003655 (RPL)44
P.O. BOX 1504 No. 003655
Building 78-105 CALLE ESTADO
Address 49-105 Calle r14ra LA QUINTA, CALIFORNIA 92253
Owner
BUILDING:,TYPE CONST: OCC. -GRP.
Mailing
Address Santa Rasa Cove A.P. Number ,
City Zip Tel.
" Legal Description
Contractor Pmol. & spa
•, Project Description
Barrile Construction
i. Address
p _ Rnx 1540
' City _ .... _ -Zip. _ Tela
La Qulnta 92253 564-61244_
State Lic. City
& Classif. �g�Y 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 that I am licensed under provisions'`of Chapter 9 (commencing with Section - i*
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect. �, 1 e .� " ci ir'' • r
_e
SIGNATURE - - DATE .
'
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following Estimated Valuation
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
requires the applicant -for such permit to file a signed 'statement that he,is 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 andProfessionsCode, or that, he is exempt therefrom, and the basis' Plan Chk. De 2
for the ~ alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit p -. - 1
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
O 1, as owner of the property, or my employees with wages as their sole compensation, will ' Plan Chk: Bal.
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const." �>
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. if;QQ
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- 2il�
of proving that he did not build or improve (or the purpose of sale.) 0
O I, as owner of the property, am exclusively contracting with licensed contractors to con Plumbing 14.00
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.I. i, w Qi
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
I
� O I am exempt under Sec. B. & P.C. for this reason Grading
J Driveway Enc.
I 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 certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. - Company
O Copy is filed with the city.. O Certified copy is hereby furnished.
TOTAL
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.) ,1: 7 ti
I certify that in the performance of thg work for which this permit is issued, I shall not It 7 {7� k„�R—w. f" �2.2 A
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California.
l 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 Minimum Setback Distances:
comply with such provisions or this permit shall be deemed revoked.
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
work for which 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. .' y �y
. I certify that I have read this application and state that the above information is correct: Issued by: Date i 8 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
HARD COPY
� Y
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
2ND FL. SO. FT. ®
YARD SPKLR SYSTEM'
STORAGE TANK
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
DUCT WORK
ROCK STORAGE
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
OTHER APPJEOUIP.
DRAINAGE PIPING
CAR P. SO. FT. ®
TEMP. POLE
WALL SO. FT.
GROUT
DRINKING FOUNTAIN
SO. 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
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
GAR. FIREWALL
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1+/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/4c
HOUSE SEWER
INSULATION/SOUND
GAS PIPING
PERMIT FEE
FINISH GRADING
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
1
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
/ e_
GROUGH PLUMB. f�
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
//BONDING
'� CUGH WIRING [/
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL 7j.((G,
S (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND85AM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_ $
GR.
FINAL INSP.
�}' ��LUMBER
A/ ,FRAMING �/ ,�j �
`�i�
FINAL INSP.
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 SIGNATURES/INITIALS,
GARDEN WALL FINAL
�.ar4
70 At
sN�Ps1 (�ry 6WeZ4S
:`�
NO,
cm
TYPE OF DETAIL
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AND ASSOCIATES
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JOB NAME
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