14757 (RPL)44Q
P.O. BOX 1504 t N o . 14757 � }
Building 78-495 CALLE TAMPICO -
Address 47-490 ilia Montana LA OUINTA, CALIFORNIA 92253
Owner I$€iI3: e's Construct; ori*' j
Mailing BUILDING-- TYPE CONST. OCC: GRP.
Address .154 E. Dessert Fano Dr.
A.P. Number
•City Zip Tel. -
La Qu.i$ta. CA 9225 _1440_: Legal Description
ContractorPool and Spa "
Califo mile -Pools & ' Spas Project Description
Address Lake La [31;12' to -
. X31-91€3 Boardwalk, Ste A2
Clt lm Desserts ' 92260 Tel. 340-9000'
State Lic. City
& Classif.. C-5:3 185102 Lic. # 355 Sq. Ft. No. No. Dw.
Size Stories 'Units
Arch., Engr.; ti, ?errell
Designer New O Add 0 Alter 0 Repair O Demolition 0
Ab Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm:that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the:Business and Professions Code, and my license is in full force
effect.' a.^ rr`_ r
SIGNATURE t'r DATE) - -
OWNER -BUILDER DECLARATION Estimated Valuation fig /
I hereby affirm that 1 am exempt from the Contractors License Law for the following ; 0t�ti000h, til : 0AEaii
reason: (sec..7031.5,Business and Professions Code: Any city: or county _which requiress-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 .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 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).
❑ I,as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. 70.20
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. 108 t}{%
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,�f A f1 0A
provided that such improvements are not Intended or offered for sale. If, however, the building Mech. -' 24.0
or Improvement is sold within one year of,completion, the owner -builder will have the burden Electrical' ' - 45.00of proving that he did not build or improve for the purpose of sale.) -
❑ 1, 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 S.M.I.
'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
D Copy is -filed with the city, ❑ Certified copy is hereby furnished.'
I TOTAL 274.20 r
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS'COMPENSATIONINSURANCE
(This section need not be completed If the permit is for one hundred dollars ($100) valuation
of 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 Owner
NOTICE TO APPLICANT: If,. after' making this Certificate of Exemption you 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
WARNING: FAILURE TO SECURE WORKERS'COMPENSATIONCOVERAGE ISUNLAWFUL. AND
-
Side Stfeet Set?f1O Ljne `
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE '
HUNDRED THOUSAND DOLLARS ($100,000), IN -ADDITION TO THE COST OF COMPENSATION,
Side Setback fr' neDAMAGES
AS PROVIDED FOR IN SECTION.3706 OF THE LABOR CODE; INTEREST, AND
pTTORNErs FEE$.
FINAL DATE
�Thisis
a building permit when properly filled out, signed and validated, and is subject to
it work thereunder is suspended for 180 days.I
/expiration
certify that I have read this applicationand state that theabove information is correct.Issued
by: '
Date�fmlt
agree to comply with all city and county ordinances and state laws relating to buildingt
O
construction, and hereby authorize representatives -of this city to enter the above-.
f
mentioned property for inspection purposesVfllldated
by:
I
Signature of applicant Date -
J�
7T 9^ i
Mailing. Address
Validation:
{ .j
city, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
.i
NO. PLUMBINU FEES
1ST FL. SO. FT. ® $
UNITS
COLL. AREA
2ND FL. SO. FT.
ROUGH PLUMB.
YARD SPKLR SYSTEM
_ ®
HEATING (ROUGH)
STORAGE TANK
POR. ` SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. ` SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. V.SQ. FT.
GAS (ROUGH)
DRAINAGE PIPING
WALL SQ. FT.
HEATING (FINAL)
DRINKING FOUNTAIN.
SO. FT. ®
GAS (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
WATER HEATER
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GRADING
cu. yd.
$ - plus - x$
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
tv
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERI IT 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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1% c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
GAR. FIREWALL
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 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.
�8�� �/
ROOFING
�% ///J,AA//
REMARKS:
VENTILATION
FIRE ZONE ROOFING '
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH ,.
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
-