001583 (RPL)P.O. BOX 1504 No, 001583
Building78-105 CALLE ESTADO
Address 44-060 mast Sundom'Crest Dr. LA QUINTA, CALIFORNIA 92253
Owner
Mailing
BUILDING: -TYPE CONST. OCC: GRP. '.
Address I ftal %3?4 %riri C4. Ger, 31.x. "
A.P. Number
..
City -- —
Zip _ . "
1'e'f �.
D
4366 :...=a,.36�..
Legal Description
Project Description
30 x 17 Pool
Contractor
- . Address...
6T -i12 117mm Road
City
Cathedie3l "
Zip.
9=14
Tel..
...- 32.3— lrM . « .
State Lic.
City
" & Classif. M102
Lic. #
Sq. Ft.
No. No. Dw.
Size
Stories" Units
Arch.,-Engr. ...
" Designer
Newl@ _ .Add ❑
Alter ❑ Repair ❑. Demolition ❑
Address
Tel.
City
Zip
State
LICENSED CONTRACTOR'S DECLARATION..
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 37 of the {Busirness and Professions Code, and my license is in full force and
effect.�y,.��j�l
.' ..
.. .. "
DATE
OWNER -BUILDER DECLARATION
• I hereby affirm that I am exempt from the Contractor's License Caw for the following,
. reason: (Sec. 7031.5, Business -and Professions, Any city_ or county which, requlies a
- permit to construct, alter, improve, demolish, -or repair any structure, 'prior to its issuance also
requiresthe 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: arid the'basis
for the alleged exemption. Any violation of Section 7031.5.oy 'any applicant for a permit
subjectstheapplicant to a'civil penalty of not more'than five hundred dollars ($500).l
❑ 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..(See. 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. ff, however, .the building
Estimated Valuation
'4`1 r Win' fin
PERMIT •
'�-� - •- 'AMOUNT -
Plan Chk.'. Dep..
-
Plan a
Bal.'
a
- `
71-
COr1St. '
- . • it
Mech.
i •_
'ElcCtrlCdl
'
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.)'
Plumbing
.
Man
.❑ 1, 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 contractors) licensed pursuant to the Contractor's License Law.) -
-0 1 a exempt under Seca 8. & P.C: for this -reason
.S.M.I.
Grading
Driveway Enc.
-
Date Owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
I hereby' affirm that I'have a certificate of consent toself-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
7129 AA
,- ... _. ... ..
REMARKS '
..
CERTIFICATE OF EXEMPTION FROM
WORKERS'..COMPENSATION INSURANCE
- -
-
(This section need not be completed if the permit is for one hundred dollars •($100) valuation
orless.) .. _. .. .. ..
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.
-
•. _ -
Date Owner'
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become
' subject to the Workers' 'CorAperisation provisions 6P the 'Labor' Code, :you :must fdrthwith
comply with such provisions or this permit shall be deemed'revoked:-
ZONE: BY: - -
Minimum Setback Distances:,
Front Setback from Center Line
.
Rear Setback from Rear Prop.,Lin.e
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.)
-
Side Street Setback from Center.Line
" • .
Side Setback from•,Property Line
Lender's Name
Lender's Address
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.
I' agree to comply with all city and'oounty ordinances and state laws' relating to building
construction, and hereby authorize representatives of -this city to enter the above-:
mentioned property for inspection purpposes.
Signature of applicant r�y?// �l .!/ i Date
Mailing Address, f Y `
'FINAL. DATE
Issued by:
Validated by:'
Validation:
INSPECTOR •
Date 9--W6. + Permit
City, State, Zip
A173_-
,,
6.... 2,5 22684--1
HARD COPY-,—
`
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SO. FT. ®
CARP. SQ. FT.
WALL SQ. FT. ®
SQ. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP.IEQUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
REMARKS:
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 APP.IEQUIP.
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
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