05820 (RPL)4 4 QUM&
-7 7 S-t,/� P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address y rCBILLEiA3 LA QUINTA, CALIFORNIA 92253
BOB FILLBATFfUM
Mailing .
Address
City Zip Tel.
LA QtTIT+i'1`A 1 92253 Y
Contractor
F&FPOOLS
Address
State Lic. I City
& Classif. Lic. #
Arch., Engr.,
Designer
Address Tel.
City I
Zip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm am licensed I alicensed under provisions of Chapter 9 (commencing with Section
7000) of Divisiio�ny3'of the Business and Professions. Code, and my license is in full force and.
effect-
SIGNATURE DATE
OWNER -BUILDER DECLARATION
1 hereby affirm that 1 am exempt from the Contractor's License Law for the following
reason:, (Sec. 7031.5.8usiress and Prolesskns Code: Any city or county which requires a
permit to construct, ager, irprove, demolish. or repair any structure, pdor to 8s issuance also
requires the applicant for such permit to lie a signed statement that he is licensed pursuant to
the provisions or the Conhactor'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
subjects die appicard to a civil penally of not more than rive hundred dollars ($500).
❑ 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
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,
provided that such improvements are not intended or offered for sale. If, however, the building
or improvement is sola within one year of completion, the owner-bullder will have the burden
of proving that he did not build or improve for the purpose of sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
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
such projects with a conhactorrs) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec 8- & P.C. for this reason
Date Owner
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. ❑ Certified copy is hereby fumished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This secBon need not be completed it the pennil is for one hundred dollars (E 100) valuation
or less.)
I certify that in the perfomnance 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
N077CE TO APPLICANT: d after making this Certificate of Exemption you should become
subject to the workers' Corrpensatin provisions of the Labor Code, you must forthwith
comply with such provk;hm or Drs Pemrt 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
Lenders Address
This is a building permit when property filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certify that 1 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
No.
BUILDING: TYPE CONST. OCC: GRP..
A.P. Number 774-211-013
Legal Description LM I
Project Description PWL
05820
Sq. Ft.
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
$,opo.
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
64.35
Const.
99.00
Mech.
24.00
Electrical
30100
Plumbing
27.00
S.M.I.
.56
Grading
Driveway Enc.
Infrastructure
r /
TOTAL
REMARKS
,, • ,, r ,
#:ax.+...+ �rlii,ari1� :tl� � s'�x• nor Yom' - � -.. -r r . , x - -
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
Issued by: Date 5/29/89 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
A.C. UNIT
COLL. AREA
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL SQ. FT. @
HEATING (ROUGH)
MOBILEHOME SVC.
BAR SINK
POR. SQ, FT. ®
UGH WIRING
/ /
L 6
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
FOUND. REINF.
GAS (ROUGH)
DRAINAGE PIPING
CAR P. SO. FT.
HEATING (FINAL)
WALL SQ. FT.
REINF. STEEL
DRINKING FOUNTAIN.
TEMP. POLE
URINAL
SO FT ®
GROUT
ESTIMATED CONSTRUCTION VALUATION $
SERVICE
WATER PIPING
NOTE Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
LUMBER GR.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FINAL INSP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
/ � O _ ` �
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1% c
SEWAGE DISPOSAL
SO.FT.GAR ® Nac
HOUSE SEWER
LATHING
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBLAL
TOTFEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR GOND. SOLAR
b
SETBACK
GROUND PLUM BI L
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
UGH WIRING
/ /
L 6
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
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
FINAL INSP.
ROOFING
l U � I ! r
/ � O _ ` �
✓Ji.��
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
`
GARDEN WALL FINAL