9932 (RPL)P.O. BOX 1504 N o . 9932
Building 7&105 CALLE ESTADO �
Address 78-520 TUJUNCA LA QUINTA, CALIFORNIA 92253 �nC
Owner
A & M CONSTRUCTION
Mailing BUILDING: TYPE CONST. OCC: GRP:"
Address P 0 BOX 366
A.P. Number
City Zip Tel.
LA QUINTA 92253 564-4832 Legal Description
Contractor Project Description POOL AND SPA.
S€ MUSE POOLS
Address
P O BOX 12.573
CityZip Tel.:
PALK DESERT 340-5521
State Lic.' City
& Classif:_ C53-556236 Lic. # 1604 Sq. Ft. No. No. Dw.
-Arch., Engr:,
Size Stories Units
• Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
City. .. Zip State
Lic. #
)f LICENSED CONTRACTOR'S DECLARATION x
I hereby; affirm that I am licensed under provisions.of Chapter 9 (commencing with Section '
7000) of. Division 31of the Business and Professions Code, and my license is i full force and
effect. J 7 �I t J t",
�_ISIGNATURE ° ik r DATE
OWNER -BUILDER DECLARATION Estimated Valuation
I hereby affirm that 1 am exempt from the Contractor's License Law for the following 12 OOC
reason: (Sec. 7031.5,Buslness and Professions Code: Any city or. county which requires a a
permit to construct, after, Improve, demolish, or repair any structure, prior to Its issuance also ..
requires the applicant for such permit to rile 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 civil penalty of not more than rive hundred dollars.($500). _-• ' ; -- t .-
❑ I, as owner of the property, or my employees -with wages as their sole compensation, will Plan Chk.. 681. yr ", 7.
do the work, and the structure.is not intended or offered* for sale.'(Sec: 7044, Buisness and COr1St. 1 � �fJ
Professions Coder 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. 'D' = - - 24 ,00
provided that such improvements are not Intended or offered for sale. If, however, the building L _
or Improvement Is sold within one year of completion, the owner -builder will have the burden Electrical 4
. - .5 �! 6
of proving that he did not build or Improve for the purpose of sale.) -
O I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 27.00
r struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply Wan owner of property"who builds or improves thereon, and who contracts for S.M.I. - - 1.20 -
such projects with a contractor(s) licensed pursuant to the Contractor's License'Law.)
Grading
❑ 1 am exempt under Sec. B. S 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 certi`ffiiV c�opiy�herero�(,JS)3800, Labor Code.)
Policy No. Company +SS
O Copy is filed with the city. - ❑ Certified copy is hereby furnished.
TOTAL T3 19+ y
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, O"r) f . 107A` AQ -,f, A-9 { i;
employ any person in any. manner so as to become subject to the Workers' Compensation g �.
Laws of California 4ir K '%., t�� c5� `' •°a
Date--LL—Owner'
NOTICE TO APPLICANT, B, 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
Lenders 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. q
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
GROUND PLUMBING ?04jqj r.CUNDERGROUN15
A.C. UNIT
COLL. AREA
IST FL. SO. FT. ® $
UNITS
f1
2ND FL SO. FT.
BONDING
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT. ®
ROCK STORAGE
DRAINAGE PIPING
WALL SO. FT.
DRINKING FOUNTAIN.
SO FT ®
HEATING (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
TEMP. POLE
FLOOR DRAIN
MECHANICAL FEES
GROUT
WATER SOFTENER
VENT SYSTEM. FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
GRADING
cu. yd.
$ plus x$
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.
SO. FT. ® c
BATH TUB
VENTILATION
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1Vi c
SEWAGE DISPOSAL
SO.FT.GAR ® V4c
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PLCK.FEE
CONST. FEE JELECT.FEE
SMI FEE PLUMB. FEE
STRUCTURE / PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR'
SETBACK
GROUND PLUMBING ?04jqj r.CUNDERGROUN15
A.C. UNIT
COLL. AREA
SLAB GRADE
f1
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
J
SEWER OR SEPTIC TANK
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH) �f G
f '!
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
I a
FINAL INSP.! f, G
[C
FRAMING
FINAL INSP./ L�
ROOFING
/�( `
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
n
FINAL INSPECTION- l G N
111
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL