14704 (RPL)a �
44
�.. P.O. BOX 1504 No. 14704
PICO
Address
.0-94.5 Calle Paloma LA QUINTA, CALIFORN78-495 CALLE TAM IA 92253
Address
Owner Mr. & Mrs. dike Brown
BUILDING: TYPE CONST. OCC. GRP.
Mailing
Address 'Sane
city
1,a Q+nta., CA ZIp 92253
Contractor
easter Peak & Spas
gad=335-. HWy 111
Desert,
State Lic.
& Classif. C53
Arch., Engr.,
Designer
Address
City
I hereby affirmlthatll
7000) of Division -3 of i
1,effectLyJ,.Lt'V t,
el.
564-5120
2270 Tel346-6115
Lic. # i
Tel.
Zip State
Lic. #
CONTRACTOR'S DECLARATION
Ender provisions of Chapter (commencing w th Section
ind Professions Code, and my license islin fuf I to and
C•f 2 f/•�fri
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: Anycity 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
the provisions of the Contractor's License law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or thathe 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 rive hundred dollars (E500). •.
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 or 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
or proving that he did not build or improve for the purpose of sale.) -
b 1, 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) (fcensed 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.)
Po�fcy No. Company
"b Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed ff 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 ishall not
employ any person' in any manner so as to become subject to the Workers' Compensation
Laws of California
Date Owner
NOTICE TO APPLICANT: g, 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.
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.
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 cartify,that I have read this application and state that the above information is correct.
1 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
A.P. Number
Legal Description
Project Description
Fool andSpa
Sq. Ft.
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑
Demolition ❑
Estimated Valuation��
PERMIT
AMOUNT
Plan Chk: bep. '
Plan Chk. Bal.
93.60
Const.
144.00
Mech.
24.00
Electrical
45. 00
Plumbing
27.00
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
333.60
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 DATE INSPECTOR
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW%3 :4ES
1ST FL. SO. FT. ® $
UNITS
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
YARD SPKLR SYSTEM
2ND FL. SO. FT. p
DUCT WORK
ROCKSTORAGE
FOUND. REINF.
MOBILEHOME SVC.
BAR SINK
POR. SO. FT.
REINF. STEEL
S (FINAL) -L� TEMP. POLE
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
WATER HEATER SERVICE
FINAL INSP.
DRAINAGE PIPING
CAR P. SO. FT. ®
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
WALL SO. FT.
LUMBER GR.
DRINKING FOUNTAIN.
FRAMING
FINAL INSP.
URINAL
S0. FT. ®
REMARKS:
ESTIMATED CONSTRUCTION VALUATION $
VENTILATION
WATER PIPING
NOTE: Not to be used as property tax valuation
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
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
SO.FT.GAR ® 3/4c
HOUSE SEWER
INSPECTOR'S SIGNATURESIINITIALS
GAS PIPING
PERMIT FEE
GARDEN WALL FINAL
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
l J
SETBACK
GROUND PLUMBING _3 UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK ROUGH WIRING
DUCT WORK
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH) METER LOOP
HEATING (FINAL)
OTHER APP./EOUIP.
REINF. STEEL
S (FINAL) -L� 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
G��/�j r//9 7/� �
REMARKS:
VENTILATION
7-6 --A6z7-
�, •c .
FIRE ZONE ROOFING '
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION y/q
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL