15352 (RPL)Buildi
75-730 W. iiarland
Halitia
,Twit4 �J
P.O. BOX 1504
78495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Mailin
Address 73-730 W. Harland
City Zip Tel.
La Quinta 92253
A nest Pools
Address . P.O. Box 11206
Pali► Desert 1" 92255
State Lic. -
&,Classif. C"53 476807
Arch., Engr.,
Designer
Address
345-5070
No. 15352
LDING: TYPE CONST. OCC. GRP.
P. Number
.gal Description
oject Description, Pool & Spa
Lic: # 130 Sq. Ft. No.
Size Stories
Tel.
City I Zip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
1 hereby -affirm diet 1 am licensed under proVislons of Chapter, 9'(commencing with Section
7 of DI (sign of theBuekiesS`siid Protfislons Code, and my license is in full force and
Me61. -
TURF -max? DATE
OWNER•BUILDER DECLARATION
I hereby affirm theft errr exempt from the Contractors License Law for the following
reason: (Sec. 7091.5,Bushmn and Professions Code: Any city or county which requires a
permit to construct. a8er. Improve, donofth, or repair any structure, prior to Its issuance also
requires lire applicant rot such -permit ro Poe a signed statement rhat,he is Ik;ensed pursuant to
-
tne'prorovlslons"ol the Conhactor's License Lew, Chapter g (commencing with Section 7000) of
Drv/slon 3 of the Business and Professions Cada, of fhaf:he is exempt therefrom, and the basis
forthe the eltegad eicemption. Any viatetion of Section 7091.5 Dy 'eny app8cenr for a permit
subjects theapp8cant to
,=Arty
penalty of not more than five hundred dolleis (5500).
❑ I, as owner: of the property, or my employees with wages as their sole compensation,mill
dothe work, and the structure is, not Intended or offered' for sale. (Sec. 7044, Buismess and
Professions Code: The Cadracfor'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 Mat' such improvements are not Intended -or offered for sale. N, however, the buliding
orImprovement Is sold within one year of completion, the owner -builder wit! have the burden
of proHrrp UW he did not build or improve for the purpose of sale.)
O I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7014, Business and-Protesskurs Code: The Contractor's License Lew
does not apply to owner of property who bufMaor improves thereon, and who contracts for
such projects with -a contractors) "wed pursuant to the Contractor's License Law.)
❑ I am exempt under Sec B. ti-P.C. for this reason
Date owner
WORKERS' COMPENSATION DECLARATION
1 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. 9800, Labor Code.)
Policy No Company
❑ s filedwith the city, O Gertifled copy Is hereby fumished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This. sectim need'not be conipieted If the permit is for one hundred dollars ($100) vahudion
or less.) '
1, certify that'lwthe performance of thg work for which this permit is Issued, I shall not
employ any ppeerson in any manner so as.to become subject to the Workers' Compensation -
Laws of Califomia
Date Owner -
NOTICE TO APPLICANT: M, after maift. this Certificate of Exemption you • should become
subject to the Workers, compermaon provisions .of the . Labor Code, you must forthwith
comply with such provisions or it* permit shall be deemed revoked.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
HUNDRED THOUSAND DOLLARS (sioo,000), IN ADDITION TO THE COST OF COMPENSATION,
DAMAGES' AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES:
TMs.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 1 have read this application and state that the above, information Is.corect.
I agree to comp)y 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 .
Signature of applicant Date
Mailing. Address
City, State, Zip
New ❑ Add ❑ Alter ❑
No. Dw.
Units
Repair ❑ Demolition ❑
stimated Valuation . .:$16,000.00
-PERMIT.
AMOUNT
Plan Chk. Dep.'
Plan Chk. Bal.
1
Const.
1171.00
Mach.
3 .24. 00
Electrical
S 4SAO
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street'Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
Validated by:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
1ST FL. SO. FT. ® $
UNITS
,ft
2ND FL. SO. FT.
BONDING
YARD SPKLR SYSTEM
POR. SO.,FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO- FT. ®
POWER OUTLET -
ROOF DRAINS 3
CARP. SO. FT.:®
GAS (ROUGH)
DRAINAGE PIPING
WALL SO. FT. ®
OTHER'APPJEOUIP.
DRINKING FOUNTAIN.-
OUNTAIN-SO.
SO.FT. ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER.PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL, FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
GARBAGE DISPOSAL
FURNACE. UNIT WALL FLOOR SUSPENDED
LAUNDRY.TRAY
AIR HANDLING UNIT CFM'
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMPUSEPERMIT SVC -
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM.
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV,ENT
SHOWER
BOILER B.T.U.
SO. FT. ®.0
BATH TUB
SO. FT: ® C
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1 Vi c
SEWAGE DISPOSAL
SO.FT:GAR ® 3Ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERM_ ITFEE
DBL
TOTAL FEES
MICRO FEE
MECH.F.EE PL.CK.FEE
CONST. FEE ELECT. FEE
SMIFEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL AHEATING 3 AIR COND. SOLAR
SETBACK
GROUND PLUMBIN
UNDERGROUND
A:C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRI
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
GRADING
cu. yd..
S plus xi
=$
LUMBER GR.
I
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
c�
`l
�\ \
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
• SPARK ARRESTOR
-
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL