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05846 (RPL)r , Building Address 49-065 99MA to Owner • W&Yn 1HARTIN . 'Mailing " Address SAM City Zip Tel. LA QUINiA -92253 '773-,444k_ Contractor• - Ut IM FOOLS BY CAPMHE Address' 74-315 VMIE WAY #I City lZiD Tel.: 4-14 P.O. BOX 1504 N o . 05,846 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 . BUILDING: TYPE CONST: OCC: GRP. - A.P. Number PARC LA QM Mi Legal DescriptionLOT 18 - TR 21555-1 Project Description POOL AM SPS State Lic. I I City & Classif.C5320�� Lic. # "µ Sq. Ft. 40 Size Arch., Engr., . Designer ;, New ❑ • Add ❑ Address:' Tel. » City Zip State Lic. # r ' LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed, under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Businessland pqPofessions,Code, and my license is in full farce and effect .•;�:�.,._. : ,.,€�...,.%#r �� .rt., , SIGNATURE ' DATE owNF31-BmtDER DECLARATION I hereby affirin that I am exempt from the Contractor's License Law for the followingEstimated Valuation �� reason" (Sec 7031 5 Business and 'Professions Code: Any city or county which requires a No. Stories t r• Alter ❑ . permit to construct, ager, urmrove, demorish, 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 rk - PERMIT the provisions of the Contractor's license Law, Chapter 9 (commencing with Section 7000) of Date . Owner " " 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 aPprrcant to a civit penalty of not more than five hundred dollars (8500). O I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. Const. • 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 Mech. builds or kWroves thereon and who does such work himself or through his own employees, provided that'such unprovements are not intended or offered for sale. If, however, the building, Electrical or inprovement 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.) , Plumbing ❑ 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 - S.M.1. does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) rcetnsed pursuant to the Contractor's License Law.) O I am exempt under Sec B. 8 P.C. for this reason , Grading Driveway Enc. Date Owner Infrastructure WORKERS' COMPENSATION DECLARATION Side Setback from Property Line - Lenders Name I hereby affirm that 1 have a certificate of; consent to selfinsure, or a certificate of Workers Compensation Insurance, or a certifiedtcopy thereof. (Sec. 3800, Labor Code.)' Policy No_Company Lenders Address 0 Copy is filed with the city. 0 Certified copy.ishereby furnished. INSPECTOR' TOTAL CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE REMARKS (This section need not be completed if the permit is for one hundred dollars ($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 amt manner so as to become sub'ect to th W ' Co t' 'c certify that I have read this application and stat the above information is correct.-;, No. Dw. Units -• Repair ❑ a Demolition ❑ ' AMOUNT ,11b.i�t{E1 .t oUU 30,100 Laws of California 1 e o ars mpensa ion Date . Owner " " NOTICE TO • APPLICAN'T: tl, aftermaking 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 pemut shah 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 - Lenders Name Lenders Address FINAL DATE INSPECTOR' 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. ythat 89 'c certify that I have read this application and stat the above information is correct.-;, Issued by: Permit -Date—Permit I allto comply wiM 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 t Date' Mailing Address r Validation: City, state, Zip _ CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SQ. FT. ® $ UNITS COLL. AREA SLAB GRADE ROUGH PLUM / YARD SPKLR SYSTEM 2ND FL Sp. FT. @ HEATING (ROUGH) STORAGE TANK FORMS MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® DUCT WORK ROCK STORAGE FOUND. REINF. POWER OUTLET ROOF DRAINS GAR. SO. FT. ® HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL GAS (FINAL) DRAINAGE PIPING CAR P. SO. FT. ® GROUT WATER HEATER DRINKING FOUNTAIN. WAIL SO. FT. FINAL INSP. BOND BEAM WATER SYSTEM URINAL Sp. FT. @ GRADING cu. yd. plus x$ -$ ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES /� /+ ^ `�' Y �/S LT / 1 ✓•(_//v /L\'� r WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER VENTILATION GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FIRE ZONE ROOFING LAUNDRY TRAY AIR HANDLING UNIT CFM FIREPLACE 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 SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1 Vi c SEWAGE DISPOSAL SO.FT.GAR ® 3/4c HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MEC:H.FEE PL.CK.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 PLUM / BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC T NK ROUGH WIRING. 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 /� /+ ^ `�' Y �/S LT / 1 ✓•(_//v /L\'� r REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIOWSOUND FINISH GRADING FINAL INSPECTION CERT. OCC. , FENCE FINAL INSPECTOR'S SIGNATURESIIIIITIALS GARDEN WALL FINAL 1