14598 (BLCK)4144
hII
P.O. BOX 1504 No. 14598
tale Harland Dr. 78-495•CALLETAMPICO
LA OUINTA CALIFORNIA 92253
Owner Larry Aiken
BUILDING: TYPE CONST > OCC: GRP.
Mailing $@
Address.
A.P. Number
City Zip Tel. y '
L8 Qu nta, CSS 92253 360-8259- Legal -Description
Contractor
Russell L. JoSePh
Ajr j00 Suiteytdiape
City. lZiD
Indio, Hills,ICA
& Classif.. _ 694110
Arch:, Engr., '
Designer
Tel-:
92291 342-1550
Address Tel.
City Zip State
Lica #..
' .LICENSED CONTMCTOR'8 DECLARATION "
1 herer affirm that,I am licensed under provisions of Chapter 9 (commencing with'Section
orf fivislon 3 of the,pus cess and Professions Code, and my license is in,full force and
x SIGNATURE DATE
OWNER -BUILDER DECLARATION '
I hereby affirin'that I am exempt from the Contractors License Law for the following
reason; (Sec.., 7037.S;Llvshess and Professlans Code: Any oAy or county, which requkea a -
'Permit to conahuct, eller, Improve, demoBsh. -'repair any structure, Prior to Ila 'Lssuance also
requires,the-appkwd for such pe/drrt-ro _ft a algriod statement that he Is•licensed pursuant to
the Provisions of Me Condacfors Uosnse`Law; Chapter 9 (commencing .with Section. 7000) of
D/vlsion 3 of the Business and Professions Code; or that: he Is exempt therefrom, and the basis•
for the aneged .exemption. Any viollstion of Section 7031.5 by 'any applicant for a permit.
- • .subjects: me epprkant ro. else penaatr,ol mol more Wren rroe hundred douars ($soo).
❑ I, as owner 'ot the, property; or. iny employees with wages as their sole, compensation, will
do the work; and the stnrcture Is not Intended or offered for sale. (Sec. 7044. Lfuisness and
Prolesslons Code: The: Conbactas License Law does not apply to an owner of property who
builds or Improves thereon and who dose such work himself or through his own employees,
provided .that such Improvements are not Intended or offered for sale. _If, however.. Me building
or /mproremerrtte sold wfthln one Year of the owner -budder wId have, the burden
o/proving tlret;ne did not
buBtl a imprcre far a:=
he purpose of sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con•
struct• the project.,;(Sec. 7044, Business and,Profesaions Code: The Contractor's'Ucense Law
does not apply to, sn;owner of property who be or Improves thereon, and who contracts for
' such projects with a contractors) peensed pursuant to the Connectors License Law.) .
❑ 1 am exempt, under Sec R. & P.C. for thIs reason
Date' Owner
WORKERV COMPENSATION DECLARATION
-tel hereby affirm that I have *a certificate of consent to self -Insure; or a certificate of
Workers Compensation Insurance, ora certified copy thereof. (Sec. 3800,. Labor Code.)
Policy No -Company
❑ Copy Is filed with the cly. ❑ Certif led copy.le hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(Tris section need not be completed H Bre pemdl is for- one hundred, dollars ($100) valuation
' or less.)
I certify that in the pedotWwwoe-of thipmork for which this permit Is issued, I shall not
employ
aCnay person
any.1manner as to become subject to the Works re' Compensation
Date { r./ `t - Dwner
TILE TO APPLICANT: 9, affer malft' this Csrtilioate of Exwrnoll o you should become
r ect * to the Wbrkam' Corrpenswon prodebna of.. the Labor Cede. - you must forthwith
comply with such provisions or Ods permit shad be downed 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 THOUSANDDOLLARS (5100,000), IN. ADDITION TO THE COST OF COMPENSATION,
DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST,. AND
ATTORNEY'S FEES.
This Is a building permit when properly filled out, signed and validated, and is -subject to
expirationaf work thereunder is suspended for 180 days.
I certify that,I have read this. application. and state -that the above, Information is correct.
I agree to comply with all cit and county ordinances, and state, laws relating to building
construction, and hereby authorize representatives- -of .this city to enter, the ;above-.
rnentloned property.for•Inspection purposes.
Signature of applicant Date
Mailing Address
city,. state; zip
jeer Description 68 ¢ of 301 retainizng Hall
Gal Line to BBQ
Electrical conductor'to spa, and-
landscap*e ligating
Sq. Ft. No: No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Future gas -line and fire ring are •.
not approved' -until manufacturers specs'
are provided and aporoyed by Buil.diTa -
..Official.
Estimated Valuation $4 2430 a 00
PERMIT AMOUNT
Plan Chk: Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical 15 , 00•
Plumbing 15.00
S.M.I.
Grading
Driveway Enc.
Infrastructure
i_
TOTAL 30.00 '
KLMARKS
ZONE!'
By:
Minimum Setback :DistanceS: .
Front Setback,from Center -Line
Rear Setback from. Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE
INSPECTOR
Issued by.Date_
Validated b'y:
I
Validation:
i
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
1ST FL. SO. FT. ® S
UNITS
COLL.,AREA
SLAB GRADE
ROUGH PLUMB.
YARD SPKLR SYSTEM
2ND FL. SO: FT.
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME-SVC.
BAR SINK
POR. SO. FT. ®
DUCT WORK_
ROCK STORAGE
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
HEATING (FINAL) .
DRAINAGE PIPING
CAR' P. SO. FT.
GAS (FINAL)
TEMP. POLE
WALL SO. FT.
DRINKING FOUNTAIN
SO FT ®
WATER HEATER
URINAL
ESTIMATED CONSTRUCTION VALUATION E
FINAL INSP.
WATER PIPING
NOTE: Not to be.used as property tax valuation
WATER SYSTEM
FINAL INSP..
FLOOR DRAIN
MECHANICAL FEES
GRADING
cu. yd.
.$-Plus-4-=$
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
REMARKS:
LAUNDRY TRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSORHP
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 ® Pk c
SEWAGE DISPOSAL
SO.FT.GAR ®'4c
HOUSE SEWER
MESH
GAS PIPING
PERMITTEE
PERMIT FEE
PPL.CK.FEE
PERMIT FEE.
DBL
TOTAL FEES
MICRO FEE
MECH.FEE
CONST. FEE ELECT: FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
.4
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL.,AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TAN
ROUGH WIRING
DUCT WORK_
ROCK STORAGE
FOUND.,REINF.
GAS (ROUGH) ?i/
METER LOOP
HEATING (FINAL) .
OTHER APPJEOUIP.
REINF. STEEL i
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM Z
WATER SYSTEM
FINAL INSP..
FINAL INSP.
/ J "
GRADING
cu. yd.
.$-Plus-4-=$
LUMBER GR.
FRAMING
ROOFING
REMARKS:
VENTILATION
FIRE' ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL '
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL-
INSPECTOWS SIGNATURESIINITIALS
GARDEN WALL FINAL
aP.
�l 1
%I/�.S
'CD tj
wA[L
e
sw�4 w J
a =
POOL AREA TO BE ENCLOSED Y
r r4 r MINIMUM 5 FT. HIGH. FENCE.
• ALL GATES TO BE SELF -CL G
k" .�' .�;r;.,� AND SEIF-LATCHING. F
�cRATS,
CITY OF LA-QUINTA
BUILDING & SAFETY DEPARTMEN-
ACCEPT" Fi ice/ `LOD�—
r�.���G � ;.•i`Y7 APS ED Y PLAN G IA*46 LL ay
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