14471 (RPL)4
4 Q
P.O. BOX 1504 N o . 14471
471
Building 78-495 CALLE TAMPICO
Address 49 '360 Desert Fox Dr. LA QUINTA, CALIFORNIA 92253
Owner
matt Bugg
Mailin
Address Same
City
Zip
Tel.
Lo Qui,nta, CA
92253.
S,M.I. '
Contractor
Sunrise. Pools
Address
P.O. Box 12573
1 2L -•IR E)esert0 Wp 92255
T�40. 5521
State Lic. C-53 555236
City 1504
& Classif..
Lic. #
Arch.; Engr.,
Designer
Address
Tel.
City Zip State
Lic. #
}} Jr LICENSED CONTRACTOR'S DECLARATION
1 hereby afg),�,9�t I am licensed under Provisions of Chapter 9 (commencing with Section
7000) of D�wsioq�he Business and Professions Code, and my license is iinn full fore and
effect. 1C-. 0 (f . % j , 6-7' 9��
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec.. 7031.5,Busfness. and Professions Code: Any city or county which requires a
penult to construct, after, improve, demolish, or repair any structure, prior to .its issuance also.
requires the applicant for such permit to rile 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 or 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 ($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will -
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Professions Code: The Contractor's License Law does not apply to an owner of property who
builds or improves thereon and who does such work himself. or through his. own employees,
provided, that such improvements are not Intended or offered for safe.../f, however, the building ..
BUILDING: TYPE CONST. OCC. GRP.
A.P. Number
Legal Description
Project Description Pool, and Spa
Sq. Ft. No. No. Dw.
Size Stories • Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation 12 000 0.0
i
PERMIT AMOUNT
.Plan Chk. Dep.
Plan Chk. Bal. 07.75
Const. 135. 00
Mech: 2$.00
orimprovement is sold within one year of completion, the owner -builder will have the burden.
or proving that he. did not build or knprove for the purpose o1 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
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.)
❑ 1 am exempt under Sec. B. & P.C. for this reason
Electrical
45.00
Plumbing
27.00
S,M.I. '
Grading
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
Workers Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
-
Policy ,N - Company
- Copy is filed with the city, O. Certified copy is hereby furnished.
•
,
TOTALt3'8.75
$
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION'INSURANCE - -
REMARKS
'
(This section need not be completed If 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 erson in any manners as t8 become subject to the Workers' Compensation
laws of.Cal�rnia L -.
Date f ^ L!1 `f'Owner =% f
'
'
NOTICE TO APPLICANT: ff, after making, this Certific to of Exemption you should become
•subject io the Worker§' Compensation provisions or the Labor Code, you must •forthwith-
'
comply with such provisions or this permit shall be deemed revoked.
'ZONE: BY:
Minimum Setback Distances: ,"•.-;
Front Setback fro ter Ll
Rear Setback ft ar P
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL, AND -
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES. UP TO ONE
Side Street S ack fyOm Cen Line
�J
HUNDRED THOUSAND DOLLARS ($100,000), IN.ADDITION TO THE COST OF COMPENSATION,
Side, Setba rOm Prc��Tiy Line
DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, -INTEREST, AND
ATTORNEY'S FEES.
Ttiis is'a building permit when properly filled out, signed and validated, and is.subject to
FINAL DATE
y 2
SPECTO
expiration it work thereunder is suspended for 180 days.
_ I 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-
ate Mailing Address
Mailing
Issued by:
Validated by:
Validation:
Date Perm'i f
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
Y
ARD SPKLR SYSTEM
2ND FL. S0. FT. p
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK i
POR. SO. FT. ®
GAS (ROUGH)
METER LOOP
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. SO. FT.
GROUT
WATER HEATER
WALL SO. FT.
FINAL INSP.
DRINKING FOUNTAIN
SO. FT. ®
WATER SYSTEM
URINAL
ESTIMATED CONSTRUCTION VALUATION $
-$
WATER PIPING
NOTE: Not to be used as property tax valuation
FRAMING
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
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 ® 11/4 c
SEWAGE DISPOSAL
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION U
SO.FT.GAR ® 3/ac
HOUSE SEWER
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 1/AItELECTRICAL fJ 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
FINAL INSP.
GRADING
cu. yd.
$ plus x$
-$
LUMBER GR.
FRAMING
FINAL INSP.
ROOFING
2a n e
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION U
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIONATURESIINITIALS
GARDEN WALL FINAL