04835 (RPL)4tIG1�CV
0483+,_
`
P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address. 54-470 ol'1d0rez .,LA QUINTA, CALIFORNIA 92253
Owner
ftat8rn Builders �
Mailing BUILDING: TYPE CONST. OCC. GRP.
Address ''" A.P. Number 774-233-011 012
City Zip Tel.
La Minta 92253 56.4 7411. Legal Description
Contractor Project Description Pool & Spa
Gary ReynoIWSPa;Ckle Plenty
Address
CityZip Tel.
Cathedral Cit X32234 329«9260
State Lic. City
& Classif. 76 Lic. # 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 Ilcensed under provisions of Chapter 9 (commencing with Section
701X)) of Division 3 of the Business and Professions, Code and my license is in full force and
effect. ,,....'.""""R'��'M..'I•�P � �t .E�}'�.r �'f!r<�,wt ..
SIGNATURE iC9..1'•' d' KJY"lxr" -+-• - DATE
•
OWNER -BUILDER DECLARATION Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following Estimated
reason: (Sec. • 7031.5,Susiness and Professions Code: Any city 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 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) of
Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis r�
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 five hundred dollars ($500). Plan Chk. Bal. '
O I, as owner of the property, or my employees with wages as their sole compensation, will
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. ti •
Professions Code: The Contractor's License Law does not apply to an owner of property who
builds or. Improves thereon and who does such work himself or through his own employees, Mech. fi lb f,J!
provided that such improvements are not intended or offered for sale. If, however, the building
or improvement is sold within one year of completion, the owner -builder will have the burden Electrical ti r
or proving that he did not build or improve for the purpose of sale.)
UU
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property who builds or improves thereon, and who contracts for S.M.I. *74
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec. B. & P.C. for this reason Grading
Driveway Enc.
Date Owner Infrastructure
WORKERS' COMPENSATION DECLARATION �
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy$thereo(. (Sec. 386O. -Labor Code.)
Policy No. Company ^•^" c'A`� 7� dFs i',�f., �., .
❑ Copy is filed with the city. O Certified copy is hereby furnished.
TOTAL
CERTIFICATE OF EXEMPTION FROM REMARKS ter, ••sn " a
WORKERS' COMPENSATION INSURANCE x
(This section need not be completed if the permit is for one hundred dollars ($100) valuation ✓s ti. E'`A fi!.! 4 'i1'ta't ..qf. i rt A r
or less.) r ....... _ .. , . , ..-. .. .. .
I certify that in the performance of th¢ 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. If, after making this Certificate of Exemption you should become ZONE: BY:
subject to the Workers' Compensation provisions of 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
This is a building permit when properly filled out, signed and validated, and is subject to FINAL DATE INSPE
P•E TO
expiration it work thereunder is suspended for 180 days. • 14/06
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
WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING; GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE
CONSTRUCTION ESTIMATE.
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL SO FT y $
UNITS
w
SLAB GRADE
ROUGH PLUMB
YARD SPKLR SYSTEM
2ND FL SO FT. C
HEATING (ROUGH)
STORAGE TANK
POR SO FT at
MOBILEHOME SVC.
BAR SINK
GAR SO. FT. 0
POWER OUTLET
ROOF DRAINS
GAS (ROUGH)
DRAINAGE PIPING
CAR P. SO FT. 6
OTHER APP.1EOUIP.
REINF. STEEL
WALL SO FT. fa
DRINKING FOUNTAIN
SO. FT. (p'
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE, Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ER(AUTOYDISH)
APPLIANCE DRYER
FINAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
�- / r2 L-ltf
/ ��G / ��i��
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 C 1'A c
SEWAGE DISPOSAL
SO.FT.GAR @ 3i4c
HOUSE SEWER
GAS PIPING
PERMIT FEE
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 8 AIR COND. SOLAR
SETBACK
GROUND PLUMBING
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)
METER LOOP
HEATING (FINAL)
OTHER APP.1EOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
S plus xS
=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
i� I
-✓
�- / r2 L-ltf
/ ��G / ��i��
REMARKS:
VENTILATION
FIRE ZONE ROOFINGG�
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
c y
THING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL