15099 (RPL)Iding
Tit!t
P.O. BOX 1504 N o . 15099
78-495 CALLE TAMPICO
d LA QUINTA, CALIFORNIA 92253
-.---_. dtilliak/Tictoria Bobbitt
Address 76-785 We Harland
City La Qiiiinta zip 92253 1'e'.
Contractor Owner/Builder
Address .
Zip I Tel.:
State LicaCity
&_Cla§sif:_ Lic. #
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number 4
Legal Description
Project.Description S- witm�'A Pool $ndSp
Arcn:; tngr.,
Designer Douglas R. Ferrell
Add[ess Tel.
.335-4362
City Zip State RCE32994
Lic. #
LICENSED CONTRACTOR'S`DECLARATION
'I hereby affirm that I am licensed under provisions of Chapter 9 (comencing with Section
Zlt of Division 3 of the Business and Professions, Code, and my licensme is In Lull force and
effec- .
SIGNATURE DATE
owNmilluiLDER DECLARATION E
.I hereby affirm that I am exempt .from the Contractor's License Law for the following
reason: (Sec. 7031.5,Bustrress and Profesalone- Code: Any. 00 or county which reoulrea a
permit to construct, after, lrrprove; demolish, or repair any ahucture, prkor to !!s issuance also
requires the appllcent lot aucli pemlR: to IBe •a signed ;sreremen/ that he .la lloenaed pursuant to '
the prov/slorrs o/ the Conhaetors LJceriae Law, Chapter 9.,.foonprrsncing wph Section 7000) of
,3 the the' Business •end Profess!ons Code, or.that: he
;exempt therelnvn, and the basis"
for ,the alleged 7esruc
ny vble0oI7091.5 bya permd
taappdcarv0enally o/ notmore MftvereddO. I;asner of tarty, or my.employees with wvlges:as their sole compensation, will
do the work, and tture is not Intended or offered for sale. (Sec. 7044, Buisneas and
Profeasiorrs Code: The Contractors License Law- does not apply to an owner of property who
txdlds 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. M, however, the building
or improvement Is add within one year of Completion,_ Me owner -budder -will have the burden
o/ proving that he dM not build or improve for tie purpose of sale.) '
0 I, as owner of the property, am exclusively contracting with licensed contractors'to con-
struct the project. (Sec. 7044, Business and.Professlons Code: The Contractor's License Law
doesnot apply to an,ownerof property who builds or Improves thereon, and who contracts for
such pro)ecta will 8=="
licensed pursuant to the Contractor's License Law.) - -
❑ 1 am exempt under Sea R• & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that 1 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.le filed withftle city.; 0 Certified copy Is hereby' furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE -
•(Thissection need not be completed If the permit Ls . for one .hundred dollars (S100) valuation
or less.)•
I certify that in,the,perfomlance of the work for which this permit Is -issued, I shall not
employ M ppeereon In any manner so as to become subject to the Workers' Compensation
Laws of Califomis
Data Owner
NOTICE' TO APPLICANT. it, after making this Certificate o! -Examdon you should become
,sub)aot to the fMorkers' Compensation provisions of the••,Labor Code, you must forthwith
oomp/y,wdh such proof ioas or this pemtlt 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,(S10O,OD0), IN ADDITION TO,THE COST OF COMPENSATION,
DAMAGES AS PROVIDED FOR IN SECTION 37011 OF THE LABOR CODE, INTEREST, .AND '
ATTORNEY'S FEES.
TTiis is a building permit when properly filled out, signed andvalidated, and, is subject to
expiration If work thereunder is suspended for 180 days: -
I certify that.1rhave read this application and state that the.ebove 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 abovo-.
mentioned property for inspection purposes • �! ,r
Signature of applicant - nate.
Mailing Address
City, State. zlo
Sq.'Ft.
Size . .. .
New ❑ Add' O
No.
Stories
Alter ❑
No: Dw.
Units
Repair ❑ _ Demolition ❑
v.
REMARKS
stimated Valuation., -
$91000.00
PERMIT
AMOUNT
Plan Chk: Dep.
Plan Chk. BaL.
BY:
Const.
g 0
Mech.
5,224 . OID
Electrical
Plumbing
Side Street Setback fl{ me ine
S.M.I.
Side Setback.from P' rty 1400 11
Grading
FINAL DATE,
Driveway Enc.
Infrastructure
Issued_by,.-
Validated by,
TOTAL
'
REMARKS
ZONE
BY:
Minimum Setback Distances:
Front Setback_ from Center Line
Rear Setback from Read o Line
Side Street Setback fl{ me ine
Side Setback.from P' rty 1400 11
FINAL DATE,
I SPEC
Date 1- it
Issued_by,.-
Validated by,
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO: PLUMBING FEES
1ST FL. SO. FT. ® i
UNITS,
'
2ND FL. SO. FT.
YARD SPKLR'SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC. '
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS f
ROUGH WIRING
DUCT WORK
DRAINAGE PIPING
CAR P. SO. FT.
GAS (ROUGH)
WALL SO: FT.
HEATING (FINAL)
DRINKING FOUNTAIN.
SO: FT. @
URINAL
ESTIMATED CONSTRUCTION VALUATION i
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
GRADING
cu. yd.
i. plus xi
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED I
'LAUNDRY TRAY
AIR HANDLING.UNIT CFM
;,FINAL INSP. -
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
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.MU.
SO. FT. RESID ® 1 Vi c
SEWAGE DISPOSAL.
SO.FT.GAR ® iic
HOUSE SEWER
GAR. FIREWALL
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PLZK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING'& -AIR COND. SOLAR
SETBACK
GROUND PLUMBIIN G 1211UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING.(ROUGH)
STORAGE TANK
FORMS
SEWER OR SE 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
GRADING
cu. yd.
i. plus xi
=i
LUMBER GR. _;
FINAL INSP.
FRAMING
;,FINAL INSP. -
ROOFING _
�,
"
V
6 "
-
l
REMARKS:-
EMARKS:VENTILATION
VENTILATION
FIRE.ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND'
FINISH GRADING l
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL