13695 (RPL)lfi4 4 a& Q"
f ,
--No.
P.O. BOX 1504
3.3695
Building 54-625 Ave. Vallejo 78-105 CALLE ESTADO
AMOUNT
Address LA QUINTA, CALIFORNIA
92253
Plan Chk. Bal.
Owner Dan FA Pari Westhoven
Const.6
_ • 0
Mailing Sams:
BUILDING: TYPE CONST.
OCC. GRP.
Address
A.P. Number
L
City Zip Tel.
Grading
La Quinta, CA $2253 564-1394
Legal Description
Contractor
Project Description Pool
American Pool Construction
AIV*50 Magnesia Palle #1
Palm Desert, C e 9226:9 Te1.340 -5876
TOTAL -
° • 20
State Lic.
City
& Classif. 51+8742 C53
Lic. # 1104
Sq. Ft. No.
No. Dw.
Size Stories
Units
Arch., Engr.,
Designer
New ❑ Add ❑ Alter ❑
Repair ❑ Demolition ❑
Address <- ---�. X
Tel.
_
CityF
Zlp
State
Lic. #
-� ` LICENSED1CONTRACTOR'S DECLARATION
11�iereby affirm that.ham>licehsedtund`erg6ovisions of Chapter 9 (commencing with Sec 'on
7000)
of Division 3 of the Busines9and�'�proffee9sions Code, and my license is in full feyr'ca nd '
effect. y. v/
ilJr..��' !
`SIGNATURE
.�• "" V i % ,f DATE
-� nwuce_mw nco ncci wowtinu !'
I hereby affirm that I am exempt fromtfie Contractor's License Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which' requires a
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
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
subjects the applicant to a civil penafty of not more than five hundred dollars ($500).
❑ 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: 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
or improvement is sold within one year of completion, the owner -builder will have the burden
of proving that he did not build or improve for the purpose of sale.)
❑ 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
does not apply to an owner of property who builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
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 cop y/thereo r(Sec. 3 0, Labor Code.)
Polic No. Company + Al
Copy is filed with the city. p Certified.copy is hereby furnished.
.N
CERTIFICATE OF EXEMPTION FROM 1
__ _ WORKERS' COMPENSATION INSURANCE p
(This section need not bevcompleted if the permit is for one hun;died dollart ($100) valuation
or less.) "*y / I I/ � s
I certify that in the performance of thg work f9r which thisfpermit isAssued, I shall not
employ, ny,person in any manner so as to beco a subject'toT _ Workers' Compensation
Lawsy C f ornla.A jjf �t
Date+ . �% i t �+�''"-' ,. . r J .xa! 1' '
�f Owner
NOTICE TO APPLICANT: If, after making'this Certificate,tof Exemption you should become
subject to the Workers�,Compensation provisions bins; Labor Code, you must forthwith
comply with such provisions orthis.peof, 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 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.
Signature of applicant -Date-
Mailing
ateMailing Address
City, State, Zip
>timatea valuation $8,425.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
• 4114
Const.6
_ • 0
Mech.
24. ty
Electrical
` 3 v
Plumbing
L
S.M.I.
Grading
Driveway Enc.
Infrastructure
.
TOTAL -
° • 20
REMARKS
ZONE: BY:
Minimum Setback Distances: r.
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Prop. ert. Line I I,
FINAL DATE INS/P/// CCTTOOF
JU
Issued by: Date � ` , Pei
Validated by:
Validation: -r
r
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. S0. 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
GROUT
DRAINAGE PIPING
CAR P. SO. FT. ®
FINAL INSP.
I
WALL SQ. FT.
WATER SYSTEM
DRINKING FOUNTAIN.
GRADING
-cu. yd.
$ plus x$
-$
URINAL
SO. 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
LAUNDRYTRAY
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 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, - cL
UNDERGROUND 2,T.-Vq1f�p
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._2 u -J No
ROOFING
� .•
REMARKS:
VENTILATION✓4
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH.
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESANITIALS
GARDEN WALL FINAL