9742 (RPL)P.O. BOX 1504
Building 78-105 CALLE ESTADO -
Address 44-060 Dalea LA QUINTA, CALIFORNIA 92253
Vwner
Neatherton
Mailing
Address same
City Zip Tel.
La Quinta 92253
Contractor
American Poral Construction
Address
68575 San Felipe Act
City lZip I Tel.:
State Lic. City
& Classif. C 53 510742 Lic. # 7104
Arch., Engr.,/
Designer j
!r
Address '! �' ' Tel.
Citv.r," lzib n ! f State_..
r -1-1,
I hereby affirm that I
1. .70(10) of Division 3 of I
effect;,
(commencing with Section
license is in full force and -
No. '9742
LDING: TYPE CONST. OCC: GRP..
P. Number
Description
rt Description POOL AND SPA
Sq. Ft. No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ -Demolition ❑
I hereby affirm that I am exempt from the Contractor's License Law for We following
CERTIFICATE
, Estimated Valuation
1.5 4Q�
reason: (Sec. 7031.5,Business and Professions Code: Ahy city or county which requires a
permit to construct, after, improve, demolish, or repair any structure, prior -to its' issuance also
r
requires the applicant for such permit to file a signed statemen`P at 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 Any Section 7031.5 by 'any for
Plan Chk. Dep.
alleged exemption. violation of applicant a permit
subjects the applicant to a civil penalty of not more than five hundred dollars (5500).
Plan Chk. Bal.
j 11 5
O 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
Const.
1'] 1 00
Professions Code: The Contractor's License Law does not apply to an owner of property who
-
s
builds or improves thereon and who does such work himself or through his own employees,
Mech. • • • •
�g Q t�
L
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 burden
"
Electrical
•
rj tiff
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 -
�' 4
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.1.��
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
O I am exempt under Sec. B. & P.C. for this reason
Driveway Enc.
Date Owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
1 herebyaffirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy. thereof (ec -`3800, Labor Code.)
Policy No. Company O'L.cY.k,.r:.' L'1$Y{
g. f? s 1
Copy is filed with the city. O Certified copy is hereby furnished.
t••ftc 4� f 6�fi v7 t ,
TOTAL
379.75-
79.75-
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed If the permit Is for one hundred dollars (5100) 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 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 permil shall be deemed revoked.
CONSTRUCTION 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
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.
Signature of applicant Date
Mailing Address
City, State, Zip
REMARKS t
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. ® $
UNITS
COLL. AREA
2ND FL SQ. FT.
V
YARD SPKLR SYSTEM
POR. SO. Fr. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. Q. FT.
DUCT WORK
DRAINAGE PIPING
WALL SQ. FT.
DRINKING FOUNTAIN.
SO FT ®
HEATING (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
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
GRADING
cu. yd.
$ plus x$
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FRAMING
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.
SO. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1 Va c
SEWAGE DISPOSAL
SPARK ARRESTOR
SO.FT.GAR ® 3V<c
HOUSE SEWER
GAR. FIREWALL
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PLCK.FEE
CONST. FEE ELECT. FEE
SMI FEE j PLUMB. FEE
STRUCTURE / PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING/ .t?/4(
UNDERGROUNtiJ�1Q 7( J'
A.C. UNIT
COLL. AREA
SLAB GRADE
V
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
InIrl
SEWER OR SEPTIC TANK
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)kl'2--7 ((p
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP. 13 Ca. (
1
FINAL INSP. l
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FRAMING
ROOFING
N /1
PlIe9(/+t 1 /� (�%lei 1 �'%
� ✓� C�
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTIOtT?(�
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL