11447 (RPL)tti9[I
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4
a 1147
P.O. BOX 1504 _'� N o . `►
7&105 CALLE ESTADO
Building
Address 51-495 JUAREZ LA QUINTA, CALIFORNIA 92253 i
Owner
A 6 M CONSTRUCTION )
BUILDING: TYPE CONST. OCC: GRP.
Mailing
Address
A.P. Number
City Zip ; Tel.
Legal Description '
Contractor Project Description POOL AND SPA 1
MCINTIERE POOLS
Address I
46301 ROUDEL YLN
CityTel.:
r�92;53
LAQUINTA 342-3521
State Lic. City I
& Classif. X53 614611 Lic. # 1945 Sq. Ft. No. No. Dw. a
Size Stories Units
Arch.; Engr., -
Designer New ❑ Add ❑ Alter ❑ Repair ❑ -Demolition O
Address Tel. +
City Zip State
Lic. # i
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division n33`o Businesslandrthe_+Professions. Code, and my license is in full force and i
effect.
SIGNATURE s" "" - DATE i
OWNER -BUILDER DECLARATION Estimated Valuation 1
I hereby affirm that I am exempt from the Contractors License Law for the following $13,500 1
reason: (Sec. 7031.S,Buslness and Pro/esslons Code: Any city, or county which requires a1
permit to construct, atter, improve, demolish, or repair any structure, prior to its Issuance also * ,
requires theapplicant for such permit to rile a signed statement that heis.licensed pursuant to PERMIT AMOUNT
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 o/ 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 o/ not more than five hundred dollars ($500). '
❑ I, as.owner of the property, or,my employees with wages.as their sole compensation, .will Plan Chk. Bal. 99,
3•
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const.
Professions Code: The Contractor's License Law does not apply to an owner o/ property who
builds or improves thereon and who does such work himself or through his own employees, Mech. -
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 ,• - s f,1{,! '
o/ proving that he did not build or improve for the purpose of sale.) , . -
O 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 P
does not apply to an owner of property who builds or improves thereon, and who contracts for S.M.I. 1.40 l
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) +
Grading
❑ 1 am exempt under Sec. • B. & P.C. for this reason
Driveway Enc. {
f
Date owner Infrastructure
j�
WORKERS' COMPENSATION DECLARATION }
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of {
Workers Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
❑ Copy is filed with the city. O Certified copy is hereby furnished. .
TOTAL .§349. 5
CERTIFICATE OF EXEMPTION FROM
WORKERS'COMPENSATIONINSURANCE
.(This section need not be completed if the permit is for one hundred dollars (8100) valuation
or less.)
I 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.
Date Owner .
NOTICE TO APPLICANT 11, 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. '
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.) -
Lenders Name _-
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.
Signature of applicant Date
Mailing Address
City, State, Zip
REMARKS
a•'�:�.�J3 •4''(`1 �.i�•� lr:.. f•��Wi C?S Y 'L.�.a, �xl sT a Ct.i �
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 j.
Issued by: Date Permit
i.
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL SO. FT. ® $
2ND FL S0. FT.
POR. SO. FT. ®
GAR. SO, FT. ®
CARP. S0. FT.
WALL SO. FT. ®
SO FT ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN.
URINAL
WATER PIPING
NOTE Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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
BOND BEAM
SO. FT. ®c
WATER HEATER
MAX HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1% c
SEWAGE DISPOSAL
LUMBER GR.
SO.FT.GAR ® 31'ic
HOUSE SEWER
FINAL INS P r� .�
ROOFING
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 PLUMBINGl UNDERGROUND (
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) G METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
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. L
FRAMING
FINAL INS P r� .�
ROOFING
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�"'Ccy c�11
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION 1
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINMALS
GARDEN WALL FINAL