06390 (RPL)TA
f •
P.O. BOX 1504 N 0 06390, ,
Building. 78-105 CALLE ESTADO. ' J
' Address 54-015 Simthern Mls. i , LA QUINTA, CALIFORNIA 92253 1
Ownersuilr
is BUILDING: TYPE CONST. OCC: GRP.
Mailing r
Address 75-005 Cdok St. "_ ,.. �PGA i -28t
A:P.-Number
City - _ Zip Tel.
:Palm Deam922.-0 56 .- Legal Description -
Contractor P-001 spa
'r
G T Pool Cowt Metion _ Project Description 1
Address
City IZip.
Cathedral City
State Lic. -
& Classif, 275796
Arch.,• Engr.,
Designer
Address'
92234
Tel.:
L
.,,,
Lic. # 69 Sq. Ft.
ity
Size •.
Tel.
-.No.
Stories
I New ❑ Add ❑ '.. Alter ❑
No. Dw:
Units
Repair 0 -Demolition•❑
CityZip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION' .
'
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
700p) of Division 3 of the Business and Professions Code, andmy license is in full force and
.. II •..
SIGNATURE DATE
OWNER-BuaDER DECLARATION
I hereby affirm that 1 am exempt from the Contractors License Law for the followingCi�e�0ee
reason: (Sec. 7031.5,�bness and Professions Code: ,Any city or county- which .requires a'
permit to construct, aftr, improve, demolish, or repair any structure,. prior to its issuance also -
requires the applicant for suchpemoTto rile a signed statement that he is licensed pursuant to•PERMIT
the provisions of the Contractor's License taw, 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
subjects the applicant to a civil penalty or not more than five hundred dollars.($500). -
„ ❑ I,.as owner of lhe,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, Suisness and
Code: The Contractors 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,
provided that such brprovernents 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.
of proving.that he did not build or knprove,for the purpose of sale.) - - . .
Estimated Valuation
Q6 101
-
'• AMOUNT
1)
Plan Chk. Dep.
.-
:
Plan Chk. Bal. $1,34.55%'
Const. 207.0.0Professions
,
Mech. �{ .30.00
Electrical' .e l a�s/ '
Plumbing ', `� 4.00
O I, as owner of the property, am exclusively contracting with licensed contractors to con-
• slruCt 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
such projects with a contmdorls) 5censecipursuant to the Contractor's License Law.) -
O I am exempt under Sec_ a- & P.C. for this reason
• �C!►
. S.M.I. „ ,l.. wt,1� .
. .
Grading •�
_
Driveway Enc.
Date owner
Infrastructure
WORKERS' COMPENSATION DECLARATION '
I hereby affirm that 1 have A certificate of, consent to self -insure, or a certificate of
Workers Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) . • .
Policy No. Company
? k .
R .
O Copy is filed with the city.: O Certified copy is hereby furnished:
TOTAL
CERTIFICATE OF EXEMPTION -FROM -
WORKERS' COMPENSATION INSURANCES
(This section need not be completed if the permitis for one hundred dollars ($100) valuation
orless.) . ..
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
`REMARKS>str°4t} `L} i1a`'-',� - ' , • ; _'
••91,��"_ ;e a 41 f s rL , t .r n ; .y.
- _' - •� -
' Date Owner
NOTICE TO APPLICANT: ll, after makhg this Certil-ovate• 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 shift bedeemed revoked.' _
ZONE: BY:
- - - - -
Minimum Setback Distances:
Front Setback.from Center Line
Rear Setback from Rear Prop.. Line
CONSTRUCnON 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, Ciro Code.) ,
Side Street Setback from Center Line
t n
Side Setback from Property,Line
Lender's Name
Lenders Address
FINAL DATE INSPECTOR
' 9122189 Ii"'
This is a building permit when property filled ouL'signed'aud validated, and is -subject to .
expiration it 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 • y
Issued by: Date Permit'.
;
;Validated by:
-Signature of applicant Date'
Mailing Address
( '
Validation:
, .. ♦ , • .. ..Cy'I _•
City,. State, Zip'
it
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST 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. SO FT ®
REINF. STEEL
GAS (FINAL) w TEMP. POLE
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
FINAL INSP.
BOND BEAM
WATER SYSTEM
DRAINAGE PIPING
CAR P. SO. FT. ®
LUMBER GR.
FINAL INSP.
WALL SQ. FT.
FINAL INSP.
DRINKING FOUNTAIN.
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REMARKS:
URINAL
SO FT ®
VENTILATION
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
GAR FIREWALL
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LATHING
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
SO. FT. ® c
WATER HEATER
MAX HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
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
d.LUND PLUMBIN�0//k� UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
S R OR SEPTIC TANK ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
(ROUGH) 1D I/ %/ METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL) w 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
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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