14650 (RPL)P.O. BOX 1504 No. 14650
Building 78-495 CALLE TAMPICO
Address 52-960 Ave. HonteZum LA QUINTA, CALIFORNIA 92253
Owner Fred & Beth Wilson
Mailing
BUILDING: TYPE CONST. OCC: GRP.
Address
A.P. Number
City Zip T-
Legal Description
ContractorPool .and Spa
Double A Construction
Project Description P
i
Ire Q $e=rer8
� •City " - Zip T .: "
L3' Quints, Cel, 92253 �71-1"61
State Lic. City
& Classif. $ 681012 Lic. # 323 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 ofrChapter 9 (commencing with Section
7000) of Division�13. of the B�iff6iness and Professions Cords, and my license isain full force and
,• effect?'i.N- 71 w_L", b_J . Ij14,,�RJ.
SIGNATURE - DATE
OWNER-BUILDER DECLARATION Estimated NdlUatiOn$12r000.00
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, after, improve, • demollsh, 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 PERMIT AMOUNT
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) o!
' 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.
t. subjects the applicant to a civil penalty or not more than rive hundred dollars ($500). plan Chk. Bal. 87.75
I 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. 135.00
$
Professions Code: The Contractor's License Law does not apply to an owner of property who r
builds or improves thereon and who does such work himself or through his own employees, 24.00
-
provided that such improvements are not Intended or offered for sale. If, however, the building Mech.
or Improvement is sold within one year of completion, the owner-builder will have the burden .Electrical 45 • v0
of proving that he did not build or improve for the purpose of sale.). ..
O 1, 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
does not apply to an owner of property who builds or Improves thereon, and who contracts for S. M. 1. - -
such projects with a contractors) pcensed pursuant to the Contractor's License Law.)
Grading
❑ 1 am exempt under Sec B. 8 P.C. for this reason
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 Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Poll&y<lo• "Company
WO Copy Is filed with the city,. ❑ Certified copy is hereby furnished. 1
TOTAL _ 3� 75
CERTIFICATE OF EXEMPTION FROM REMARKS"'
WORKERS' COMPENSATION INSURANCE
(This section need not be completed ff the permit is for one hundred dollars ($100) valuation to conji unci. 'fn with SFm nomit
'or less.)'
1 certity that in the performance of thg 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: ff. -after making this Certificate of Exemption you should become ZONE: BY:
j subject to the Workers' Compensation provisions of the Labor Code, you must forthwith '
comply with such provisions or this permit shah be deemed revoked. Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
WARNING: FAILURE TO SECURE.WORKERS'COMPENSATIONCOVERAGE ISUNLAWFUL,AND Side Street Setback from Center Line
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, Side Setback from Property Line
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 FINAL DATE INSPECTOR
expiration it 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 —Pefmit
1 agree to comply with all city and county ordinances and state laws relating to building /l�\
construction, and hereby authorize representatives -of thiscity to enter the above-. r�
mentioned property for inspection purposes. Validated by:
Signature of applicant —Date—.
Mailing. Address Validation: FFR (1 9 %a
City, State, Zip
L` -
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
1ST FL. SO. FT. ® $
UNITS
COLL. AREA
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL. SO. FT.
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
DUCT WORK
ROCK STORAGE
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
METER LOOP
HEATING (FINAL)
DRAINAGE PIPING
CAR P. SO. FT.
GAS (FINAL)
WALL SO. FT. ®
DRINKING FOUNTAIN
SO. FT. ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
GRADING
cu. yd.
$ plus x$
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
ROOFING
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
-
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1 Va C
SEWAGE DISPOSAL
SO.FT.GAR ® 3/.c
HOUSE SEWER
MESH
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI Fii---j PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING,-,$ V % /
UNDERGROUND A s
r�
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 APP.IEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
e�'117v44A
FINAL INSP.
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FRAMING
FINAL INSP.
ROOFING
n
4
n
0
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