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9883 (RPL)t!'�GitrCv Z�b P.O. BOX 1504 No. 9883 4 Building 7 �� �t� 7&105 CALLE ESTADO Aririrpec Ave. Fernando LA QUINTA, CALIFORNIA 92253 Owner Jakk Clark BUILDING: TYPE CONST. OCC. GRP. Mailing Address 54065 Herrera A.P. Number City - Zip Tel. La Quinta 92253 Legal Description Project Description POOL AND SFA Contractor California Dater Creations Address 68782 Hermosillo CityZip Cat City 92234 Tela 327-0027 State Lic. City & Classif. C53 563347 Lic. # 2024 Sq. Ft. Size No. No. Dw. Stories Units Arch., Engr., Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION /1 hereby affirm that I am licensed under ov_isions of Chapter 9 (commencing with Section 000) of DiviisioFtn 3 of the Business an ro essions Code, and my license is in full force and f I, ecI. ,SIGNATURE' - DATE OWNE -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractors License Law for the following reason: (Sec. 7031.5,Business 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 the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) or 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 permitPlan 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 orimprovement is sold within one year or completion, the owner -builder will have the burden 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- 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.) ❑ I am exempt under Sec. B. 8 P.C. for this reason Estimated Valuation 18000.00 PERMIT AMOUNT Chk. Dep. Plan Chk. BBI. �-l5 u�J G . L Const. 1 y Mech. 24 • OU Electrical 45. 0U Plumbing 21 S. M. 1. I Grading Driveway Enc. Date Owner Infrastructure WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insure re, or a certified copy thereof. (Sec 3800, Labor Code.) V Policy No 1 f. i V V J :i !6 ompany :9 LCi ..'a L V!"" . C Copy is filed with the city. ❑ Certified copy is hereby furnished. - TOTAL 4U9.65 CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE REMARKS t1C1 'f,A,7 4 (1 -,,44 % t77 (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less.)1.,ltJ 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. 11 j. 1 U 1 IiL �. .' / . 0-iI Date Owner NOTICE TO APPLICANT. n, 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. ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line 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.) Side Street Setback from Center Line Side Setback from Property Line Lender's Name FINAL DATE INSPECTOR 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. I 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. Issued by: Validated by: Date Permit Signature of applicant Date Mailing Address Validation: City, State, Zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES " 1ST FL. SO. FT. ® $ UNITS A:C. UNIT COLL. AREA SLAB GRADE YARD SPKLR SYSTEM 2ND FL. SO. FT. BONDING HEATING (ROUGH) MOBILEHOME SVC. BAR SINK POR. SO. FT. ® SEWER OR SEPTIC TANK ROUGH WIRING. GAR. SO. FT. ® POWER OUTLET ROOF DRAINS FOUND. REINF. DRAINAGE PIPING CARP. SO. FT. HEATING (FINAL) WALL SO. FT. REINF. STEEL DRINKING FOUNTAIN. SO FT ® TEMP. POLE URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation WATER HEATER FLOOR DRAIN MECHANICAL FEES FINAL INSP. WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER G GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LUMBER GR. LAUNDRY TRAY AIR HANDLING UNIT CFM FINAL INSP. 'Q L 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 ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR ® Vea 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 I PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING 9 UNDERGROUNDI Db (( 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) /1 AtOl � f '�/ METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM FINAL INSP. O G GRADING cu. yd. $ -Plus-X$-=$ LUMBER GR. FRAMING FINAL INSP. 'Q L ROOFING ' � C ?ire- REMARKS: VENTILATION FIREZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION- NSPECTION CERT. CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL