9677 (RPL)Building
Address 53-51-5 Cortez
Owner
John otterness
Address same
T4tq�
P.O:. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
City Zip Tel.
La Quiri�a 92253
Contractor
ChautDion Pools
69104 35th Ave.
Cat City 92234 321-00724
State Lic. City
& Classic 4.50332 Lic. # 1995
Arch., Engr.,
Designer
Address
City IIZip State.
Lic. #
LICENSED -CONTRACTOR'S DECLARATION
oby affirm that 1 am licensed undef provisions o Chapter Q (commencing with Section
of Division 3 of the Bus((t(eea and+,Profesalons. e, and y.license Is in full fore app
r OWNER•BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason:, (Sec. 7031.5,Susinass and Professions Code:.AnY CRY or counly '- requires a
permit to conatrucI, after, bnprove, dwnofth, or repair any StrwKlce, prior to its. Issuance also
requires the applicant for such Permit to file a . signed statement that he Is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (oonimerndog with Section 7000) of
Divislon 3 of the Bushes sod Professlons Code, or that. he is exempt therefrom; and the basis
for the alleged exemption. Any violation of Section 7031.5 by ''or* app9card for a permit
subjects the appfteant to a civil penalty of not morethen,five hundred dolws (5500).
.q I, as owner of the property, or my, employees with wages as their sole compensation, will
do the work, and the..structurets not Intended or offered for, sale. (sec. 7044, Buaness and
Professions Code: The Contractor's License Law does not apply 10 an owner of property. who
builds or knproves thereon and who does such workhirnself or through his own employees,
provided that such improvements are not Intended or offered for see. If, however, the building
or Improvement is add wfthin one year of completion, the ownerbu lder wID have 'the burden
of proving that he did not build or hnprove for the purpose,of sale:)
1, as owner of the property, am exclusively. contracting with licensed contractors to con-
struct the project. (Sec. 7044, Busineas.and Professions Code: The Contractor's License Law
does not apply to an owner of property who builds or briprovas-Merson, and who contracts for
such projects with a contractor(,) itcensed pursuant to Me Contactors, License Law.) -
❑ 1 am exempt under Sec B. & P:C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to seiflnsure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Poli o Company
'&ropy iefiled with the city. O Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(rhis section need not be cOMWed ft the pemdt is for one hundred dollars ($100) vahow n
or -loss.)
I certify that In the performance of the work for which this permit Is issued, I shall not
employ any ppeerson In any manner so as to become subject to the Workers' Compensation
Laws of Celitomla..
Date Owner
NOTICE TO APPLICANT.• if, af& making this Certificate of Exemption you should become
Subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply withsuch provisions or this permit shall be deemed revoked. .
CONSTRUCTION LENDING AGENCY
Ihereby affirm that there Is a twnstruction lending agency for the performance of the
work for which this permit 19 Issued. (Sec. 3097, Civil Code.)
Lenders Name
Lender's Address
This Is abulldingipermit 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
No. 9677
TYPE CONST. OCC: GRP.
1. Number
,Legal Description
Project Description
FOOL ONLY,
Sq. Ft. No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated. Valuation 10.00.0.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
76.05
Const:
117. 0
.Meth.
—74. ou
Electrical
3.0. GO
Plumbing
21.00
S.M.I.
1.OU
Grading
Driveway Enc.
Infrastructure
A Tu e .4
6755
TOTAL
• U
REMARKS
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 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES'
1ST FL SO. FT. ® i
UNITS
`
2ND FL SO. FT.
ROUGH PLUMB.
YARD SPKLR SYSTEM
POR SO FT ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. I SO. FT.
DUCT WORK
DRAINAGE PIPING
WALL SO. FT.
GAS (ROUGH)
DRINKING FOUNTAIN,
SO FT @
HEATING (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION i
GAS (FINAL)
WATER PIPING
NOTE. Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER HEATER
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
WATER SYSTEM
FINAL INSP.
A''
!�
f
�J/' • '�`
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
=i
LAUNDRY TRAY
AIR HANDLING UNIT CFM
VENTILATION
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR. HP
POLE, TEWPERM
LAVATORY
HEATING SYSTEM. FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER. B.T.U.
SO. FT. a c
BATH TUB
SO. FT.® c
WATER HEATER
MAX HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1Vi c
SEWAGE DISPOSAL
SO.FT.GAR ® rlic
HOUSE SEWER
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 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 APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP.
A''
!�
f
�J/' • '�`
FINAL INSP.
(�
GRADING
cu.:yd.
i plus xi
REMARKS:
=i
LUMBER GR.
FRAMING
ROOFING
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR FIREWALL
LATHING
MESH
INSULATIOWSOUND
FINISH GRADING
FINAL INSPECTION -
CERT. OCC.
FENCE FINAL
INSPECTOR'SSIGNATURES/INITIALS
GARDEN WALL FINAL