07567 (BLCK)VT
- ACL
Building W55S soul
Address •
Mailing;;;;
Lai; Wnta,
Contractor
P.O. BOX 1504 07,
78-105 CALLE ESTADO
LA,QUINTA, CALIFORNIA 92253 ,.
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BUILDING: TYPE CONST. OCC: GRP.
r6arn Rill A.P. Number PGA t@S$
Zip Tel.'
9U5 562358 Legal Description
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1'-910. Boatl k
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State Lc: ;
Arch:;. Engr`;
Designer.,,,-,:...
Address., "
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City • Zip
Project Description pool Et soa
Spa
A-52 AA g r 1.41z4,, V& 5` High Mod Wall:. �.
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City ,
Y LIc. #
Tel.
State
Lic. #
DR'S DECLARATION . �
ions of Chapter 9 (comm e cin��gg with Section
ons Code, and my Iicens7jr n�fyll'fbjpe and
Sq: Ft. No.
Size . Stories
No. Dw. '
Units=
New ❑ Add -,O Alter ❑ Repair ❑'.,.-:Demolition ❑
�'�� V f 'f/f IJT�
• 5 GNAT.yA DATE
OWNER -BUILDER DECLARATION .
- .g.,
•I;hereby,<affirm that'I am exerPipt from 'ihe Contractor's License Law for the .following
'reason:.(Sec. ^7031:5;8usiness; and- Pro/essions Code: Any city or county which requires a
permit -oto construct;alte�'improve,'demolish, or repair any structure, prtor to its issuance also
M re "a applicanLloresuehpeiinit tolile a signed statement that he is licensed pursuant to
e_
- (he%provisions of. the -Contractor's License Law, Chapter 9 (commencing 'with, Section 7000) of
'f' Division 3"o/'the Business' and Pro%essions Code, or that. he is exempt therefrom, and the basis
lor the alleged `exemption.' Any violation o/ Section 7031.5 Dy 'any applicant for a permit
subjects the applicant t0 . clvO penalty o/not more than five hundred dollars.(5500). -
'. ❑ I, as owner of the property,'or my employees with wages as their sole compensation, will
Estimated Valuation
--
$ ��
PERMIT
MOl1NT .: '
- - AMOUNT..-
-
Plan Chk. Dep.
-
Plan Chk. Bal.
COnSt
.The'Contractor's
1
-
' do the work, and the structure is not intended or offered -for -sale. (Sec. 7044, Buisness and
Professions Code:.:License Law does not apply to an owner of property.who
-
Mech....
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- - w,�i:����
builds , or improves'.theieon 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
EIBCtrICdl
r��,�
-
or improvement is sold' within one year o/ completion,: the owner -builder will have the burden
of proving that hedidnot build or improve for the purpose o/ sale.)
O I, 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
owner of property who builds or improves thereon, and. who contracts for
does not apply to anylia
Plumbing .
- 24400,
S.M.I.SMI
�y� -
.. ,,,
- such projects with a:contractor(s) licensed pursuant to the Contractor's License Law.)
r% O 1 am exempt under Sec. B. & P.C. for this reason
-e
Grading
Driveway Enc.;
r
DateOwner
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 -
O Copy -is filed with the city. ❑ Certified copy is hereby furnished.
+
TOTALi��.3
% CERTIFICATE OF EXEMPTION FROM
.. - .'WORKERS' COMPENSATION INSURANCE
(This section need• not, be completed it the permit is for one hundred dollars (8100) valuation
or less.)
I certify that in .the. performance of thg work for which this permit is issued; I shall not
=any pperson,in any manner so -as to become subject to. the Workers' Compensation
Laws of California:
REMARKS
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d °."2�
MYi
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Date ., "'•. _... _, Owher
NOTICE TO APPLICANT., If,, after -making this Certificate o/ Exemption you. should become
' subject to the' Workers' Compensation provisions o/ the Labor Code, you must. forthwith
• comply with such provisions. or this permit shall be deemed revoked.
ZONE:
Minimum Setback
' BY: -
Distances: - -
•-;- `, Y,
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.)
Lender's Name
FINAL DATE
Slde•Setback from Property Line
INSPECTOR
(� �}� ,
�ta9l90
Lend'er'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 I 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:-•
Issued by-,
4
Validated by: %'
Date Permit
Signature of applicant Date
Mailing Address
Validation:,
City, State; Zip
.. .�, �Q. Y••. .« ,.. - .t L` .l. :a ,tit :,�,,, iii.,.
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CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL SO. FT. ® $
UNITS
A.C. UNIT
COLL. AREA
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL SO. FT.
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. FT.
HEATING (FINAL)
WALL SO. FT.
REINF. STEEL
DRINKING FOUNTAIN.
SO FT ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
SERVICE
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(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% c
SEWAGE DISPOSAL
SPARK ARRESTOR
SO.FT.GAR ® 114c
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 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
GciC) S�L�
�j V
�r
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
�
GARDEN WALL FINAL