06797 (RPL)} P.O. BOX 1504 N o .
Building 78-105 CALLE ESTADO
Address 45-135 Southiarn RUIs 'Road w";LA,QUINTA„ CALIFORNIA.92253�
Mailing
Address $aMg
City Zip Te!
La.-Quinta 92253.
Contractor_
kassett Construction
City - Zi
palm Desert
State Lic.
& Classif. 514$01
06797
u
BUILDING: TYPE CONST. OCC: GRP. •
A.P. Number- PGA''W"t
LegaLQli cription
.o is 'Spa
Project Description
;a Rrai
eTl.: ..._._.. _,,.
92260 327--9.231.
^ y
City
Lic. # Sq. Ft.
Size • ..
Arch., Engr.;
' Designer New ❑
Address' Tel.
City Zip State
Lic. #
t LICENSED CONTRACTOR'S DECLARATION
> I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
70011) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.
SIGNATURE- DATE
OWNER. UILDER DECLARATION" "
No.
Stories
Add ❑ Alter ❑
y ;
No. Dw.
`Units
Repair ❑ ; Demolition,❑ .
t.
rti - • '
•yI i
' '•"
• I : (Sec`.`703 that I am exempt from the.Contractofs License Law for the following
reason: (Sec. ;'7031:5,Bus6ness and Professions. Code:.Any city or county which requires a
Permit to construct, after,• 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) o/
'Drvlslon 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basisr
for the, alleged. exemption. Any violation of Section 7031.5 by 'any applicant for a permit
" subjects the applicant to a'civil penalty o/ not more than rive hundred dollars .(8500).
❑ 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
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 o/ completion, the owner -builder will have the burden
of proving that he did not build or improve for the purpose o/ safe.) , i ..
EStlmatea Valuation
$27.000 •
-
- PERMIT `AMOUNT
..
Plan•Chk. Dep. $172:251.
Plan Chk. Bal.
Const. 265.00Professions'
-
.to�
Mech. - - �y,
y
r n
Electrical �7r.V�'.
Plumbing " 24.00
• 0.1, 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,contractor(s) 8censed pursuant to the Contractor's License Law.) -
'
1. ❑ I am exempt under SecB.'& P.C. for this reason
S.M.I.. - *., 1.89
_
Grading
Driveway Enc. ,
Date' owner
Infrastructure
•
> ,
- WORKERS' COMPENSATION DECLARATION
I hereby affirm that l have a certificate of consent -to self -insure, or a certificate of
Workers Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
..
• Policy No. . - Company •
'rte• - . ❑ Copy is filed with the city.. O Certified copy is hereby furnished.
r
_
TOTAL
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
!s section `need not be c
(Thcompleted f/ the permit is for one hundred dollars (3100) valuation • -
' or less.) :. - - _
I certify that in the perforrnance 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
REMARKS ^'
✓i
,.x�4i•s ,+`9.- 4'. 1 .
r . ....r., ._ .. ,... ,...
;.
Date___L• . Owner.
. NOTICE TO APPLICANT: f/, alter making this Certirrcate of Exemption - you should become .
subject to the ' Workers' Compensation provisions of the Labor' Code, you must forthwith
'• comply with such provisions or this permit shall be deemed revoked.- J_- -
•• ZONE: ' •' BY: r'f
-
Minimum Setback. Distances: -
`Front
Setback from Center Line '
Rear Setback from Rear Prop: Line,
` CONSTRUCTION LENDINGAGENCY ,
Ihereby affirm that there is a construction lending agency for the performance of the
work for'which this permit is issued. (Sec. 3097, CIO Code.).'
Lender's Name
Side Street Setback from Center Lirle
Side Setl)aCl(.frOm Property Line '
Lenders Address
FINAL DATE INSPECTOR
1 I(3,>t4�
' Issued by: 'Date' ` 7 Perm -
t _
r ••
Validated by:
'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 certity that I have read this application and state fttothe above •information is correct.
" I agree to comply with all -city and county ordinances and state laws relating •lo building
construction, and hereby authorize representatives -Of this 'city to enter the above-: '•
mentioned property for inspection purposes..
-Signature of applicant Date'
Y
._ Mailing Address
Validation: ►'
City,. State, Zip
CONSTRUCTION ESTIMATE
too. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. Sp. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. SQ. FT_
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING.
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
GAS (ROUGH)
METER LOOP
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CARP. SQ. FT. ®
GROUT
WATER HEATER
WALL SQ. FT.
FINAL INSP.
DRINKING FOUNTAIN.
BOND BEAM
WATER SYSTEM
URINAL
SOFT ®
LUMBER GR.
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
IWATERSOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
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.
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
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEEPLUMB. 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 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.
ROOFING
- G
V
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION -
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL