001584 (RPL)ce w
Pik/:'
P.O. BOX 1504 -No. .001584
Building 78-105 CALLE ESTADO
Address AA—711 T.4=4_-* 1,chvnr min y4,1L� QUINTA, CALIFORNIA 92253
Owner ,.... _ .
BUILDING: TYPE -CONST. OCC: GRP.
Mailing
Address rani., A.P. Number
City Zip V Tel. -
96813
11 '800 367_5054 Legal Description
Contractor Project Description -30 x 17 Poo1.
CoUbmia Pools and spelil
.....Address .. . _..
67.412 MMM Pload
City.... _.. Zlp.. Tela..
Com' l city 9223 323-i3€ 3
State Lic. City
&, Classif: 195182 Lic. # Sq. Ft: No. No. Dw.
-..
`Size Stories- - Units
Arch.; Engr., .
.:Designer New M Add ❑ Alter ❑. Repair ❑ Demolition ❑
Address Tel.
City Zip State
Lic: # -
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm.lhat I am licensi d'under provisions of Chapter 9 (commencing with Section R
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect. -—J-1, .3".`-,X
SIGNATURE DATE -
OWNER -BUILDER DECLARATION Estimated Valuation
I hereby affirm that I am exempt from the Contractor's' License Law for the following' .
reason. (Sec, 7031. S, Business and Professions : Code: Any, city or county which- requires. a. ''15.00.00
permit •to construct, alter, improve, demolish, or iepair any' structure, prior'lo 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) of. - • ++-
. Division 3 or the Business and 'Piolessions 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: .
subjects the applicant to a civil penalty of not more than five hundred dollars ($500):- ' , , - r ' --
❑ I, as• owner of the property, or my employees with wages as their sole compensation, will . Plan Chk. Bal. 71•82
'
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const.
Professions Code; The Contractor's License Law does not apply to. an owner of property who _ w
50
builds or improves, thereon and who does such work - himself or, through. his own employees, Mech. .
provided that such improvements are not Intended or•offered for sale. If, however, the building l w.:iu
- &or improvement is sold'within one year of completion, the. owner -builder will have the burden Electrical- '-wti<t3
of proving that he did not build -or improve for the purpose of sale.) 12
-O 1, as owner of the property, am exclusively contracting with licensed contractors.to con- - .Plumbing " �� e�
. struct the. project. (Sec. 7044, Business and Professions Code: The Contractor's License: Law x
does not apply to an owner of property who builds orimproves thereon, and who contracts for •' S.M.I.• .1.02
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
'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. , ❑ Certified copy is hereby furnished..
TOTAL 226.94
CERTIFICATE OF EXEMPTION FROM REMARKS
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 is issued, I'shall not
employ any person in any manner so as to become subject'to the Workers" Compensation
Laws of California. '
Date ' Ownei
NOTICE TO APPLICANT: If, after making this Certificate of Exemptionryou 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 fs a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civi(Code.) ' Side Setback from Property Line
Lender's Name
Lender's Address
This, is"a building permit when properly filled out, signed arid validated; and is subject to ' ,FINAL.DATE INSPECTOR
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. ISSued,by: Datefi" 25"95 Permit
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 properly for inspection purposes: Validated by:
Signature of applicant` Date
Mailing Address ` ` r `' Validation:
City, State, Zip
A17.1..,9... .6 _L5 1'11584 CK
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SO, FT. ®
CARP. SQ. FT.
WALL SO. 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.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP./EQUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
S0. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
REMARKS:
VENTILATION
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./EQUIP.
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
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL