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06870 (RPL)P.O. BOX 1504 No. 06870 Building 78-105 CALLE ESTADO Address 53-413 Southern LA QUINTA, CALIFORNIA 92253 Owner » » ' Mailing SUDXiSCI CA . XWany BUILDING: TYPE CONST. OCC: GRP. Address 42-600 Cook Street, Suite 200 • A.P.-Number «. City Zip Tel. Palm. De"tt 92260 368_-U ,$ _ Legal Description Contractor Patrol & Spa is H Pool C vlgstruall a Project Description Address » 68—"3 P$rex Road _ City Zip Tel.:. Cathedral Cite 92234 326-2681 State Lic. City & Classif. 275796 Lic. # _ b Sq. Ft. No. No. Dw. • -Arch., Engr.; Size _ • Stories t Units Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I: hereby affirm that I am`licensedaunder provisions of<Chapter,9 (commencing with Section 7000) of Divisiom3 ofAt a Business"and Professions,Code, and my license is.in full force and effect. i� /:� :r ty:'^r ! % 'rfi "``< .. f � f I _ A 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 permit to constnrct, after, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to Me 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 civilpenalty of not more than five hundred dollars (8500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. $134.55 do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and COrISt.'�� }(% Professions Code: The Contractor's License Law does not -apply to an owner of property who builds or Mproves thereon and who does such work himself or through •his own employees, 31-i�ite r% provided that such Improvements are not intended or offered for sale. If, however, the building Mech. 3q 0 or improvement is said within one year of completion, the owner -builder will have the burden Electrical L� �.® of proving that he did not build or improve for the purpose of sale.) ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 24.00 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. 1.40 such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading ❑ I am exempt under_Sec B. & P.C. for this reason Driveway Enc. Date owner Infrastructure WORKERS' COMPENSATION DECLARATION 1 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 CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed ft 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: ft, after 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. CONSTRUCTION LENDING AGENCY ' 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.). Lender's Name Lender's Address '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 1 have read this application and state that the above information is correct. 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. Signature of applicant' Date' Mailing Address City,. State, Zip REMARKS G7 tis ff Z m f 6& 1 `"Ra: -.,4r Y.x ZONE: BY: Minimum Setback Distances: .• Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR 1/:12/90 Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL SQ. FT. ® $ UNITS ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK YARD SPKLR SYSTEM 2ND FL SQ. FT. DUCT WORK ROCK STORAGE FOUND. REINF. MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® REINF. STEEL GAS (FINAL) TEMP. POLE POWER OUTLET ROOF DRAINS GAR. SQ. FT. ® FINAL INSP. BOND BEAM WATER SYSTEM DRAINAGE PIPING CAR P. SQ. FT. ® LUMBER GR. 6� FINAL INSP. - FRAMING FINAL INSP. DRINKING FOUNTAIN. WALL SQ. FT. REMARKS: URINAL SQ FT ® ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM MESH 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 IBATH TUB CERT. OCC. SQ. FT. ® c WATER HEATER MAX HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL INSPECTOR'S SIGNATURESIINITIALS SQ.FT.GAR ® V4c HOUSE SEWER GARDEN WALL FINAL 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 NDERGROUND//, 67 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. AS (ROUGH)�,%Si � METER LOOP GAS(ROUGH)LLD [[ 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. 6� FINAL INSP. - FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL 1