04376 (CP)i
• . ( • � � '� • �� ' '�. `y to 3 A
.,w"� s
P.O. BOX 1504 '.
Building 78-105 CALLE ESTADO a
Address 55-279 TaMilevood LA QUINTA,,,CALIFORNIA 92253, „
Owner ..
sulirise c2 FA
Mailing
Address 75-005 6=tr
City Zip
• palm Desert 92260
Contractor
G H POOL cells
+4 r
" BUILDING: TYPE CONST. OCC. GRP.
Club Dr";b ... A:P: Number, Yost
Tel.
Legal Description
Project Description � � - 70 — P1001 Spa
Address
68-465 Feroz 9041d
r
City :-
Zip
92234-
Tel.
_M-4681
State Lic. '
City
& Classif.?
27,5796
Lic. #
69
Sq. Ft.
Size- - - "
No. "i ,,No. Duv.,
Stories .4 Units
Arch., Engr.,•
Designer
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Address.
Tel.
•;`+'
City
Zip
State
Lic. #
r LICENSED CONTRACTOR'S DECLARATION
Lhereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license.is in full forceand
SIGN TUBE 1 DATE
OWNER -BUILDER DECLARATION
" I hereby affirm that I am exempt from the Contractor's License law for the following
. reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
• permit to construct, alter, improve, .demolish, or repair any structure, 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 (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 of not more than rive hundred dollars (5500).
0 I, as owner of the property, or my employees with wages as their sole compensation, will
Estimated Valuation
$20 f OOO
PERMIT
,AMOUNT
Plan Chk. Dep.
- - --
Plan Chk. Bal.
ice` 1 • 2 A—
Const.
e.,, 1 -
-
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
builds or'lmproves 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 sold within one year of completion, the owner -builder will have the burden
or proving that he did not build or improve for the purpose of sale.)
O 1, 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
Mech.
1-6. 001
Electrical
' :;'►
Plumbing
14.00
S.M.I.
+4{ g
�d ., 1',.
Grading
'Driveway Enc.
Date owner
Infrastructure
"
;A P
WORKERS' COMPENSATION DECLARATION
I hereby affirm that 1 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
❑ Copy is filed with the city. O Certified copy is hereby furnished.
.,
TOTAL
CERTIFICATE OF EXEMPTION FROM
r WORKERS' COMPENSATION INSURANCE'
(This section need not'be completed if the permit is for one hundred dollars ($100) valuation
REMARKS
or less.) ...A
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.
El �.eF.S)*i X15 mak„ . x:t<3�Y a ,•'�
Date Owner
NOTICE TO APPLICANT: If, after 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.
T -
ZONE: BY: _
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 --
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to ,.
expiration it work thereunder is suspended for 180 days.
FINAL DATE
INSPE TOR
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 'ofthis city to enter the above-
mentioned property for inspection purposes.
Issued by:'
Validated by:
' Date -Permit
- -
Signature of applicant Date
Mailing AddressValldatlOn:
'
r
,,,.
c
GOLDENROD,= ASSESSORS OFFICE, HARD COPY - FILE
_..'..•7+1.1`^. ?+'r'- .. 1�..�.�5l ,-. .. .... _. ,_.. .t c1....,,,5.. .":^ncl"._. *. .. . .r -P. u•NY,
City, State, Zip
+ s WHITE FINANCE, PINK APPLICANT GREEN BUILDING,
.. ,:'A �. _. 7.n ,.. f'.- .,.t. .. b.~".K• .. - ..--��.7:. .i'.., i .t.":. ,_. . .��e4`, ..T3
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
ISI FL SO Fl lir S
UNITS
SLAB GRADE
ROUGH PLUMB
BONDING
YARD SPKLR SYSTEM
2ND FL SO FT. tir
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING -
MOBILEHOME SVC.
BAR SINK
POR SO FTar
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR SO. FT. tp
TEMP. POLE
GROUT
DRAINAGE PIPING
CARP. SO FT. (d
FINAL INSP.
BOND BEAM
WATER SYSTEM
DRINKING FOUNTAIN
WALL SO. FT. a
=S
LUMBER GR.
FINAL INSP.
URINAL
SO. FT. 0
ROOFING
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
VENTILATION
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTONDISH)
APPLIANCE DRYER
FIREPLACE
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
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. g c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID g i'A c
SEWAGE DISPOSAL
SO.FT.GAR @ 3/4c
HOUSE SEWER
CERT. OCC.
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE bL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE 7FEE
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 APP.IEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus xS
=S
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
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