10019 (RPL)4
P.O. BOX 1504
Building 44-060 CRISTOL PLACE LA QUINTA78-105 , CALIFORNIA 92253
__7�
No. 100.9
Owner
LA QUINTA VISTA PARTNERSHIP
BUILDING: TYPE CONST.
A.P. Number
POOL SPA
OCC: GRP.
Mailing
Address SAME
City
Zip
Tel.
LA QUINTA
92253
360-1619
Legal Description
Project Description
POOL AND SPA
Contractor
UNIQUE POOLS BY CARMINE
Address
74-818 VELIE NAY #1
City
Zip
Tel.:
PALK DESURT71
92260
466335
State Lic.
& Classif. C 53-521432
City 1366
Lic.41,
Sq. Ft.
Size
No. No. Dw.
Stories Units
Arch., Engr.,
' Designer
New ❑ Add ❑
;
Alter ❑ Repair ❑. Demolition ❑.
11
Address
Tel.
$
City
Zip
State
...
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby firm that I am:licensed under,orovisions of Chapter 9 (commencing 'with Section
70pp)-of Division 3 of the,Business and Professions Code; and my license is iirniful force and
effect.
SIGNATURE'e—. y Z J i ✓ %DATE
OWNER -BUILDER DECLARATION •
I hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
permit to construct, after, Improve, demolish, or repair any structure; prior to its issuance also
requires the applicant for such permit to rile a signed statement that he is licensed pursuant to
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
' subjects the applicant to a civil penalty or 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 enproves thereon and who does such -work himself or through his own employees,
provided Nat such improvements are not intended or offered for sale. If, however, the building
orimprovement is sold within one year of completion, the owner -builder 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 contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec. B. & P.C. for this reason
Estimated Valuation
$8000
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
'
0,2
Const.
�8 • 50
Mech.
1475 0
Electrical
6S -00
Plumbing
2 7,00
S.M.I.
• 90
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 thereof. (Sec. 3800, Labor Code.)
Policy No. Company =% It-. aiT. y.. r^ .,
�O Copy is filed with the city. . ❑ Certified copy is hereby furnished.
^
TOTAL
--
CERTIFICATE OF EXEMPTION FROM
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, alter 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.)
Lender's Name
Lenders 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.
1 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 +.
1,000-5tvfofi 10
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. ® $
UNITS
ROUGH PLUMB. BONDING
2ND FL. SO. FT. ®
STORAGE TANK
YARD SPKLR SYSTEM
FOR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT.
REINF. STEEL
DRAINAGE PIPING
WALL SO. FT.
DRINKING FOUNTAIN.
SQ FT ®
FINAL INSP.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
WATER PIPING
NOTE: Not to be used as property tax valuation
LUMBER GR.
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1Vi c
SEWAGE DISPOSAL
INSULATIONISOUND
SO.FT.GAR ® V4c
HOUSE SEWER
FINISH GRADING
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 & AIR COND. SOLAR
SETBACK
ROUND PLUMBI 1774�7GX DERGROUND -' v(
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.
1AGAS (ROUG ,/ ,q 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.
VIFJNAL INSP. LO 1q
FRAMING
FINAL INSP.
ROOFING
�� (• V ` // /r�— `�v� — ��
V �(
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