09005 (PAT)P.O. BOX 1504 No. OS•5
Building 78-105 CALLE ESTADO
Address Aft g+4 salra LA QUINTA, CALIFORNIA 92253
Owner
r BUILDING:- TYPE CONST., OCC: GRP.
Mailing
Address
_ - A.P. Number
CityZip Tel. '
�, �aro4
City*
4 9 1 Z Legal Description
Confracior Project Description
Allied Pool
Address Patio Cover
AIS90 UAIM411A Cv-
City Zip Tela
Palm Desert 92260 340-5474
State Lic. City
& Classif.� y42660 Lic. # �� Sq. Ft. No. No. Dw.
Size 2A0 Stories Units
Arch., Engr.,
Designer New ❑ Add ❑ Alter ❑ 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 Sof the Business and Professions Code, and my license is in full force and
- effect. -•
_SIGNATURE- �' DATE
OWNER -BUILDER DECLARATION Estimated Valuation
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 7AQ- f
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 PERMIT AMOUNT
the, provisions o/ 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 o/ Section 7031.5 by 'any- applicant for a permit Plan Chk. Dep.
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
O I, as owner of the property, or my employees :with wages as their sole compensation, will Plan Chk. Bal.
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const..
'-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, MBCh
_v provided that such improvements are not intended or offered for.sa/e. If, however, the building . ,
.:or improvement is sold within one year of. completion,. the owner -builder will have the burden Electrical
'A Of proving that he did not build or improve for the purpose o/ sale.)
❑ I; as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing
* 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.1.'
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. , O Certified copy is hereby furnished.
TOTAL qA
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 thg 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 C� ! c�+
NOTICE TO APPLICANT: If, after making' this Certificate o/ Exemption you should become ZONE: BY: a >8.t+ �,.�i,k; 9j fiA
subject to the Workers' Compensation provisions o/ the Labor Code, you must forthwithMinimum Setback Distances: x� vwr♦ .y
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,.Civit 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 it work thereunder is suspended for 180 days.
I certify that I have read this application and state that theaboveinformation 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
S -
CONSTRUCTION ESTIMATE
NO.. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
UNITS
COLL. AREA
2ND FL. SQ. FT.
ROUGH PLUMB.
YARD SPKLR SYSTEM
MOBILEHOME SVC.
BAR SINK
POR. SQ. Ff. ®
SEWER OR SEPTIC TANK
ROUGH WIRING
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
FOUND. REINF.
GAS (ROUGH)
DRAINAGE PIPING
CAR P. SO. FT. ®
HEATING (FINAL)
OTHER APP./EOUIP.
WALL SQ. FT.
GAS (FINAL)
DRINKING FOUNTAIN.
SQ FT ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER HEATER
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FINAL INSP. 1�'��
LAUNDRYTRAY
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.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
GAR. FIREWALL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
LATHING
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
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EOUIP.
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. /q
FRAMING
FINAL INSP. 1�'��
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION i2 —ct
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL