Mrs. Jesse Fair
Mailing ��
Address
"a tuinta, Zip X2253 Tel.
CoNacVer Fools
Address
73563 Highway 131
C'Vlalm Desert, 0DR. 9226 Te1.346-6315
State Lic. City
& Classif. C53 238947 Lic. #
Arch., Engr.,
Designer
Address Tel.
City (Zip( State
Lic. #
.'LICENSED CONTRACTORS DECLARATION
I hereb'y`affirm that I am licensed under provisions of Chapter 9 (commencing with Section
Z70) of Division 3 of the Business and Professions Code, and my license is -in full force°and
/ct
SIGNATURE - DATE
OWNER -BUILDER DECLARATION
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 basts
/or 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).
O 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
orimprovement 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 contractor(s) licensed pursuant to the Contractor's License Law.)
O 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.)
Policy No. Company
O&Copy is filed with the city. O 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, after 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.
CONSTRUCTION LENDING AGENCY
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.)
Lender's Name
Lender's Address
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.
1 -certify that I have read this application and state that the above information is correct.
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.
Signature of applicant Date
Mailing Address
City, State, Zip
BUILDING: TYPE CONST
P. Number
No.
OCC. GRP.
Legal Description
Project Description fool mid Spa
C -
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL [
Issued t
ValldatE
Validati
r -
Sq. Ft.
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
gig 0000.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
1�� •
Const.
1 i s i3
Mech.
° 00
Electrical
°
Plumbing
°
S.M.I.
Grading
Driveway Eno.
Infrastructure
TOTAL
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL [
Issued t
ValldatE
Validati
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
f N
COLL. AREA
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
ROUGH PLUMB.
BONDING
MOBILEHOME SVC.
BAR SINK
FOR. SQ. FT. ®
FORMS
SEWER OR SEPTIC TANK
POWER OUTLET
ROOF DRAINS
GAR. SQ. FT. ®
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
DRAINAGE PIPING
CAR P. SO. FT. ®
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
DRINKING FOUNTAIN.
WALL SQ. FT.
TEMP. POLE
URINAL
SQ. FT.
WATER HEATER
ESTIMATED CONSTRUCTION VALUATION $
SERVICE
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM . FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
LUMBER GR.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FRAMING
LAUNDRYTRAY
AIR HANDLING UNIT CFM
ROOFING
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.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SPARK ARRESTOR
SQ.FT.GAR ® 3/ac
HOUSE SEWER
GAR. FIREWALL
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
C//J��ae��/✓"v
</16 / yr(/
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING I Miol
FINAL INSPECTION .9
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
:d
a
FROM AFTER HDURS IMAGING PHONE NO. 760 360 0407
a
Alt i
CITY OF�l4-"' UINTA
pp MENT OF PLANNING&,DEVELOPMENT
G
BUILDINDIVISION
4th •i a'''
44 -HOUR NOTICE FO.R1NSPECTIONS
777=7153
Mr.. & Mrs, Jesse Fair
Contrator c,Master 'i?ools
• 4
POST ON JOB,IN'CONSPiC000S PLACE
INSPECTOR MUST SIGN ALL'APP.LfCABLE SPAGES'
rA7 Way
7
JOB ADDRESS 8 - 8 69''
a.
Pool and Spa
ABOVE APPROVALS Do NOT INCLUDE;RIGHT TO
Tl1RN'ON UTILITIES OR OCCUOY. BUILDING f
A -
Oct. 28 2003 03:42PM P1
P