08747 (BLCK)7t/
P.O. BOX 1504 No. 0$747
Building 78-105 CALLE ESTADO
Address.,,� LA QUINTA, CALIFORNIA 92253
Owner a
Mailing Jb BUILDING: TYPE CONST. OCC: GRP.
Address
A.P. Number
City Ub Z405uve Tel.
Legal Description
Contraetor u tU 5,62T3 .5ou-7013 Project Description
136 X s is '
Addregs3 horn $ Fools & spas ct1G uuftud spa
A2 Yto ,..A.... Y t,. R .% _
City aar ..ry ,,v Zipw�r�w Tel.47' 'm: '425 Mgui retal"Mi.ng Wall
State f-f'iCAuurc 111440V City .Y 0-9101 v
& Classif. Lic. # Sq. Ft. No. No. Dw.
Arch., Engr., ibbIUZ Cbi Size Stories Units
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
City Zip State
Lic. #
R % LICENSEb CONTRACTOR'S DECLARATION
I hereby affirmethat I am licensed under p ovisions of Chapter 9 (commencing yvith Section
7000) of Division 3 oftheBusiq ss ana Prroofessions'Code, and my license is in{{fbll force and
effect. f�,e ! �..
SIGNATURE Y If P A ,*' t! !. .f -t 14,4 1.`i ►f DATE
OWNER -BUILDER DECLARATION I )
I hereby affirm that I am exempt from the Contractor's License Law for the following Estimated Valuation
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a 1!" AA
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 PERMIT AMOUNT
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) or
Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for the alleged exemption. Any violation or Section 7031.5 by any applicant for a permit Plan Chk.`Dep.
subjects the applicant to a civil penalty of not more than five hundred dollars ($500). '
❑ I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. _
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and 1 L s 4.7
Professions Code: The Contractor's License Law does not apply to an owner of property who Const. y
builds or improves thereon and who does such work himself or through his own employees, Mech. s { 0
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 Electrical 4. V
of proving that he did not build or improve for the purpose or sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing • to
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. Y w
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
❑ 1 am exempt under Sec. B. & P.C. for this reason
Driveway Enc.
Date owner Infrastructure
WORKERS' COMPENSATION DECLARATION
1 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.
TOTAL
CERTIFICATE OF EXEMPTION FROM REMARKS ' f
WORKERS' COMPENSATION INSURANCE y
(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 thg 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.
Date Owner
NOTICE TO APPLICANT: If, 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
Ihereby 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
Lender's Address FINAL DATE INSPECTOR
This is a building permit when properly filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct. Issued by: Date Permit
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives sof this city to enter the above-
mentioned property for inspection purposes. Validated by:
Signature of applicant Date
Mailing Address Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES,
,1ST FL. SO. FT. ® $
UNITS
COLL. AREA
2ND FL. SQ. FT.
YARD SPKLR SYSTEM
(iya
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
SEWER OR SEPTIC TANK ROUGH WIRING.
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
FOUND. REINF.
DRAINAGE PIPING
CAR P. SQ. FT.
HEATING (FINAL)
OTHER APPJEQUIP.
WALL SO. FT.
DRINKING FOUNTAIN.
SQ FT ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
FINAL INSP.
FINAL INSP. �� �l Q(
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
ROOFING
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.
SO. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1Vi c
SEWAGE DISPOSAL
LATHING
SQ.FT.GAR ® Vic
HOUSE SEWER
MESH
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
NECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK1A hd
GROUND PLUMBING �(;IL+ UNDERGROUND
! Q
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB. BONDING y0
(iya
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH) HIM, f/ / METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL) TEMP. POLE
/
`.,
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM L&6 LL �Q
WATER SYSTEM
FINAL INSP.
FINAL INSP. �� �l Q(
It
Zr I
GRADING
J10 cu. yd.
$ -Plus-X$-=$
LUMBER GR.
FRAMING
ROOFING
��✓O~ L� ��/ � !d ��
G
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
^.
FINAL INSPECTION 2 w/
l
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL