10871 (RPL)uu'�ttcv
P.O. BOX 1504 N o . 10871
Building 76-825 La Palma Drive 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner
Bart Taff?y
Mailing
BUILDING: TYPE CONST. OCC: GRP.
same- -
Address
A.P. Number
City Zip Tel.
La Quin :a 92253 1714/ Legal Description
Contractor
14astex Pools Spas Project Description
.. _-.
POOL AND SPA
''Andress
73547 Hwy 111
CityZip. Tel.: 1160—t3Al 3
.
P# D. 92250 346M 615
State Lic. City
& Classif. C53 738947 Lic. # 16 Sq. Ft. No. No. Dw.
Arch., Engr., Size Stories Units
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolitiori ❑
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
Ltiereby affiPOatil am licensed under piovislons of Chapter 9 (comniencing with Section
7 ) of Diwsion•3/,�of�the Gsiness•and'Professibns Code; aridmyTic/ense is in full force and
jef eci ' � � 77..Iz-
S NATU / DATE
OWNER -BUILDER DECLARATION Estimated Valuation
1 hereby affirm that I am exempt from the Contractors License Law for the following. , 14 3S0
reason: (Sec. 7031.5,8usiness and Professions. Code: Any city or, county which requires a - t
permit to construct, alter, improve, demolish, or repair any structure, prior to • its issuance also ,
requires the applicant for such permit to We 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
Divislon 3 of the Business and Professions 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 rive hundred dollars.($500). -
0
,1, as owner of the property, or my employees with wages as .their. sole compensation, will Plan Chk. Bal. 105.30
do the work, and the structure isnot intended or offered for sale. (Sec. 7044, Buisness and Const. 162. 00
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,Mech. 24. 00 .
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 burdenElectrical 45.00
of proving that he did not build or improve for the purpose of sale.)
❑ I, as owner of the property, am exclusively contracting, with licensed contractors to con- Plumbing Is 77.00
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 S.M.I. r/. a :' 1.50
- such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) -
❑ I am exemptunder Sec.Grading
p. & 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, ora certified copy thereof.'(Sec:3800, Labor Code.) - �',ricr..6Ci^ 4^, Cf" tji 31�t.�."!?�.y.i ,
Poligy, No. company a t - x 1
O Copy is filed with the city. ❑ Certified copy is hereby furnished. u ` f � 6 ,
TOTAL 364 €30
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed ff 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 O
w
NOTICE TO APPLICANT: n, after making this Certificate of Exemption you should become
ZONE:
BY:
subject to the Workers' Compensation provisions of the labor Code, you must forthwith
complywithsuchprovsionsorthispermitshaftbedeemedrevoked.
-
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
Lenders Name
Lender's Address
FINAL DATE
INSPECTOR
This* is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
J. .
I certify that I have read this application and state that the above information is correct.
-agree
Issued by:
Date Permit
I 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 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. SQ. FT. ® As
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SQ, FT, ® r
CAR P. 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
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYERGARBAGE
r
DUCT WORK
DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDbD
LAUNDRYTRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
IKITCHEN 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
BOND BEAM
SO. FT. ® c
WATER HEATER
MAX. HEATER,O&PUT, B.T.U.
SQ. FT. RESID ® 1% cSEWAGE
DISPOSAL
LUMBER GR.
SQ.FT.GAR ® 3/4cAFEE
HOUSE SEWER
FRAMING
FINAL INSP.
GAS PIPING
PERMIT FEE '• ^ _"'�
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEF MECH.FEE
PLCK.FEE
CONST. 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 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
��/✓ r
Zai
l
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNITURESintfIRALS
GARDEN WALL FINAL