09194 (RPL)414
X 1504
it 'n 7810 .0. BOLE ESTADO NO. 09194
Bu dl g LA QUINTA, CALIFORNIA 92253 J�
Address --55-215 LAUREL VALLEY Ffij L AND
Owner
SUNRISE SPA
Mailing BUILDING: TYPE CONST. OCC: GRP.
Address b + �tlE CO R OA A.P. Number
City Zip Tel.
PALK DESERT A 92260 569-2828 Legal Description
Contractor Project Description POOL AND SPA
C A R P001. CONTRACTORS
Address
68-463 PHREZ 8D,
CityZip
Tela
CATBSDRAL Cl2 92254
323-2681
State Lic.
City
& Classif. C53 275796
Lic. # 59
Sq. Ft.
No. No. Dw.
Arch., Engr., ` -
Size
Stories Units
Designer
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
City
Zip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed of
under provisions Chapter 9 (commencing with Section
7000) of Division,$ of the Business andel awfessions Code, and my license is in full force and
effect. ^..
r / iia .
OWNER -BUILDER DECLARATION
Estimated Valuation .
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: 7031.5,Business Professions Code: Any
$20-400.00
(Sec. and city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also
y'
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 of the Business and Professions Code, or that. he Is exempt therefrom, and the basis
for the alleged Any Section 7031.5 -any
Plan Chk. Dep.
*- ,.rtY wc. ;.dl
exemption. violation of by applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
❑ I, as owner the
Plan Chk. Bal.
13 5
of 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
Const.
207.00
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,
Mech.
A/s
provided that such improvements are not intended or offered for sale. If, however, the building
V V -
or improvement is -sold within one year of completion, the owner -builder will have the burden
Electrical
o►AA
of proving that he did not build or Improve for the purpose of sale.)
45.00
4 5 • V L
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing
27.00
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
r
S.M.1.
t L tf
such projects with a contractor
licensed pursuant to the Contractor's License Law.)
is) • APV
Grading
,
O I am exempt under Sec. 8. 8 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 Com ensation Insurance, or a certified o thereof. (Sec 3800, Labor Code.)
Policy No. .Co mpany SIV i�AN3TON
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished..
TOTAL
$438.95
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 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
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
'CONSTRUCTION LENDING AGENCY
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.)
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 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.
Signature of applicant Date
Mailing Address
City, State, Zip
REMARKS
+s
d46r+V'••-. trHa+r r.dd •+ +7 •l,r rryY-. m.,e c,rr r.. �Y�
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued.by: Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SO. 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.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP.IEQUIP.
LAUNDRYTRAY
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.
SO. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
/
lJ G J
SQ.FT.GAR ® 3/ic
HOUSE SEWER
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.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
/
lJ G J
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