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14384 (AR)f44uu�c� P.O. BOX 1504 N o . 14"44,m, Building 78-8.60 Senna LA QUINTA, CALIFORNIA92253 Address - Owner .Terse Fair Address sa id City Zip Tel. 'La Quinta, CAI. 92253 Contractor Owner/Builder Address . Tel.: BUILDING: TYPE CONST. OCC. GRP. A.P. Number Legal Description Project Description Room Addition State Lic. ���0 City & Classif.. Lic. # Sq. Ft. 312 No. No. Dw. Arch., Engr., -Size Stories Units Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State Lic. # LICENSED CONTRACTOR'S. DECLARATION I hereby affirm that I am'licensed under provisions of Chapter 9 (commencing with Section - 7000) of Division 3 of the Business and. Professions Code, and my license'is in full force and effect. SIGNATURE DATE - OWNER -BUILDER DECLARATION ' Estimated Valuation L F $16, 9 2 c OO 1 hereby affirm that I am exempt from the Contractor's License Law for the following . reason: (Sec. 7031.5,Busi7ess and Professions Code: Any. city.or county- which requires a. permit to construct, atter, 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 t+ Division 3 of the Business and Professions Code: or that he, is exempt- therefrom, and,the basis ' Any Section 7031.5 'any for Plan Chk. Dep. for the alleged exemption. violation of by applicant a permit. }}subjects the applicant to a civil penalty of not more than five hundred dollars ($500). 4wner of the property, or my employees with wages as their sole compensation, will LY1� Plan Chk: Bal. I .(a? 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 builds or improves thereon and who does such work himself .or through his. own employees, Mech. np(� IT.00 .. provided that such improvements are -not intended or offered for. sale. Jf, however, the building or improvement is sold within; one year of completion, the'owner-builder will have the burden Electrical - ��ff _- C. a 92 of proving that he did not build or Improve for the purpose of sale.) ❑ 1, 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 improves thereon, for S does not apply to an, owner of propertywhobuilds or and who contracts - such projects with a contractor(s)pcensed pursuant to.the Contractor's • License Law.) - -M.1. - Grading 0-1 am exempt under Sec. B. & P.C. for this reason 1 Driveway Enc. ,/date `Z coA-- "C-1 Owner —01A Infrastructure WORKERS' COMPENSATION DECLARATION I hereby affirm that 1 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 f O Copy is filed with the city. . O Certified copy is hereby furnished. TOTAL 339 . Ei 1 CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE be If the is for hundred CA 1 (This section need not completed permit one dollars ($100) valuation.* or less.) I certify that in the performance of the work for which this permit is issued, I shall not •1 s (• . J employ any pperson in any mannerlo as to become subject to the Workers°'Compensation Laws . California .f Call j, Owner OTO APPLICANT: 'N, after making this Certificate of Exemption you should become Aa1Te,,_,_—_ bject to the Workers' Compensation -provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND 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, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF. THE LABOR. CODE, INTEREST, AND ATTORNEY'S FEES. - TNs is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 160 days. . I certify that 1 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 ZONE: BY' �' i Lf -77 '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 DATE INSPECTOR Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBINu FEES , 1ST FL. SO. FT. ® $ UNITS SLAB GRADE 2ND FL. SQ. FT. ROUGH PLUMB. YARD SPKLR SYSTEM HEATING (ROUGH) MOBILEHOME SVC. BAR SINK POR. SO. FT. ® SEWER OR SEPTIC TANK ROUGH WIRING GAR. SO. FT. ® POWER OUTLET ROOF DRAINS GAS (ROUGH) DRAINAGE PIPING CARP. SQ. FT. OTHER APP./EQUIP. REINF. STEEL WALL SO. FT. TEMP. POLE DRINKING FOUNTAIN SQ. FT. ® GROUT URINAL ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP. WATER PIPING NOTE: Not to be used as property tax valuation WATER SYSTEM FLOOR DRAIN MECHANICAL FEES =$ WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM VENTILATION 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 ® 1✓e c SEWAGE DISPOSAL SO.FT.GAR ® 3/ac HOUSE SEWER 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 1 FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCKSTORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP./EQUIP. 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 r / y O ��c+ YYY REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL M im .. ,. � _ - - t. r � - ` -'� ` � :, . `J' � � � . � .-• �.rI� 3/g4ti�l S" boy ss�e..fs ��N I -o' S1ubt �►0 �.� - .. y� I� 1.v ; / 16 ©. C • o� Gen�;nu�G let�ar Waco C iA Y 24 oW i pEVATIOP� At'1.�n/ ;1-citicCAL c� s3l�l,iianco-: Re.siae-�>toat oiect Title (Page -1- of .2 Date . CF -1 R oiect Address Budding Permit"$ . xumentation Author Telephone i. Plan Check i ()ate. ' Field Check i Date ampliance Method (Package. Point System or Computed climate Zone Enlorcoment Agoncy use only !ENERAL INFORMATION otal Conditioned Floor Area: -2� :2 ft2 ''Wilding. Type: _ j Single Family Addition y :heck one or morel . Multi -Family Existing -Plus Addition :vont Orientation: North / East / ou / West / All Orientations (input onentatlon in degrees and cirde,one V b f Dwellin Units' 1 um er o g =loor Construction Type: SI / Raised Floor (circle one or both) 3UILDING SHELL INSULATION Construction . :;omponent Insulation Assembly LocatiorvConiments x . ; type R -Value 1.11 -Value: ..(attic. to praae. typical. etc:) i Wall .............. R=moi tjp>^ Wall .............. . Roof ............. R 3� ,.. Roof ............. Floor ............. Stab a . C,a '. Floor ............. , Slab Edge .... FENESTRATION Shading Qevices Fenestration Area. Fenestration inte[or Exterior (roller blind. etc.) (shadescreen.. etc.) Overhang a Framing Type we5/nol 3(metal/woodNin I) Orientation (st LI -Value Front.-... ( ) : -s G T Front .. Left....... (✓j ssF , ,.ct�r.�t;..�aS Left . Rear . t Rear ..... (:) . Right..... ( ) - '.• Skylight....... .' . Skylight THERMAL.MASS { k Type/Covering Area Thickness ,; �F . LOcat(ori/DesCriptlort (krtchen bath etc:) 1. (slab/exoosed. tile, etc.) (st) (inches) t-, iievlMd January1992 k ITA CITY OF LA QU114-- BUILDINC-2 & SAFETY DEDARTMENT CU c TO 1.0,TION AS PER P �Vfo' r�JMC-: P, PMJS CXJ ACCUGRAPHICS REORDER NO. AG46479 4- on ot, -4 J Designers & Builders for over 35 years 73-547 Highway 111 /Jensen's Shopping Center Palm Desert, California 92260 619-346-6115 State License # C53-238947 APPROVED: -` - I A CUSTOM DESIGN FOR: to • Tf�- re r f 7 P :SPECIFICATIONS Size — )( V.4.rne C100 Gallons. Template No. 7rJ4 1VC.2'__Shape _CA# Surface PeriT jr ii" —.%.Depths: Minimurn_�_,�_Maximurn Break Spa Size _SSY-.--Volume Gallons. EXCAVATION Finish Elevation Method Access Site Preparation Grading Removal/Loads /Loa 0 Dirt p Dry Well Location: — --- Fence Rerno ­ved_B —Y-19- yl)j�;f i ed By OVIA-IMaterial - /I Size of Opening___j?7.—r2_ Wc NOTE: No painting or matching of texture will be done! DATE 4- _'Zj_ CJ A, SCALE NAME MC.' _M 6:. - ADDRESS 76 CITY ( A -L PHONE -7-7-.4017 AREA U L N Zk h FAL P9Z CL F7 [SHEET OF C) jj[DWN. BY CHK. BY Filter Type PLUMBING _j 1 7 _ r f,(- - — Si Pump Type -C C q --Size Skimmer Type -,-----No. --Size Heater -Size, Heater Vent By Jet Pump Type -.-E_ C(.Ar" BlowerType e Equipment LocationP-C Slab/Pit Plumbing Material ? Suction: Size Length Ft. Mscharge Size __ Lgth. —Feet. Waste To. -Length Feet. -----S Returns in Pool. Nv�;­;tj�� So ---Length Feet, Return Inlet Type 7_� Fill Line (With No Chstruct,ons)s le -,---Lgth Ft. A/S Valve Location. Gas Line By Size + Length Feet. Auto 4 SPA INFORMATION Ft. 11 Feet. Suction, __.__Djschg.Size )' �gth. Jet Type _______Numbe, Jet Air Line Number_S 01_Size —Length Feet. Feet. Blower Return Size —Length _-_.__-Number._i Selector Val pe ,4 —Size, Filter Type ---Size Pump Type --4.11 —_ Size Skimmer Type .—Size --No. Heater Type— Heater Vent By Tci(4iji��_z Jet Pump Type --'M- e Blower Type_ Equipment Location P/C Slab/Pit Plumbing Material Suction: Size Length Ft. D,,,I,rg.- Size_- Lgth. ------Feet. Waste Size ---Length Feet. Returns in Pool Number -4f'-/ Size -----_-Length Feet. Return Inlet Type Fill Line (With No Obstru )Size ;7wh, --- Ft. A/S Valve Location. Gas Line By -Size,___.___Length..__ Feet. Automatic Cleaning -u STEEL Standard/Special:- Raised Bond Beam: 6" 12'_---I B'_'Other Spa Dam Wall: 13UNITE Corner Radii: Steps -Fill Line Lo _sati n Grab R.0 0 ----Hand Pail --Cup Anchors _(__J Seat/Bench - - - Spa Information -F:Z=- iL TILE AND COPING Tile c__1 ---Color ____Coping/0ther_F_�_> Cantilever Trim: umbered Tile Brick t ick Special Detail: See "STEEL". "GUNITE' ELECTRICAL By: Light 2A554— Cord Leop!th Feet. "ill Box Location Switch Location C*-)_Pjf-e_r_ - Filter Run 100 _-,Ft. Jet Run -_ Ft. Light Run Feet. Switch Run JIFI_AGQ Ft. Panel Chanjje Spa Switch'Location Heater Switch Location AREA TO BE ENCLOSED BY DECKING POOL 5 FT. HIGH FENCE. By: �J�L__Finish --Sq. Ft. MINIMUM Color ----Cantilever —Rail Anchors ALL GATES TO BE SELF-CLOSING Risers --_Ft. Expansion: -- Standards: --Board/Slide AND SELF -LATCHING. Deck Drain.: PLASTER Lights _:�_(LLName Plates nmif_;�(,,-Recessed St Cup Anchors LQ Rail Anchors �1—Grill 4- 4' of DATE: DATE 4- _'Zj_ CJ A, SCALE NAME MC.' _M 6:. - ADDRESS 76 CITY ( A -L PHONE -7-7-.4017 AREA U L N Zk h FAL P9Z CL F7 [SHEET OF C) jj[DWN. BY CHK. BY WATER HEATING SYSTEMS Water Heater Distribution T-._ .. Energy' Ratedt Tank Factoror Number Input (kW .Capacity Recovery in System or Btu/hr) . (oallons► ;:"if -ion- e%1 External Tank Standbys Insulation Loss (%) R -Value t u 11 • 1: Fdr smell gas storage (rated input_S 75 000"BtWhr), "electric reslatancs.and heat pump water h�aters,`list Ene Factor, Fy. orlarge gas storage water hester rirated input 2 Z5,000•Btu/hr), het Rated Input, Reoove uhso ►9y For Instantansow gas water heiters fiat RateQlnput and Recovery Efficienry: ry = cy and Standby Loss. SPECIAL FEATURES/REMARKS,(Add extra sheets if necessary) COMPLIANCE STATEMENT,- -This certificate of complianceiists the Wilding features and pertormance specifications needed to comply with Title 24; Parts 1 and 6, of " the California Code of Regulations, and the administrative regulations to tmpiementthem:'This certificate hast een signedby the individual ,Mth overall design respons,biliry When this certrttcate:of compliance is'submitted fora single building plan. to be built in multiple, orientations, any shading•feature that is Vaned is indicated m the Special'Featuresrtemarks section: " Designer or Owner (per 8us'no" d Prolesslon8 Code" „D Name: ocumentatioAuthor � t4 \r ..� m Tide/Finn: O Name: " - Tide/Firm: Address: -78 54, r_n j . F"�n. ► d" Sri " r Address: Telephone: y Telephone: 7 co h`/ hic. x: " (signature) O `� �, (dater (signature). (dam) Enforcement Agency Name: Tide: Agency: t, Telephone: (Signatureistamp) Revised January 19944. r Certificate.of Compliance: Residential ,•w ` "` (Page2 of -2) CF -1 R Project Title oats HVAC SYSTEMS Note: Input hydrbrnc or`combined hydropic data under Water Healing Systems, except l)esgn.Heating Load. Heating Equipment ,Minimum Distribution Type and -Duct or - Type (furnace, neat Efficiency " 'pump, Location .. Piping Thermostat etc.) (AFUE/HSPF) (� l (ductsianic etc.-) - R Value Type ' Cooling Equipment : Minimum Duct Type (air conditioner, Efficiency. ' , heat pump, evao..coolinq) (SEER) Location 'etc) Duct Thermostat Configuration r, r1 (attic R' Value Type . (sofirnr nnrlrnr,n► WATER HEATING SYSTEMS Water Heater Distribution T-._ .. Energy' Ratedt Tank Factoror Number Input (kW .Capacity Recovery in System or Btu/hr) . (oallons► ;:"if -ion- e%1 External Tank Standbys Insulation Loss (%) R -Value t u 11 • 1: Fdr smell gas storage (rated input_S 75 000"BtWhr), "electric reslatancs.and heat pump water h�aters,`list Ene Factor, Fy. orlarge gas storage water hester rirated input 2 Z5,000•Btu/hr), het Rated Input, Reoove uhso ►9y For Instantansow gas water heiters fiat RateQlnput and Recovery Efficienry: ry = cy and Standby Loss. SPECIAL FEATURES/REMARKS,(Add extra sheets if necessary) COMPLIANCE STATEMENT,- -This certificate of complianceiists the Wilding features and pertormance specifications needed to comply with Title 24; Parts 1 and 6, of " the California Code of Regulations, and the administrative regulations to tmpiementthem:'This certificate hast een signedby the individual ,Mth overall design respons,biliry When this certrttcate:of compliance is'submitted fora single building plan. to be built in multiple, orientations, any shading•feature that is Vaned is indicated m the Special'Featuresrtemarks section: " Designer or Owner (per 8us'no" d Prolesslon8 Code" „D Name: ocumentatioAuthor � t4 \r ..� m Tide/Finn: O Name: " - Tide/Firm: Address: -78 54, r_n j . F"�n. ► d" Sri " r Address: Telephone: y Telephone: 7 co h`/ hic. x: " (signature) O `� �, (dater (signature). (dam) Enforcement Agency Name: Tide: Agency: t, Telephone: (Signatureistamp) Revised January 19944. r