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08911 (RPL)T 6 . 44 Atyl P.O. BOX 1504 No.8,t7� Building 78-105 CALLE ESTADO Address ji'3 780 Skyfaard LA QUINTA, CALIFORNIA 92253 Owner - Pool Brad Dr.uel BUILDING: TYPE CONST. & Sya OCC: GRP: Mailing Address 43-780 SkRmard A.P. Number City1A Zip Tel. Lot fl�l< n �, � Legal Description S»ftth' P001timp, 2253 Contractor Project Description Ifs; X 22t 2' to § • doers Address City Zip Tela - I I 922M 11A7205954 'State Lia City & Classif.3$' S Lic. # Sq. Ft. No. No: Dw. Size _ • Stories Units ' Arch., Engr., Designer New tj Add ❑ Alter ❑ Repair'❑: Demolition ❑ Address Tel. "CityZip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am,licensed under provisions of Chapter 9 (commencing with Section 7000) Division 3 of the Business andProfessionsCode, and my license is in full force and effect st as a wt l S. s s iY` .••1 "'iJ SIGNATl1FE' '�'JV_ WW f NW DATE .. 1JOWNER•BUILDER DECLARATION Estimated Valuation $20.000.00 I rm hereby affithat 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 thconstruct, alter, improve, demolish, or, repair,any structure, prior to its Issuance also AMOUNT requires e applicant for such permit to'file a signed statement that he is licensed pursuant to PERMIT - 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. _ $134.55 subects the applicant to a civil penalty of not more than five hundred dollars ($500). 01 1 , as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. 207.00 do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. �Qd 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..7 provided. that such improvements are not intended or offered for sale. If, however, the building C00 or improvement is sold within one year of completion, the owner -builder will have the burden Electrical of proving that he did not build or improve for the purpose of sale.) 27,00 O I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 1.40 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. such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading ❑ 1 am exempt under Sec. B. & P.C. for this reason 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 ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. TOTAL yGla `4°�,' MAW , 49—A-901" axs - io CERTIFICATE OF EXEMPTION FROM REMARKS 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, after making this Certificate of Exemption you should become ZONE: BY: subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Minimum Setback Distances: comply with such provisions or this permit shall be deemed revoked. 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 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. I 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 above-. 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. ® $ -i UNITS A.C. UNIT 2ND FL. SQ. FT. SLAB GRADE YARD SPKLR SYSTEM POR. SQ, FT. ® MOBILEHOME SVC. BAR SINK GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS CAR P. SQ. FT. ® SEWER OR SEPTIC TANK DRAINAGE PIPING WALL SQ. FT. DUCT WORK DRINKING FOUNTAIN. SO. FT. ® URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation REINF. STEEL f FLOOR DRAIN MECHANICAL FEES TEMP. POLE WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER WATER HEATER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FINAL INSP. 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. SQ. FT. ® c BATH TUB �J,,�� . zoctv c ib 1 ' f P 1Q�wt l / O 111 SO. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1 Vi c SEWAGE DISPOSAL SO.FT.GAR ® 3/.c HOUSE SEWER FIRE ZONE ROOFING 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 GROUND PLUMBING q(a UNDERGROUND aCO(o 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) q(9 / d`h lYl METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL f 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 �J,,�� . zoctv c ib 1 ' f P 1Q�wt l / O 111 REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTIO C CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL