14461 (RPL)1
f r.
P.O. BOX 1504 No. 14461
Buyding 50-970 ti@C18ZeiJ 78-495 CALLE TAMPICO
Address LA QUINTA, CALIFORNIA 92253
Owner
Frame
Mailing BUILDING: "TYPE CONST. OCC. GRP.
Address Same
A.P. Number
City La Tel. Zip
uinta, CA 92253. Legal Description
Contractor Pool and Spa
California -Pools & Spas Project Description
Address
41-910 Boardwalk
,Wta Desert, C K 92264 s40-9000
State Lic. City
& Classif.. C -i53 1$5102 Lic.# 355 Sq. Ft. No. No. Dw.
Size • • Stories � Units
Arch., Engr., D. Fer ell
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Addicts Tel.
City Zip State
Lic. #
//Y LICENSED CONTRACTOR'S DECLARATION
I hereby affirm7lhat I am licensed under provisions of Chapter 9 (commencing with Section.
000) of Division Sof the Busines's°an Professions Code, and my license is in full force and
effect. 1
ii _
SIGNATURE 4 X I .f' DATE _
i"
/,.OWNER -BUILDER DECLARATION Estimated Valuation*13,U00.00
I hereby affirm that 1; am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,8usiness and Professions Code: Any city or county which requires a
permit to construct, after,kimprove, demolish, or repair any structure, prior to its issuance also 1
requires Me applicant for such permit to lila 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
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).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. •
do the work, and the structure is not Intended or offered for sale. (Sec. 7044, Buisness and Const. 1411#411 • U U
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. 7
provided that such improvements are not intended or offered for sale. It, however, the building -
or improvement is sold within one year of completion, the owner -builder will have'the burden Electrical V3 • UU
of proving that he dM not build or knprove for the purpose of sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing ;17 • uti
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. -
such projects with a contractor(s) G,censed pursuant to the Contractor's License Law.) -
Grading
0 1 am exempt under Sec. B. & 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.)
Policy NoCompany
i;(?Opy is filed with the city. O Certified copy is hereby furnished.
TOTAL i 1j • 0
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE '
(This section need not be completed if the permit is for one hundred dollars ($100). 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. If, -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
• WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, 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 ./I
`
ATTORNEYS FEES. FINAL DATEINSPECTO
This is a building permit when properly filled out, signed and validated, and is subject to V
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_ =Pefil,
1 agree to comply with all city and county ordinances and state laws relatingto building l
construction, and hereby authorize representatives of this city to enter the above.. it
mentioned property for inspection purposes: Validated by: 1•�/�•
Signature of applicant -Date
�t7
Mailing Address Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING. FEES
1ST FL. SQ. FT. Qa $
2ND FL. SQ. FT.
POR. SO. FT. ®
GAR. SQ. FT.
CAR P. I SQ. FT.
WALL SQ. FT.
SO. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS i
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be usec as property tax valuation
R UGH PLUMB. 1-7
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
COAS (ROUGH)
LAUNDRYTRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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.
SQ. FT. ® c
BATH TUB
BOND BEAM
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
LUMBER GR.
SQ.FT.GAR ® 34c
HOUSE SEWER
AL INSP. /A —?
J
ROOFINGice'
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEEPLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING —;1
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
R UGH PLUMB. 1-7
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCKSTORAGE
FOUND. REINF.
COAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
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.
FRAMING
AL INSP. /A —?
J
ROOFINGice'
lT C�
GJ
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REMARKS:
VENTILATION
FIRE ZONE ROOFING'
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
NAL INSPECTIONZ-
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATUREWINITIALS
GARDEN WALL FINAL