15148 (SFD)44
P.O. BOX 1504 N o , 15148
Building 78-495CALLE IAMPICO
Address 47-840 Via Firenze LA QUINTA, CALIFORNIA 92253
Mailing _
Address 1535 South D Street
CityZip Tel.
•-Sart Bernadiz- .92408 1909-381-6007
same as above
idress
City Zip Tel.:
State Lic. City
& Classif.. S'. 314473 Lic. # 2120
Arch., Engr.,
Designer F rank, G6nzalles and A,s soda$
AddTel.
.1ress. 36 East Chapman. Avenue 714-532--15878
City Zip State
' Qaanere_-• 92666 LIC. #
I '/ LICENSED CONTRACTOR'S DECLARATION .
I hereby affirm that I am licensed under provisions• fo Chapter 9 (commencing v
7000) of Division 3 of -the Business and Professions Code. and my license is in It,
Section
ince and
WNER-BUILDER DECLARATION
I hereby affirfn: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 rile 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 thathe.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 than five 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.'If, however, the building .
or improvement is sold within one year of completion, the owner -builder will have the burden
of proving that he did not build or improve for the purpose of sale.)
❑ I, 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) pcensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec. B. & P.C. for this reason
w -
Date Owner
{
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.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if 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 person in any manner so as to become subject to the Workers' Compensation
Laws of California.
Date Owner
NOTICE TO APPLICANT. ti, after 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.
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 ($100,000), IN ADDITION TO THE COST OF.COMPENSATION,
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF—THE LABOR CODE, INTEREST; AND
ATTORNEYS FEES. %
l_.
This is a building permit when properly filled out," signed and validated, and is subject to -
expiration it 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 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
apurposes-'
uru�rp ses-
Signature of applicant .%%� -=" Date((s'
Mailing Address—�'�__7
City, State, Zip
BUILDING: TYPE CONST. V—N OCC: GRP. L3
A.P. Number 617-•790-014
Legal DescriptionLot 14 Tract 26152 Phase
Project Description 5F' P14n 3G
Spinnaker Ove at Lake ' La Quina
Sq. Ft. 2198 No. No. Dw.
Size Stories 'Units
NeWXQ Add ❑. Alter ❑ Repair ❑ Demolition ❑ _
imated valuation 131 0,54 . 00
PERMImT
AMOUNT
Plan Chk. Dep.
'
Plan Chk. Bal..
628.53
Const.
751.50
Mech.
0
55.50
Electrical
153.29
Plumbing
-156.00
S.M.I.
13.20
Grading
20.00
Driveway Enc.
fl
Infrastructure
2968.97
t n Publi Planes
79.89
TOTAL
4$26.$$
REMARKS
fey
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 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FI=ES
IST FL. SO. FT. ® $
2ND FL. SO. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CARP. SO. FT.
WALL SO. FT. ®
SO. 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
ROUGH PLUMB.
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GAS (ROUGH)
LAUNDRYTRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
IKITCHEN 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.
SO. FT. ® c
BATH TUB
BOND BEAM
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1+/e c
SEWAGE DISPOSAL
LUMBER GR.
SO.FT.GAR ® 3/ic
HOUSE SEWER
s `
FRAMING1,e
FINAL INSP.
GAS PIPING
s3� '
PERMIT FEE
PERMIT FEE
n
TOTAL FEES
MICRO FEE
1
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMB
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE 9�
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
WER R
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
'GAS (FINAL) `
J
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
CU. yd.
$ plus x$
-$
LUMBER GR.
FINAL INSP.
s `
FRAMING1,e
FINAL INSP.
///
ROOFING �y
s3� '
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
PROTO-UTM WALL SYSTEMS
SPECIAL DEPUTY INSPECTION FORM
DATE: ell
As an accredited and certified Deputy. Inspector of Proto-H Wall
Systems, I/we hereby witnessed and certified the torqueing of the post -
tension rods by L-d+j dW %e q,
Tliis 1� day of U ,19�
A. Wall System Description (Block Product and -Height):
B. Location' an Builder: 4
Lo
S p AJ-
C. Length of Wall and number of rods and spacing:`B
D. Torque Applied to each Rod:
Deputy Inspector '
Distribution: Department of Building and Safety ,
Proto-H Wall Systems
Builder/Developer
Angelus Block Co.
Installer