08401 (RPL)4
P.O. BOX 1504 No 08401
Building 78-105 CALLE ESTADO
Address 4$--502 0I Encant8 LA QUINTA, CALIFORNIA 92253 /� f
Owner
Mailing rAnhAl
BUILDING: TYPE CONST. DCC. GRP.
Address A.P. Number OI G1 v �. pe L -k Pat ---
r Averme
21,
City ip Tel.
RmMhvid1m 91324 8181272-111092 Legal Description
Contractor Project Description
4
Address0*1 as
City Ip Tel.
La Qu tot 92253 A
State Lie. City
& Classif. Lie. # Sq. Ft. No. No. Dw.
Arch., Engr., (!_53 54999n
0657 Size Stories Units
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
City Zip State
Lie. #
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Divisi n 3 of the Business and Professions Code, and my license is in full force and
effect. t /j
SIGNATURE p� "` D
OWNER -BUILDER DECLARATION Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following 1510W."
reason: (Sec. 7031.5,Buslness and Professions Code: Any city or county which requires a
permit to construct, after, 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 pursuan! to PERMIT AMOUNT
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 Plan Chk. Dep.
subjects the applicant to a civil penalty of not more than five hundred dollars (5500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal.
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const.
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, Mech.
provided that such improvements are not intended or offered for sale. If, however, the building24.00
or Improvement is sold within one year of completion, the owner -builder will have the burden Electrical
of proving that he did not build or improve for the purpose of sale.) 30.
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law 37.00
does not apply to an owner of property who builds or improves thereon, and who contracts for S.M.I.
such projects with a contractors) licensed pursuant to the Contractor's License Law.)
Grading
0 I am exempt under Sec. 8. & P.C. for this reason
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
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL •27 �z ,%
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE l wrfc t
(This section need not be completed if the permit is for one hundred dollars ($100) valuation �itFtl`.?tI� {jam j, !('j�i�-i'�--�'(,h a ,>7 10
or less.)
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.
Date Owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become ZONE: BY:
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Minimum Setback Distances:
comply with such provisions or this permit shall be deemed revoked.
Front Setback from. Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY Side Street Setbacx from Center Line
I 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.) Side Setback from [Property Line
Lender's Name
Lender's Address FINAL DATE INSPECTOR
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. Q `�
I certify that I have read this application and state that the above information is correct. Issued by: Datey [ Permit
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. Validated by:
Signature of applicant Date
Mailing Address Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. SQ. FT. ®
FOR. SO. FT. ®
GAR. SO. FT. ®
CAR P. SQ. FT.
WALL SQ. FT. ®
SQ. FT ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM'
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN.
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEQUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1+/. c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/4c
HOUSE SEWER
REMARKS:
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE JELECT.FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. 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 APPJEQUIP.
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
REMARKS:
VENTILATION
FIRE ZONE ROOFING ,
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
COUNTY OF RIVERSIDE DEPARTMENT OF HEALTH
ENVIRONMENTAL HEALTH SERVICES DIVISION
POOL AND SPA PLAN CORRECTION 000000,56 OO6
DISTRICT # 2 PLAN
DATE F-, %(J
PROJECT NAME A/14 6' 1 R {��Z PROJECT LOCATIONCCCAI�LrJ- f'
OWNER/CONTRACTOR —&LaepL D F &LQPM Cx C ON —rrlV?Po POOCS
The plans are now approved subject to the conditions listed below:
A L t lieAt -ra sax P7MgIVT (.t)RP�LnAln � 2a 4 h ai r f -r, Prn mign>,
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AICU ' A I DCK16, Fti� IIJ Nn fvY 001RU) ANUCt kV rAb f LI-MrS
—�T �oQM�' �1�v � yEcrn� COMnLC7'K11 7'D 7'NG� J'lfA�71N a e �N[r �f't��, 1-;r
.t>rPAP-r,orA1`r, AL( ral r nwp _b Pkjrk akkaaw finkon2znoN
Vof1 6 ti 9 CaA)XXRuC--r1ot\) of -NIS Pv0L A H n ANYA clr; Arty
A9/L4iA)1,c7' Ar/Uig AND VAllfokm c096Jl
CONSTRUCTION INSPECTIONS: Contact the Plan Checker for pre-gunite and pre -plaster inspections at least three (3) working days in advance.
M
A FINAL INSPECTION MUST be made upon completion of all work including fencing, safety equipment and signs. APPROVAL to operate shall
not be granted until the facility has passed th!�INAL INSPECTION, and "APPLICATION TO OPERATE" has bee -1 completed and PERMIT fees
have been paid.
REQUEST FOR FINAL INSPECTION SHOULD BE MADE AT LEAST FIVE (5) WORKING DAYS IN ADVANCE.
PLAN CHECK BY �v C-�.. /< -r Phone (� a) S V.2 F;2 F'Al
I acknowledge the corrections noted herein and as indicated on the plans and agree to incorporate them during construction:
Signature _ _40
Company
Date
vvn.0MV_101 pmew310u) W-ur-Hut — Y -APPLICANT — P -BLDG. DEPT.
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