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14451 (RPL)T4tvl 4 cl P.O. BOX 1504 No. 14451 Building 78-495 CALLE TAMPICO Addre3s 78--735 Dolce Del Mar LA OUINTA, CALIFORNIA 92253 Owner; Wilma La Quiata Mailing ' BUILDING: TYPE CONST. OCC. GRP. Address "sit3.Lt e A.P. Number City 'Zip Tel. Lig Qluinta, CA 12253 Legal Description Contractor Project Description Po© and S6` California Pools VLdLeegs10 Board alk$ Suite A-2 - al.Zli Desert,i 1p 92260 Te�40-91000 State Lic. C-53 185102 City 355 & Classif.. Lic. # 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,tfat I am licensed under provisions of Chapter 9 (commencing with Section tot of Division 31of the Busine sand Professions Code, and my license is in full force and SIGNATURE A., DATE //rr WNEWBUILDER DECLARATION I hergaaffirm that I exempt from the Contractors License Law for the following Estimated Valuation $100000.00 _reason: (Sec. 7031.5,113usiness 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 requires the applicant for such permit to file a signed statement that he is licensedpursuant 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 alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit Plan Chk. Dep. subjects the applicant to a civil penalty of not more than rive hundred dollars ($500).. ` e 5 O I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. v do the work, and the structure is not Intended or offered for sale. (Sec. 7044, Buisness and Const. 117.00 7t 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, Mech.- 2� �Q 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 Electrical 45.00 ofproving that he did not build or knprove for the purpose of sale.) O 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 Contractor's License Law- does not apply to an.owner of property who builds or Improves thereon, and who contracts for • S. M. 1. such projects with a contractor(s) Pcensed pursuant to the Contractor's License Law.) Grading ' O 1 am exempt under Sec. B. ti P.C. for this reason y 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 No. Company O Copy Is filed with the city: O Certified copy is hereby furnished. TOTAL 289.05 CERTIFICATE OF EXEMPTION FROM REMARKS 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 thg 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 I n Y Laws of California Date Owner 1 I u I t NOTICE TO APPLICANT. If, after making this Certificate of Exemption you should become ZONE: - ' BY: ! 1 subject to the - Workers' Compensation provisions of the Labor Code, you must forthwith DEC 15 1994 comply with such provisions or this permit shall be deemed revoked. - Minimum Setback Distances: Front Setback fro enter Line Rear Setback from Rear Prop. Line WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND Side Street Setback 066 Center SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($10),000), IN ADDITION TO THE COST OF COMPENSATION, . Side Setback from Property Line DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. FINAL DATE INSPECTOR This•ls 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 • lf' . CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBINU 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 POR. SO. FT. ® GAS (ROUGH) / 7� /v METER LOOP GAR. SO. FT. ® POWER OUTLET ROOF DRAINS GAS (FINAL) TEMP. POLE DRAINAGE PIPING CAR P. SQ. FT. ® GROUT , WALL SQ. FT. ® FINAL INSP. DRINKING FOUNTAIN BOND BEAM WATER SYSTEM URINAL SO. FT. ® =$ LUMBER GR. ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP. WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES I WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER VENTILATION GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FIRE ZONE ROOFING LAUNDRYTRAY AIR HANDLING UNIT CFM FIREPLACE 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. SQ. FT. RESID ® 114 c SEWAGE DISPOSAL SO.FT.GAR p 3/4c 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) / 7� /v 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. $ plus x$ =$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. 3/9 9V ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL