13030 (RPL)P.O. BOX 1504 No. 13030
Building 78-105 CALLE ESTADO
Address 79-100 Ladera LA QUINTA, CALIFORNIA 92253
Owner
Kim Job
BUILDING: TYPE CONST. OCC: GRP.
Mailing
Address Sane
A.P. Number
City. •
Zip
Tel.
La, Quinta, CA,
32253
Legal Description
Project Description
P6ol and Spa 4
Contractor
Sutiriae Pools
;Address
P.O. Box 12573
CityZip
Tela
Paha desert, CK
32264
340-5521
State,Lic.
City
&,Classif. C-53 556236
Lic. #
Sq. Ft.
No. No. Dw.
Size
Stories Units
Arch:,,-Engr.,
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Designer
Address .
Tel.
City
Zip
State
•
Lic. #
' [LICENSED CONTRACTOR'S DECLARATION
I hereby affign that Ilam licensed under provisions of Chapter 9 (commencing with Section
,.00) of Divviision 3 of a Business and Professions Code, and my license is i full force and a
_ tett. ' r. E1 i '•d r� ia �
�99
'
YSIGNATURE° DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
. permit to construct, alter, 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) of
Division 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
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
❑.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,
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 burden
of proving that he did not build or Improve for the purpose of sale.)
Estimated Valuation
$13,600.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
• 45
Const.
1 3 • 00Professions
M2ch.,
T4 • 010provided
Electrical
45.00 -
Plumbing
21.00
• O I, 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) licensed pursuant to the Contractor's License Law.)
❑ I am exempt under Sec. B. & P.C. for this reason t
.S.M.I.
• 40
„ Grading
Driveway Enc.
Date owner r
Infrastructure
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have, a certificate of consent to self -insure, or a certificate of
Worker's Compensatio Insurance, or a certified copy theeo_f. (Sec. 3800, Labor Code.)
Policy No. �. 'it -'113 - Company
❑ Copy is filed with the city. .gKertifled copy is hereby furnished.
TOTAL.
ti:Y
'
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
REMARKS
,,„-„.,,,•,; ,,,,,� , ,,. ,;��,,.,,,.,,• ,_.;,,•,r,,.,,,, , �,
"'x+17aStJ
(This section need not be completed If the permit is for one hundred dollars ($100) valuation _
orle
I c
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.
' .�;�i77'.S-t`Yt.'” S' z ve PL- 9t.kr 7,
_
Date Owner
NOTICE TO APPLICANT: It, 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.
ZONE: BY:
Minimum Setback Distances: •••
Front Setback from Center Line
coNsrRucTloN 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.)
Lender's Name
-
FINAL DATE
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
11
Side Setback from Property Line
INSPECTOR
Lender's Address
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.
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 -of this city to enter the above-.
mentioned property for inspection purposes.
Issued by:
Validated by:
Date Permit
Signature of applicant Date -
Mailing Address
Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES '
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
C 0 �y w
BONDING
HEATING (ROUGH)
2ND FL. SO. FT. ®
FORMS
YARD SPKLR SYSTEM
POR. S0. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®.
I POWER OUTLET
ROOF DRAINS
CARP. SO. FT.
OTHER APPJEOUIP.
DRAINAGE PIPING
WALL SO. FT.
TEMP. POLE
DRINKING FOUNTAIN.
SO FT ®
GROUT
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
WATER SYSTEM
FLOOR DRAIN
MECHANICAL FEES -
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
(, A141
LAUNDRYTRAY
AIR HANDLING UNIT CFM
VENTILATION
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
GAR. FIREWALL -
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1+/a c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE LPL.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 APPJEOUIP.
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
�' �
(, A141
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
416
All�
SPARK ARRESTOR
GAR. FIREWALL -
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESJINITIALS
GARDEN WALL FINAL