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05819 (RPL)4 f GGf)tiCV P.O. BOX 1504 N o . 05819 Building5 g59SHOAL 7&105 CALLE ESTADO Address LA QUINTA, CALIFORNIA 92253 Owner WILLIAM .& KAREU FMIRR . Mailing T BUILDING: TYPE CONST. OCC: GRP. Address SIM A.P. Number City Zip Tel. LA �A 1.92253 77I-233 Legal Description Contractor Project Description SPA BACK= POOL$ & SPAS Address lt� 924 VELLA ROAD C SPR t�df�5 14,!PZ262 Tek 60— State Lic. City & Classif.—�� Lic. # Sq. Ft. No. No. Dw. Arch., Engr., Size Stories Units Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolitio�i ❑ Address Tel. City Zip State Lic. # 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 Business and Professions Code, and my license is in full force and effect. SIGNATURE DATE OWNEWBUILDER DECLARATION Estimated Valuation I hereby affirm that I am exempt from the Contractors License Law for the following 9.1500 reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a permit to construct, after, improve,- demorrsh, or repair any structure, prior to its issuance also requires the applicant for such permit to life a signed statement that he is licensed pursuant to PERMIT AMOUNT 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 Plan Chk. Dep. subjects the applicant to a ciw7 penalty of not more than five hundred dollars ($500). ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. 76.00 do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. 117..00 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, Mech. 24.00provided 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 "I have the burden Electrical 15.00 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- Plumbing 27.00 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 S.M.I. .70 such projects with acontractor(s) licensed pursuant to the Contractor's License Law.) Grading ❑ I am exempt under Sec a- 8 P.C. for this reason Driveway Enc. Date owner Infrastructure WORKERS' COMPENSATION DECLARATION I hereby affirm that 1 have a certificate of consent to self -insure, or a certificate of Workers 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. �– TOTAL CERTIFICATE OF EXEMPTION FROM REMARKS ,-,,>r:s<w ,a �x WORKERS' COMPENSATION INSURANCE ,� e' xSrt (This section need not be completed ff the permit is for one hundred dollars ($100) valuation •f'''``°4' "4iV x.+r04.m.sr%1W .F— r. -0a a , + or less.) I certify that in the performance of thg work for which this permit is issued, 1 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: 11, after making Mis 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 permit shall 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 C ©g expiration if work thereunder is suspended for 180 days. 1,� ��G17 1 certify that I have read this application and state that the above information is correct. ISSUed by: Date Permit 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 al mentioned property for inspection purposes. Validated by: Signature of applicant Date Mailing Address Validation: City, State, Zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS SLAB GRADE ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL. SQ. FT. FORMS SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® GAS (ROUGH) METER LOOP HEATING (FINAL) POWER OUTLET ROOF DRAINS GAR. SQ. FT. ® TEMP. POLE GROUT DRAINAGE PIPING CAR P. SO. FT. ® FINAL INSP. BOND BEAM WATER SYSTEM DRINKING FOUNTAIN WALL SO. FT. ® =$ LUMBER GR. FINAL INSP. URINAL SQ. FT. @ ROOFING ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTONDISH) 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, 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 ® 11/. c SEWAGE DISPOSAL FINAL INSPECTION( SQ.FT.GAR ® V4c HOUSE SEWER CERT. OCC. 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 UNO PLUMBIN 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 APPJEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus xi =$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING D /� REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INS TION/SOUND INISH GRADING 646#52- 2 AL1 !/ FINAL INSPECTION( CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL I