15225 (RPL)4
44
tt P.O. BOX 1504 No. 15225
BuildinAddrress 1/8 "755 Spyglass LA QU NTA, CALIFORNIA 92253
Owner r
John Fairchild
BUILDING: TYPE CONST. OCC: GRP.
Mailing
AddressSaMt
A.P. Number
Gity Zip ]Iel-
.La
.Quinta, . 6, 922-53 Legal Description
ContractorProject Description pool d•1rld S10a
Address . A
82--756 Boston Ct..
16dio, Cps ZIP92201 Te1347-1617
State Lic. City
& ClassiV 5.73948 Lic. # 2633 Sq. Ft. No. ` No. Dw.
• Size Stories Units
Arch., Engr., "
Designer New ❑ Add'❑ -Alter ❑ Repair ❑ 'Demolition.❑
Address Tel.
CityZip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
+
I hereby affirm that Ifam licensed under provisions of Chapter 9 (commencing with Section
000) of -Division 3 of trhe Business Prot ssions Code,
-
and and my license is in full force and
' effect.• ,,,."^'1..J � � r ? ��1�
;
-
iSIGNATURE 1 DATE
.
OWNER -BUILDER DECLARATION
I hereby that I from the Contractor's License Law for the following
Estimated Valuation 500 ri A
11 0th
affirm am exempt
reason: (Sec.-7031.5,Buslness and Professions Code: Any city or county ,which requires a
t a
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
I
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 Nat. he Is exempt therefrom,and the basis
for the Any Section 7031.5 'any for
Plan Chk. Dep.
alleged exemption: violation of by applicant a permit
'subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
Plan Chk. Bal. 87.75
❑ I, as owner of the property, or my employees with wages as their sole compensation, will
do the work, and the structure Is not intended or offered for sale. (Sec: 7044, Buisness and
Const. 135.00
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.- (�p
provided 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 will have the burden
Electrical' '
of proving that he did not build or knprove for the purpose of sale.)
'
O 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.
such projects with a contractors) (tensed 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. fiel
❑ Certified copy is hereby furnis.
. `
''.TOTAL .. _ 3 1 Y3 . 7.5
CERTIFICATE OF EXEMPTION FROM
_
REMARKS
WORKERS'COMPENSATIONINSURANCE
(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
v
employ any person in any manner so as to become.subject to the Workers' Compensation
A
Laws.of,Call or a. —4-4
" ! s %"
x
,'
Date twiner--`:`^
NOTIC TO APPLICANT ff, • after making this Cert�c`ate' o/ Exemption` you should become
ZONE: BY: '
subject to the Workers' Compensation provisions of the L•etor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
Minimum Set back .Distances:
Front Setback from C.ente i e
—Rear fro e rop. Line
WARNING: FAILURE TO SECURE WORKERS'. COMPENSATION COVERAGE IS UNLAWFUL, AND.,
j
Side Street Setba. k from Centerline
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
HUNDRED THOUSAND DOLLARS ADDITION TO THE COST
/
Property Line�
($100,000),.IN OF COMPENSATION,
Side SetbaCkrf60m
`Y
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
/
C
ATTORNEY'S FEES.
FINAL DATE NSP CTQI v
iiE
This Is a tiudin g permit when properly filled out, signed and validated, and is subject to
_
- U x
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
y `.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives this city to the
,of. enter .above.
mentioned for Inspection
lJ
property purposes.
Validated by:
Signature of applicant Date
' Mailing Address
Validation:.
City, State, 21p
- `� /•
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW FEES
IST FL. SO. FT. ® $
UNITS
A.C. UNIT
COLL. AREA
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL. SO. FT.
BONDING
HEATING (ROUGH)
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
ROUGH WIRING
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
FOUND. REINF.
GAS (ROUGH)
DRAINAGE PIPING
CAR P. SD. Ff.
HEATING (FINAL)
WALL SO. FT. ®
REINF. STEEL
DRINKING FOUNTAIN
SO. FT. ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LUMBER GR.
LAUNDRYTRAY•
AIR HANDLING UNIT CFM
FRAMING
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
FIRE ZONE ROOFING
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
GAR. FIREWALL
GAS PIPING
PERMIT FEE
LATHING
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 APPJEOUIP.
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
^ /v`` / `
/
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
66WAL INSPECTION - 7-Z
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL