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15617 (RPL)P.O. BOX 1504 Building 78-495 CALLE TAMPICO Address 45-425 € exert Air LA QUINTA, CALIFORNIA 92253 owner _ " Brenda Hull Moling ' - Address -same as above City Zip Tel. La Quinta 92253 Contractor :iodaon P®o1$ City Zip Tel.: Cathedral Citi 92234 324-1232 State Lic. City & Classif. 574127 Lic. # 1044 Arch., Engr., Designer Address Tel. City (Zip (State Lic. # LICENSED CONTRACTORS DECLARATION I hereby affirm that I am licensed under provisionsNgf Chapteuq (com nciKgiwith Section 7,000) of Division 3;of the Business and Professions'^Code, and'mv licenae is mifull force and J�'SIG NATURE UAII 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, atter, 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 Professlons 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, 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 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-struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law I does not apply to an • owner of property who builds or improves thereon, and who contracts for such projects with -a contractors) (Icensed pursuant to the Contractor's License Law.) 0 1 am exempt under Sec. B. & P.C. for this reason Dale Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Com nsation Insurance, ora certified copy thereof. (Sec. 3800, Labor Code.). Policy No Company �Ifsopy is filed with.the city.. ❑ Certified copy is hereby furnished. +� CERTIFICATE OF EXEMPTION FROM ' WORKERS' COMPENSATION INSURANCE (This section need 'not be completed N 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 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. WARNING: FAILURE -TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND 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, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABORCODE, INTEREST, AND ATTORNEY'S FEES. This is a building permit when property filled out, signed and validated,'and is subject to expiration it work thereunder is Suspended for 180 days. 1 certify that I have read this application and state that the above information is correct. 1 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 No. 15&1' BUILDING: TYPE CONST. OCC. GRP.: Number Legal Description Project Description Pool and Spa Sq. Ft. No. No. Dw. Size . Stories Units Newx Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $12; 400. 00 PERMIT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical AMOUNT S.M.I. Grading Driveway Enc. Infrastructure TOTAL 3.13 60 REMARKS f d /7 � 1 ! T ,� Lyi yI lye t� i T11 V X 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. PLUMBIW FEES IST FL. SO. FT. ® $ UNITS SETBACK SLAB GRADE GROUND PLUMBVG .' ROUGH PLUM YARD SPKLR SYSTEM 2ND FL. SO. FT. @ COLL. AREA STORAGE TANK FORMS MOBILEHOME SVC. BAR SINK POR. SO. FT. ® ROCK STORAGE ' FOUND. REINF. GAR. SO. FT. ® POWER OUTLET ROOF DRAINS HEATING (FINAL) OTHER APPJEOUIP. DRAINAGE PIPING CAR P. SO. FT. @ GAS (FINAL) TEMP. POLE WALL SD. FT. ® DRINKING FOUNTAIN SO. FT. ® WATER HEATER URINAL ESTIMATED CONSTRUCTION VALUATION $ 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 LAUNDRY TRAY AIR HANDLING UNIT CFM 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 SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1 Va C SEWAGE DISPOSAL SO.FT.GAR ® 3/ac HOUSE SEWER MESH 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 A e.4 SETBACK SLAB GRADE GROUND PLUMBVG .' ROUGH PLUM UNDERGROUND 'BONDING A.C. UNIT !. -HEATING (ROUGH) COLL. AREA STORAGE TANK FORMS SEWER OR SE I TA K 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 FINAL INSP. ;GRADING cu. yd. $ plus x$ -$ LUMBER GR. FRAMING FINAL INSP ROOFING lx^ter [t V �� 1V� REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIONATURES/INITIALS GARDEN WALL FINAL 0 0 OL E 8 ACCESS? I)ECK WIDE q1� ACCESS gm LITE 111114) %,v e, T -T S -:APE p C—P I r TR' LEVEL SU%TS iILE SIZE C -,A INAL- WiC-TH SE KAM NO SP LL Sgt-' CA-NTll.F-VF-R' 9 ; 3 6" rl-'ALS !A , MP -r.'-�' 90 11 141 --p r d/ SQ :T NVELITE PLASVIE R {--!LTEP. RAT[ 100 41 -,PNI REMOVE AND I RM -RN LINES. REPLACE --DECK 3' WIDE WALL A: A 'lk AREA P I AN TE DF -0) DR ,L- S F LIGHT S 6V I TC IIFS .j BOINXS-17 POOL' 4DO EQUIPNHENT q1� ACCESS gm k ,1' -:ATE:; LAARS S,ZE2Z(J.QfJ0E7- -:SASLINE --Y SOC. 2S: PC -CL L'GHT 400 WATT SPA UG.HT 100 WATT C.CCK 24.3140 U R L- ELECTRIC 13Y 1) C ELECTRICAL, &JKDNG E-: SDC CECKINI, rY'44)0 SF NATURkL SALT nNIUSIBI CO.,M.ACT OR cannot assume resporsibil vy cirbs, sidew-aIks, driveways, t;=irilg i a Is, sprir Hers, to e one i -.es NT- ar shrruns. When acc is made 5• eiqyb0r,3 -rf)DerN it is �1 -1 "ri AM -1-1 ti�a-� You NFowner, tv Y-2 that -le'qhbte - ermission - and aisur-K-- fij I ro4 AC C`E ED SUBJECT TO iNNS i L; BRENDA H 45425 DESE'T AIR Q"L CA AND ALL APPLICA L GWES TOPAZ TE BY' SHOW RCH-II CUB CR. *F-4. R 4, - M D ES T. I k °_7'6C " N:: 4 C- ? LITE 111114) %,v e, T -T S -:APE p C—P I r TR' LEVEL SU%TS iILE SIZE C -,A INAL- WiC-TH SE KAM NO SP LL Sgt-' CA-NTll.F-VF-R' Pc.:)L �APACTY 10890 rl-'ALS !A , MP -r.'-�' 90 Z? %k HP MAXI H 1.-: --p :-.-LTFF-. SYSTEM 3 -W SQ :T NVELITE PLASVIE R {--!LTEP. RAT[ 100 41 -,PNI REMOVE AND I RM -RN LINES. REPLACE WALL IMACCESS SQ MPDRAIN E; M03EL DUA L. POR k ,1' -:ATE:; LAARS S,ZE2Z(J.QfJ0E7- -:SASLINE --Y SOC. 2S: PC -CL L'GHT 400 WATT SPA UG.HT 100 WATT C.CCK 24.3140 U R L- ELECTRIC 13Y 1) C ELECTRICAL, &JKDNG E-: SDC CECKINI, rY'44)0 SF NATURkL SALT nNIUSIBI CO.,M.ACT OR cannot assume resporsibil vy cirbs, sidew-aIks, driveways, t;=irilg i a Is, sprir Hers, to e one i -.es NT- ar shrruns. When acc is made 5• eiqyb0r,3 -rf)DerN it is �1 -1 "ri AM -1-1 ti�a-� You NFowner, tv Y-2 that -le'qhbte - ermission - and aisur-K-- fij I ro4 AC C`E ED SUBJECT TO iNNS i L; BRENDA H 45425 DESE'T AIR Q"L CA AND ALL APPLICA L GWES TOPAZ TE BY' SHOW RCH-II CUB CR. *F-4. R 4, - M D ES T. I k °_7'6C " N:: 4 C- ?