06798 (RPL)Building
Address 54-039
Lila` In
,Mailirig
s
Addres
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City
La Ejnlnta
V _
P.O. BOX 1504 N o . 067 8 y
78-105 CALLE ESTADO + '
soutbem HiUS _ I.A gVINTA, CALIFORNIA 92253 „
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BUILDING: TYPE CONST. ' •• OCC: GRP.
A.P. Number tua wear t '
Zip Tel. _
92253 . 77Legal Description
Gtanite Pool, riga
i Project Description X
• Dadton Poole
ddress.
68-305 Perez Rom -
City
Zip
Tela
Cat ral' City
922
_ a2.4- tZ_32,
' State Lic.
City ._
& Classif. 5'74127
Lic. #
Sq. Ft.
No. No. Dw.
- ,
""�
Size"
Stories • Units
Arch:, Engr., --
.'•Designer
'-Designer
New ❑ Add Alter ❑ Repair ❑- -Demolition ❑- ,
Address"..
Tel.
-
City
Zip
State
Lic. # ...
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensedunder provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and '
-
effect.
DATE
••
_SIGNATURE
-OWNER-BUILDER DECLARATION
Estimated Valuation '
I -hereby affirm that 1'am exempt from the Contractors License Law for the following
p�
12l1v
,reason: (Sec.'7031.5,Business and Professions Code: .Any city or county which requires a
permit to construct, after. Improve, demolish, or repair any structure, prior to its issuance also
'
-
`I
,requires the applicant for such permit to file 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.
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0
,subjects the applicant to a civilpenalty of not more than five hundred dollars ($500). '
Plan Chk.. Bal.
❑ 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
Professions Code:
Const.
OQ' '
. 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,
provided that such improvements are not intended or offered for sale. If, however, the building
Mech.
•
'24 00 "
•
y or Improvement is sold within one year of.completion, the owner -builder will have the burden
Electrical
gp
30.00
of proving Mat.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
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.
_ ��9g..!
i.9L
• such projects with a,contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
-_
• O 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
O Copy is filed with the city.. .O Certified copy is hereby furnished. •'_
TOTAL
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CERTIFICATE OF EXEMPTION FROM '
REMARKS"
WORKERS' COMPENSATION INSURANCE
. (This section need not be completed if the permit is for one hundred dollars (S 100) valuation
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• �to05,2 .& ti 1 "`.-� .J.4
Of Iee
I certify
certify that in the performance of thg work for which this permit is issued, I shall not
..,2.
employ any person in any manner so as to become subject to the Workers' Compensation '
Laws of California
Date " ' Owner t
NOTICE TO APPLICANT. N, after making this Certificate of. Exemption you should become .
ZONE: -
BY:
subject to the Workers' Compensation- provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked: '
Minimum Setback Distances:. -. ,'{
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
3
„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: . ' -. , ;,
1 certify that I have this
—
J)
�^ ���� '
read application and state that the above information is:correct.-
I.agree
Issued by:
Date—Permit -
to comply with all city and county ordinances and state laws relating to building
construction,, and hereby. authorize representatives -of this"cityto . enter the above..'
r mentioned property for inspection purposes.
Validated by:
-''
' .Signature of applicant ;
r
—Date..`
Mailing Address'
Validation:
a :`
City,., State,' Zip
r {
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT, ®
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SQ. FT. ®
TEMP. POLE
I
GROUT
DRAINAGE PIPING
CAR P. SQ. FT. ®
FINAL INSP.
WALL SQ. Ff.
WATER SYSTEM
DRINKING FOUNTAIN.
GRADING
cu. yd.
$ -Plus-x$-=$
URINAL
SQ FT ®
FINAL INSP.
FRAMING
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
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.
SQ. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/. c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
FINAL INSPECTION
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 APPJEQUIP.
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
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/" d
/
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