10731 (RPL)Building 54-230 Velasco
Address
Owner
James Elir'iter
ti
44
j�f
P.O. BOX 1504 No. 10731' l (. �
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253% 1
Address same
city
aQuinta Zjp.92253 Tel.
Contractor
Spa Specialists
Address. _
72431 Cholla Dr
City Zip Tel.: "
P. D. 92250 34£6355
State Lic. City
& Classif. C53 614597 Lic. # 2226
Arch.,- Engr.,
Designer
Address : Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION '
1 hereby affirm that lam 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 force and •
SIGNATURE t YJ !' DATE
yr- 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.counly 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 or the Business and Professions Code, or that. he is exempt therefrom,; and, the, basis
r 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 five hundred dollars.(S500). '
O 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'sold within one year of completion, the owner -builder will have the burden
of proving thathe 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
Date Owner
WORKERS' COMPENSATION DECLARATION
1 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
. ❑ Copy is filed with the city., ❑ Certified copy is hereby furnished:
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION.INSURANCE
(This section need not be completed if . the - permlt is for one hundred dollars ($100) valuation
or less.) '
1 certify that in the performance of thg work for which this permit is issued; I shall not
employ any person in* any manner so as j become subject to the Workers' Compensation
Laws of California-
Date
aliforniaDate Owne
NOTICE TO A) PLICAN'W. aft erf making this Certificate of Exemption you should become
subject to the Workers' 'Compensation provisions or the Labor" Code, . you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.) -
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days. '
I certify that I have read this application and state that the aboveinformation is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this city to enter the above-.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
BUILDING: TYPE CONST. - OCC: GRP.
A.P. Number
Legal Description
Project Description
POOL ANM SPA. '
Sq. Ft. No. No. Dw.
Size .Stories Units .
New ❑ Add ❑ Alter ❑ Repair ❑ -Demolition ❑
Estimated Valuation 12, 000
PERMIT AMOUNT
Plan Chk. Dep:
Plan Chk. Bal.
-87.75
Const.
135.00
Mech.,
'24.00
Electrical,
45.00
Plumbing
27.00
S.M.I.
1.20
Grading
Driveway} Enc.
Infrastructure
TOTAL
319.95
REMARKS
iiti�tiifi':r•,4�'a:lrafti:ri5te-year—r� r•t� ai$f's
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
Val idated• by: ,
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. @ $
2ND FL. SO. FT.
POR. SO. FT. @
GAR. SO. FT. @
CAR P. SO. FT. @
WALL SO. FT. @
SO FT @
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN.
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEOUIP.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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.
SO. FT. @ c
BATH TUB
FRAMING
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR @ 3/4c
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 PLUMBINGi�hUNDERGROUND
�i
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. ��
FINAL IN 2 C
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FRAMING
ROOFING
� �
4/� v�
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION L
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL