11269 (RPL)4
P.O. BOX 1504 N o . 11269
Building 54-565 Diaz 7&105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner
Karen Retscher
Mailing BUILDING: TYPE CONST. OCC: GRP.
Address sane
A.P. Number
City La Quinta Zlp92253 Description
Contractor Project Description Pool & S*pa
McIntyre Pools & Spas
Address
46301 Roudel, Lane
City
7�Zip Tel.:
aQuinta 92253 342--3521
State Lic. City
& Classif. C53 614611 Lic. # 1945 Sq. Ft. No. No. Dw.
Size Stories Units
Arch., Engr.,
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
City Zip State
Lic. #
' LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
-7000) of Division 3 of,the Business and Professions Code, and my license is in full force and
effsct
SIGNATURE `" / DATE
OWNER -BUILDER DECLARATION Estimated Valuation
I hereby affirin that I am exempt from the Contractors License law for the following 9,()00
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 me applicant for such permit to rde a signed statement that hes 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 afleged exemption. Any violation of Section 7031.5 by 'any appli;ant for a permit Plan Chk. Dep.
subjects the applicant to a civil penalty or not more than rive hundred dollars ($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. 70.20
do the work, and the structure is not intended or offered for sale. (sec. 7044, Buisness and l',Onfit. Q$ �Q
Professions code: The contractor's License law does not apply to an owner of property who �f ,! Ate
builds or improves thereon and who does such work hknself or through his own employees,
provided that such improvements are not intended or offered for sale. ff, however, the buDdang Mech. 24vy
orimprovement is said within one year of completion, the owner-buider wS have the burden Electrical 4 Q
or proving that he did not build or improve for the purpose of sale.)
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 27.00
struct the project (Sec. 7044, Business and Professions Code: The Contractors License Law A
does not apply to an owner of property who builds or improves thereon, and who contracts for S.M.I. .90
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
❑ 1 am exempt under Sec. S. & P.C. for this reason
Driveway Enc.
Date owner Infrastructure
WORKERS' COMPENSATION DECLARATION
I hereby affirm that 1 have a certificate of consent to self -insure, or a certificate of
Workers Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Poliicy,No Company - ,j)t'• >Z�>,aii,}il` i+-•�1+. i,iL' C .: t y•�
b.py is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL 275.10
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed ff the pemnit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of Ing 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
alifornia.DateOwner
NOTICE TO APPLICANT: If, after making this Certdkate of Exemption you should become ZONE: BY:
subject to the Workers' Compensation provisions of the labor Code, you must forthwith
comply with such Provisions or 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
1 hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, CW Code.) Side Setback from Property Line
Lender's Name
Lenders 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.
1 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. SO. FT. ® $
UNITS
ROUGH PLUMB. BONDING
2ND FL SQ. FT.
STORAGE TANK
YARD SPKLR SYSTEM
POR. SQ. FT. ®
MOBILEHOMESVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
OTHER APPJEOUIP.
REINF. STEEL
DRAINAGE PIPING
CAR P. Q. FT.
GROUT
WALL SQ. FT.
FINAL INSP.
DRINKING FOUNTAIN.
SQ FT ®
WATER SYSTEM
--------------- t FINAL INSPZQ—y!�
FINAL INSP,/, —I a —Ir i
URINAL
ESTIMATED CONSTRUCTION VALUATION $
LUMBER GR.
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
FIRE ZONE ROOFING
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FIREPLACE
LAUNDRY TRAY
AIR HANDLING UNIT CFM
SPARK ARRESTOR
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.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1% c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3Vic
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PLCK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING UNDERGROUND L
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
--------------- t FINAL INSPZQ—y!�
FINAL INSP,/, —I a —Ir i
GRADING
cu. yd.
$ plus x$
-$
LUMBER GR.
FRAMING
ROOFING �
^ / /
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION- J—%y
CERT. .
FENCE FINAL
INSPECTOR'S SIGNATURESJINITIALS
GARDEN WALL FINAL