Loading...
15292 (RPL)4 P.O. BOX 1504 No. 15292 78-495 CALLE TAMPICO Address y 78,-395 Via Caliente LA QUINTA, CALIFORNIA 92253 Owner Mary Kay Gough BUILDING: TYPE CONST. OCC. GRP. Mailing Address Sate A.P. Number ZONE: i City Zip Tel.' La �, rota, CAI 92253 36t3-799? Legal Description Project Description t and Spa ContractorP©ol owner/Builder Address City Zip Tel.: Issued by: �// Date jPermit /1 State Lic. City Validated by: �-\ & Classif. Lic. # Sq. Ft. No. No. Dw. Size Stories Units Arch., Engr., Designer LewinBishop New ❑ Add ❑ Alter ❑ Repair ❑ Demolition. ❑ Address r Tel. 75 .45 St. Charles 340-0604 City Palm -Desert, Zip a 92211 State Lic. # LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm that I am licensed under 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. SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Business and Professions .Cale: Any city or county which requires a permit to construct, atter, Improve, demoltsh, or repair any structure, prior to its issuance also requires the applicant for such permit to rile 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 Ove 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 /or 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.) s owner of the property, am exclusively contracting with licensed contractors to con- . trust 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) Pcensed pursuant to the Contractor's License Law.) O 1 am exempt under Sec. B. & P.C. for this reason ? Estimated Valuation y� $17,000.00 VV PERMIT AMOUNT Plan Chk. Dep. Plan Chk. BBI. 7 .!t .y 1 0u Const. tots 180.00 Mech. _ �(3Q Electrical 45.00 Plumbing 27.00 S,M.I,' Grading Driveway Enc. Sale —f - (f Owner 1 L` ��- �'- �, Infrastructure . r. 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 ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. TOTAL 393.00 CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed If the permit is for one hundred dollars ($100) valuation or less.) I certify that in the performance of the work for which this permit ieissued, I shall not employ any person . inn any manner so as to become subject to the Workers' Compensation Lataf f� Califor%.tOwne NOTICE TO APPLICANT. O, after making this Certfcate' of Exemption fyou should become ubject to the Workers' Compensation provisions {'of;the Labor Cod_e,J you must forthwith comply with such provisions or this Permit shall be deemed revoked. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF.COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. This is a building permit when properly filled out, signed and validated, and is subject to expiration it work thereunder is suspended for 160 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 Address City, State, Zip REMARKS Validation: X ZONE: i BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from R�� Pop. Line Side Street Setback/from Center Line Side Setback fro RropertyaL e' FINAL DATE- INSPEC OR Issued by: �// Date jPermit /1 9S /// Validated by: �-\ Validation: X CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBINU FEES IST FL. SO. FT. ® $ UNITS COLL. AREA SLAB GRADE ROUGH PLUMB. YARD SPKLR SYSTEM 2ND FL. SO. FT. HEATING (ROUGH) STORAGE TANK FORMS MOBILEHOME SVC. BAR SINK POR. SO. FT. DUCT WORK ROCK STORAGE GAR. SO. FT. ® POWER OUTLET ROOF DRAINS HEATING (FINAL) DRAINAGE PIPING CAR P. SO. FT. ®' GAS (FINAL) ell TEMP. POLE WALL SO. FT. ® DRINKING FOUNTAIN SO. FT. ® WATER HEATER URINAL ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP. WATER PIPING NOTE: Not to be used as property tax valuation WATER SYSTEM FLOOR DRAIN MECHANICAL FEES GRADING cu. yd. $ plus x$ WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER ROOFING 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, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. ® c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR ® 3/ac HOUSE SEWER MESH 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 n HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBIN - UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC K ROUGH WIRIN DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. 'REINF. STEEL - GAS (FINAL) ell 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 - Y VVV 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 s 7-10-95 To: The City of La Quinta Building Dept. 78-495 Calle Tampico La Quinta, CA 92253 From: Mary Kay Gough Property Owner 78-395 Via Caliente La Quinta, CA 92253 RE: Sub -Contractor List for an "Owner Builder" NAME .TRADE A@F Gradin pool dig restige -Gunite steel and gunite Rammel Pool Constructio plumbing Rammel Pool Constructio the and pool plastering Pacific Concre pool decks and, stone trim