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10915 (RPL)P.O. BOX 1504 N Q . 10 915 Building 79-345 Desert Rocs Ct 78-105 CALLE ESTADO Address LA QUINTA, CALIFORNIA 92253 Owner Fatal Davis Mailing BUILDING: TYPE CONST. OCC: GRP. ----- Address same A.P. Number City Izip ITel. La Quinta 92253 36Q-.®db3 Steve Dodson Construction Address 68805A Pe--eZ Rd #E9 City Zip Tel.: Cat City 92234 324--1.232 State Lic. City &Classif. A 574227 Lic.# 1044 Arch., Engr,, Designer Address Tel. City Zip �`� I State Lic. # I hdreby affirm that I am,llcensed underapro"_visions of Chapter 9 (commencing wii ?00)o,f Division 3 of thd'Business and P,rofessions•Code, and my license is in,i II ffect V /I- _ _p, - 1/. -.% -L - OWNER•BUILOER 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, 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 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, willw do the'oFk, 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'fhat 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 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.) - ❑ 1 am exempt under Sec. B. & P.C. for this reason Date Owner 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.) Poljgy. No. Company Yxopy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (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 th? work for which this permit is issued, I shall not =any person in any manner so as to become subject to the Workers' Compensation laws of California. -t ` t• 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 permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY • k 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 property filled out, signed and validated, and is subject to expiration it work thereunder is suspended for 180 days. 1 certify that 1 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 Legal Description Project Description POOL AND.,SPA Sq. Ft. No. No. Dw- Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation 12.900 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. 93.60 Const.' 144.00 Mech. 24.00 Electrical 45.00 Plumbing 27.00 S.M.I. 1.30 Grading Driveway Enc. Infrastructure TOTAL 334.90 REMARKS 0015192 f"'1:�4 fY L4.�"i^7 'ii]i{ S�yf : •Y. �jtY�i ZONE: - BY: Minimum Setback Distances: Front Setback from Center Line Rear,Setback from Rear Prop. Line t 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 SLAB GRADE ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL. SO. FT. FORMS SEWER OR SEPTIC TANK ROUGH WIRING. MOBILEHOME SVC. BAR SINK POS0. FT. ® GAS (ROUGH) METER LOOP GAAI. SO. FT. ® POWER OUTLET ROOF DRAINS o CAA P. SQ. FT. TEMP. POLE DRAINAGE PIPING WALL SQ. FT. GROUT DRINKING FOUNTAIN. SQ FT ® FINAL INSP. URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER SYSTEM WATER PIPING NOTE: Not to be used as property tax valuation =$ FLOOR DRAIN MECHANICAL FEES FINAL INSP. WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED VENTILATION LAUNDRY TRAY AIR HANDLING UNIT CFM 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. SO. FT. RESID ® 1 Ve c SEWAGE DISPOSAL SQ.FT.GAR ® V4c HOUSE SEWER INSULATION/SOUND GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE It 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. $ pius x$ =$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING /lowy��/�%�� REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION - CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL