11128 (RPL)P.O. BOX 1504 N o . 11128
Building 78-105 CALLE ESTADO
Address 19-355 DESERT ROCK LA QUINTA, CALIFORNIA 92253
Owner
SANTA ai3SA r�Ev.
BUILDING: TYPE CONST.
A.P. Number
Legal Description
Project Description
.
OCC: GRP.
'
POOL AND SPA
Mailing
Address
" City
LA QUINTA
Zip
i92253
Tel.
Contractor
SUFAIR POOLS
Address
P 0 BOX 835
Front Setback from Center Line
City
PALH DESERT
Zip
92261
Tel.:
568-4014
CONSTRUCTION LENDING AGENCY
State Lic.
& Classif. 053397252
City
Lic. # 529
Sq. Ft.
Size
No. No. Dw.
Stories Units
Arch., Engr.,
Designer
New ❑ Add ❑
Alter ❑ Repair ❑ -Demolition ❑
Address
Tel.
:
Lender's Address
FINAL DATE
INSPECTOR
City
•.f
Zip
a
State
Lic. #
expiration if work thereunder is suspended for 180 days.
Y
LIC049ED.CONTRACTOR'S DECLARATION
!/ L{ r rr r r
I hereby fflrm that I m licensed under provisions of Chapter 9 (commencing with Section
TO(" of Division 3'o�f the El'uufsiness ind'Professions Code, and my license is in full force %d
Ve""ffFectiis w"� "°/1 `t �., f,/ -Z —27
�""
I certify that I have read this application and state that the above information is correct.
Issued by:
Date Permit
I agree to comply with all city'and county ordinances and state laws relating to building
SIGNATUREt r A r DATE
OWNER•BUILDEZE ECLARATION
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, alter, improve, demolish, or repair any structure, prior to its issuance also
I requires the applicant for such permit to file a signed statement that he is licensed pursuant to
Division 3 o/ the Business and Professions Code, or that. he is exempt therefrom, and the basis
i the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) o/
for the alleged exemption. Any violation o/ Section 7031.5 by 'any applicant for a permit
subjects the'applicant to a civil penalty o/ not more than five hundred dollars.(8500).
❑ 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 sale. If, however, the building
or improvement Is sold within one year or completion, the owner -builder :will have the burden
Y .4 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 o/ 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
Estimated Valuation
13,800 til
- -
PERMIT
=` AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
$99. 43
Const. -
153. 00
Mech.
24. 0 i0
Electrical
45.00
Plumbing
27.00
S.M.I.
1.40
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
Worker's Compensation Insurance, or a.certifted copy thereof.. (Sec. 3800, Labor Code.).
/Poticj'No. Company
Copy is filed with the city. O Certified copy is hereby furnished.
%^' . - - -- -
CERTIFICATE OF EXEMPTION FROM
WORKERS'COMPENSATIONINSURANCE
(This section need not be completed if the permit is for one, hundred dollars (8100) va)uation
or less.) ti -
I certify that in the performance of thg work for which this permit is issued, 1 shall not
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California.
{irfz # .fit, r �y� _ter':
!Tr ' Y'1SS t? i A-,
TOTAL
$349.00
REMARKS
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
complywllhsuchprovisionsor this permit shall be deemed revoked.
-
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear.Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
I hereby affirm that there is a construction lending agency for the performance of the
workforwhich this permit is issued. (Sec. 3097, Civil code.) . -
Side Setback from Property Line
Lender's Name
:
Lender's Address
FINAL DATE
INSPECTOR
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.
Issued by:
Date Permit
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.
Validated by:
Signature of applicant Date
Mailing Address
Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
COLL. AREA
2ND FL. SQ. FT.
ROUGH PLUMB.
YARD SPKLR SYSTEM
POR. SQ. Ff. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SQ. Fr. ®
DUCT WORK
DRAINAGE PIPING
WALL SQ. FT.
GAS (ROUGH)
DRINKING FOUNTAIN.
SQ FT ®
HEATING (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GAS (FINAL)
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER HEATER
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
WATER SYSTEM
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GRADING
cu. yd.
$ -Plus-X$-=$
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.
SQ. FT. ® c
BATH TUB
SQ. Fr. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11% c
SEWAGE DISPOSAL
SPARK ARRESTOR
SQ.FT.GAR ® 3Vac
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 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
y
GRADING
cu. yd.
$ -Plus-X$-=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
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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
P
GARDEN WALL FINAL