14813 (RPL)Building
Address 79"655
Owner Austin
P.O. BOX 1504
78-495 CALLE TAMPICO
Tangelo LA OUINTA, CALIFORNIA 92253
Mailing
Address • Same-
City
ameCity Zip
La Quin , CA 42253
Contractor
. Cal.ii'orfiia Pools aid . SQ2
Address
41-910 Boardwalk A-2
C.Palm Desert, 4zip 92211
State Lic.
& Classif..C53 656128
Arch., Engr:,
Designer
No. 14813 , .-
BUILDING: TYPE CONST: OCC: GRP.
A.P. Number
Tel.
Legal Description
Project Description - .'Pool s=ad SPa
40-9000
Lic. # 3551. Sq. Ft. No:
Size Stories
IL
New ❑ Add D . Alter ❑
No. Dw.
-Units
Repair ❑ Demolition ❑
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
OWNER -BUILDER DECLARATION '
1 hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5, Business and Professions. Code: Any cfty_-or county which requires a
r gg A/�!s �p�3 }� at
Estimated Valuation 411000.00
rY�,.7 000. 00
-
..PERMIT - AMOUNT --
permit to construct, after, 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
Plan-Chk. Dep.
' • subjects the applicant 7o a civil penally of not more than rive hundred dollars ($500):
O. I, as owner of the property,.or my employees with wages as their sole compensation,-wiII
y.
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. •. ` ' • Qj�
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
Electrical - - 15 a 00
or improvement 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 ,' •
0A, 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 propertywhobuilds or Improves thereon, and who contracts for
' such projects with'a contractors) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt underSec B. & P.C. for this reason
_
S.M.I.
Grading
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. O Certified copy is hereby furnished.
TOTAL 333.6a
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 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: It, atter 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.
ZONE:' - BY: -
Minimum Setback Distances:
Front Setback from Center Lin
Rear Setback from Rear Prop: Line- '
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL", AND
SHALL SUBJECT AN EMPLOYER. TO CRIMINAL PENALTIES AND CIVIL. FINES UP TO* ONE
Side Street Setback from Center Line
HUNDRED THOUSAND DOLLARS. ($100,000), IN ADDITION -TO THE COST OF COMPENSATION,
Side Setback from,Property Line '
DAMAGES AS PROVIDED FOR IN. SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
This is abunding permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
FINAL DATE INSPECTOR
. , I certify thatI have read this application and state.that the above information is correct.
I agree to comply with all ciyand 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.
issued by: Date
Q
Validated by:
Signature of applicant Date'
Mailing Address
Validation:
MAK U 0 1 ZJZJ-)
I BY
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
1ST FL. SO. FT. ® $
UNITS
_
V
2ND FL. SQ. FT. p
BONDING
YARD SPKLR SYSTEM
STORAGE TANK
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. 0
DUCT WORK
ROCK STORAGE
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
OTHER APPJEQUIP.'
DRAINAGE PIPING
CAR P. SO. FT.
TEMP. POLE
WALL SQ. FT.
GROUT
DRINKING FOUNTAIN.
SO. FT. ®
FINAL INSP.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
WATER PIPING
NOTE: Not to be used as property tax valuation
_$
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.0OOL HOOD
SIGN
WASHER(AUTO)(DISH)
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.
SO. FT. ® c
BATH TUB
GAR. FIREWALL
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1 Va c
SEWAGE DISPOSAL
MESH
SQ.FT.GAR-® 3/sc
HOUSE SEWER
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
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 x$
_$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING '
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
INAL INSPECTION .
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
MEMORANDUM
CASE: TS Locations) : r7q
Request (s) : e e -1�2-�:A.r �{.!� �� S��-b,a cJ, .',.-.�, • iy
Your setback adjustment application is hereby approved, subject to
the following: conditions:
Conditions:
1. Obtain a building permit from the Building and Safety
Department.
2. -The other Zoning Code provisions shall be'met:
3. If ground excavation is required', 'please contact Underground
Service Alert (USA) at i-800-422-4133. The service is -free of
charge provided USA is given at least two working days'
notice-,
4. Additional Conditions:
After review it was determined that:
1. This.adjustment is consistent with the intent and purpose of
the Zoning Ordinance.
2. There are special circumstances applicable to the property,
including such factors as size, shape, topography, location or
surroundings that justify approval of the adjustment. These
circu stances are.-
Thank
re:Thank ou for your cooperation.
i er ly,
i
ity velopment Department
Atta hments
M
c: Building and Safety Department