9897 (RPL)P.O. BOX 1504 � N o .
Building 78-105 CALLS �
Address 44360 FO�.TAZL DR. LA QUINTA, CALIFORNIAORNIA 92253
Owner
9897
HLFRIEDE HURL
BUILDING: TYPE CONST.
PG�OL
OCC: GRP.
Mailing
Address SAME
A.P. Number
City
Zip
Legal Description
Project Description
ContractorFOOL
SWAN POOLS
Address
68-300 RAMON HD.
City
Izip
Tel.:
CATHEDRAL CITY
92234
324-4460
State Lic.
City
& Classif. 421014
Lic• # 249
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
r
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, license is in full force
and my and
effect t..•,`r. `S✓• f , j�.�
r
SIGNATURE "" DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Susiness and Professions Code: Any city or county which' requires a
permit to construct, atter, 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 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
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, 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
Estimated Valuation
$ 1 19000
,
� PERMIT
AMOUNT
-
Plan Chk. Dep.
Plan Chk. BBI.
$81.90
Const.
126.00
Mech.
Z 4 . Vii
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 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-
Strutt 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.)
❑ I am exempt under Sec. B. 8 P.C. for this reason
Electrical
45.00
Plumbing
27000
S.M.I.
1.10
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 certified copy thereof. (Sec. 3800„Labor Code.)
Policy No. Company e .1 ° • i r r r /
19 co Is filed with the city. ❑Certified copy is hereby furnished.
TOTAL
� 3 0 5.00
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
REMARKS
A„ ,, — - ,.--
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
orless.)
I certify that in the performance of the 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.
trtve �c ,d. S
(} F.Y�{1 '� y�j ^7Ttr, Msa Q
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.
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
j I hereby affirm that there is a construction lending agency for the performance of the
I work for which this permit is issued. (Sec. 3097, Civil Code.)
Side Street Setback from Center Line
Side Setback from Property Line
Lender's Name
i Lenders Address
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.
FINAL DATE
INSPECTOR
I certify that I 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.
Issued by:
Validated by:
Date Permit
Signature of applicant Date
Mailing Address
Validation:
City, State, Zip
r ,
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
COLL. AREA
2ND FL. SO. FT.
ROUGH PLUMB. BONDING
YARD SPKLR SYSTEM
FOR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
DUCT WORK
DRAINAGE PIPING
CAR P. SO. FT. ®
GAS (ROUGH) METER LOOP
WALL SO. FT.
HEATING (FINAL)
DRINKING FOUNTAIN.
SO FT ®
GAS (FINAL) TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
WATER HEATER SERVICE
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GRADING
cu. yd.
$ plus x$
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FRAMING
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
SO. FT. ® c
.. WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1% c
SEWAGE DISPOSAL
GAR. FIREWALL
SO.FT.GAR ® 3/ac
HOUSE SEWER
LATHING
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 GOND. 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
FINAL INSPI,�,
FINAL INSP. G L G /0
l
/Z
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FRAMING
ROOFING
Pre) 0 w it
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Cal t
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REMARKS:
VENTILATION
FIRE ZONE ROOFING
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTIO Q ZZ
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL