13583 (RPL)4
Building 78-775 Wiest Harland 78-105CALOLEESTADO No.13583
Address LA OUINTA, CALIFORNIA 92253
Owner
Angel Rodrigues
Mailing BUILDING: TYPE CONST. OCC: GRP.
Address same
A.P. Number
Lot 133 Tract 23268
Gity Zip IT11-
Legal Description
?,nactor Pool ane Spa -
nique Pools sy carmine Project Description
Address
74818 Velie Way #1
City- Zip Tel.'
Pala DeGrt, 9226+0 346-6335
State Lic. u53 680794
City 1366
& Classif.
Lic. #
Sq. Ft. No. No. Dw.
Size Stories Units
Arch., Engr.,
Designer
New El Add El Alter El Repair ❑ Demolition 1:1
Address
Tel.
City
Zip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I,hereby affirm that I am licensed under provisions of Chapter 9 (co mencing with Section
7 ffectof Division 3 of the Busin 93 and Professions Code, and m liea se i In Joll,forcefand
SIGNATURE DATE
'r..
OWNER•BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
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
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 then rive 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
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. N, however, the building
or Improvement Is sold within one year or completion; the owner-builder will have the burden
of proving that he did not build or Improve for the purpose of. sale.)
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con-
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
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
Estimated Valuation
$1121500.00
PERMIT AMOUNT
Plan Chk. Dep.
Plan Chk. Bal. •
Const. • Ou
Mech. •
Electrical :) + U0
Plumbing /.U
S. M. 1.
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
'ensa4ion Insurance, or a certified copy thereof: (Sec: 3900, Labor Code.)
Workee0DVIS
Policy Company
led with the city. ❑Certified copy is hereby furnished.
TOTAL •
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
REMARKS
(This section need not be completed it the permit Is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of the work for which this permit is Issued, I shall not
employ any parson in any manner so as to become subject to the Workers' Compensation
Laws of California.
.
Date Owner
NOTICE TO APPLICANT: if, atter 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
Side Street Setback, from Center Line
1 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.)
Lender's Name
Lender's 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.
1 certify that 1 have read this application and state that the above information is correct.
1 agree to comply with all city and county ordinance! and state laws relating to building
construction, and hereby authorize representatives of this city to enter the above-.
mentioned property for Inspection purposes.
�.
Side Setback from Property y Line
FINAL DATE INSi TOR
Issued by: Date Perrn
)
Validated by:
signature of applicant Date
Mailing Address
/ i I
Validation: B
�� i
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
COLL. AREA
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL. SO. FT.
BONDING
HEATING (ROUGH)
STORAGE TANK
MOBILEHOME'SVC.
BAR SINK
POR. gq- FT. ®
ROUGH WIRING
DUCT WORK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (ROUGH)
DRAINAGE PIPING
CAR P.SO. FT.
OTHER APP.IEOUIP.
REINF. STEEL
WALL SO. FT.
GAS (FINAL)
DRINKING FOUNTAIN
SO. FT. ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
SERVICE
FLOOR.DRAIN
MECHANICAL FEES
BOND BEAM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
-$
GARBAGE, DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FINAL INSP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U;
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEWPERM
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 ® IVi c.
SEWAGE DISPOSAL
SO.FT.GAR @ Ac
HOUSE SEWER
GAR. FIREWALL
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
'CONST. FEE ELECT. FEE
SMI'FEE Lf]
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
tr !
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC T K
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF:
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
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.
ROOFING
,
/ v?
jy/
/-
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION t
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL