11335 (RPL),.
it it 4'4
Qum&
r P.O. BOX 1504 No. 11335
Building 7&105 CALLE ESTADO r %
Address 77070 Ave. Fernando LA QUINTA, CALIFORNIA 92253
Owner I
Glen Sather BUILDING: TYPE CONST. , OCC: GRP.
Mailing
Address 77-070 Fernando
A.P. Number
City Zip JTel-
La
Quinta 92253 Legal Description
Contractor Project Description
Bruce Wells/PuArfect Pool
Address POOH and Spa
P. O. Bax 1524
City Zip 92260 Te568-4963
p.G.
State Lic. City
& Classif. C53 483498 Lic. # 2453 Sq. Ft. 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: i I
SIGNATURE— DATE
OWNER -BUILDER DECLARATION Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following C� Q
reason: (Sec. 7031.5,Buslness and Professions Code: Any city or county which requires a d
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 be is licensed pursuant to PERMIT AMOUNT
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 Plan Chk. Dep.
subjects the applicant to a civil penalty of not more than rive hundred dollars ($500). Plan Chk. Bal. .111.15
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 COnSt. 7 .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. �� (jIQ
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 Electrical 5
of proving that he did not build or improve for the purpose of sale.)
0 I, as owner of the property, am exclusively. contracting with licensed contractors to con- Plumbing , 27.00
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law t ^
does not apply to an owner of property* who builds or improves thereon, and who contracts for S. M.1. •6 V
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ I am exempt under Sec. B. & P.C. for this reason Grading
Driveway Enc.
Date M owner Infrastructure
WORKERS' COMPENSATION DECLARATION
1 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.)
PoTNo. Company
Copy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL 379.75
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars 5100 valuation }rei r1117 C i f
f I a't' _§ '�... 4i' 't�3tyfl Zvi -`.35;? -7�- 1
or less.) . .
I certify that in the performance of the work for which this permit is issued, 1 shall not
employ any person in any manner so as to become subject ;to the Workers' Compensation
I Laws of California.
DateL—Owner
NOTICE TO APPLICANT.. It, after making this Certificate of Exemption you should become ZONE: BY:
subject to the Workers' Compensation provisions or the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked. Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line'
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 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 if 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, State, Zip
' f
J
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
2ND FL. SO. FT.
BONDING
YARD SPKLR SYSTEM
STORAGE TANK
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
DUCT WORK
ROCK STORAGE
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
OTHER APP.IEOUIP.
DRAINAGE PIPING
CAR P. I SO. FT.
TEMP. POLE
WALL SO. FT.
GROUT
DRINKING FOUNTAIN.
SO FT ®
FINAL INSP.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
WATER PIPING
NOTE: Not to be used as property tax valuation
=$
FLOOR DRAIN
MECHANICAL FEES
FRAMING
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIRE ZONE 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.
SO. FT. ® c
BATH TUB
LATHING
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1% 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 PLCK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING'/// 7
j, UNDERGROUND 9(( JUC9
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) `t1 A
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
REINF. STEEL q1gt4
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP. /
`
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FRAMING
FINAL INSP.///�S qac.
ROOFING
-
fps(jwk, 8 c�
�-�co,
-7` / + 7D
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION l`
CERT. OCC.
FENCE FINAL
IN SIGNATURESIINITIALS
GARDEN WALL FINAL