15486 (RPL)414
u�
P.O. BOX 1504 N O . 11:486 r +
Building 78-495 CALLE TAMPICO
Address 47-845 Via Firenze LA QUINTA, CALIFORNIA 92253
Ownercenturry Home
Mallin BUILDING: TYPE CONST: OCC: GRP.
Address 1535 .Sotrlt`C.'3 "Ela . St. + '
_ A.P. Number
City Zip Tel.
.�sE't:l Hert3artz3 ��� .(909)381
Legal Description
Contractor':l,3I9i$ S.cA
.E3C3t�son Pools' � Project Description
Address t;
68-605 A Perez Rd. E9 ".
C' y Zip Tele
&Ltliedral #. p C 92234 324-1232 {
State Lic City
& Classlf ,74'.7 Lic. # 104.4 . •. Sq. Ft No No. Dw. x
Arch. Engr ;'�
Size - Stories Units w✓
I • ` .
L,> Designer I: New ❑ Add.0 Alter ❑ : •Repair ❑ Dernolltion O" '
I Address Tel.
c City Zip • State
ti Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section '
000) of Division 3 of the Business and Professions Code, and my liiccense,is in full force and F
effect f « i Via" d
i �:��'9j'��-�!�d.'*-•.
$LGNATURE - DATE _ I • •' -
' OWNER-BUILDER DECLARATION .:
' Estimated Valuation �i 00 +rb
I hereby affirm that I am exempt from the Contractors License Law for the following ��"� 0 `000vv ;t, ' •
;yreason: (Sec.. 7031.5,Business.and .Professions Code: Any cIfY or county which requires a `
'
permit to construct, alter, improve, demolish, or repair any structure,' prior to its issuance also rpt _ -
requires the applicant for such permit to file a'signed statement that he is licensed pursuant to PERMIT ' AMOUNT
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section - 7000) of -•r
Division 3 of the tBusiness and Professions, Code, or that. he is exempt therefrom,, and the basis • - - :„,�
.tor the alleged..exemption. Any violation of section 7031:5: by 'any applicant for a permit Plan Chk. Dep. - b�
subjects the applicant to a civil penalty of not more than five hundred dollars ($500). f(�f[� • . 4'Plan Chk. BBI. - - 7`�
0 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 Const.:.;� +=
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,- - i
provided that such improvements are not Intended or offered for sale. If,' however, the building Mech. _ ..2
or improvement is sold within one year of completion, the owner-builder will have the burden Electrical %� •'^I•'�''r - 45;00- '
of proving that he-did notbuild or improve for the purpose of sale.)
66 O'I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing u��• - _
tf struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law `r .27. 0
"��•_'��
•_' does not apply to an owner. of Property, who builds or improves thereon, and who contracts for . S.M.I. • 7' ? •j, ` - ;t+•,
such projects with contractor(s) licensed pursuant to the Contractor's License Law.) '
Grading ,. ^
- ❑'I am exempt under Sec.' B: & P.C. for this reason
Driveway Eric.,-':.'
,Date ownerInfrastructure -
r-
WORKERS' COMPENSATION DECLARATION '
I hereby affirm that I have a certificate of consent to self-insure, or a certificate of r
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No.,/' Company t' r
opy is filed with.the city, O Certified copy.is hereby furnished_. '
TOTAL r 348..45' I•;r
CERTIFICATE OF EXEMPTION FROM REMARKS r ”
WORKERS' COMPENSATION INSURANCE-
(This section heed-not .be `completed H the permit is for one hundred dollars ($100) valuation
or less.) t
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 thelWorkers' Compensation
Laws of California.• xx //
Date Ownery t i ?'rf1(Eii/P -* `.r°�,.- f r^. •-•,- � t
,NOTICE TO APPLICANT:.ff after -making this Certificate df—Exemption your should become ' 'ZONE: - BY:
#?�,subject to the., Workers' ,Compensation provisions of.-the Labor Code you must forthwith Minimum'Setback DlStaflC@S � /
comply with such provisions or this permit shall be deemed revoked. - / , -
t Front Se�tbaEk from Center Line
R�rS tback from Rear Prop: Line
" WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL; AND Side Street-Setback rlom Center Line'
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, Slde'Setbac from Property Line'
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, .AND C . _
ATTORNEY'S FEES. \ 1.
FINAL DATE - INSPECTOR T -
This is a bmit w
uilding perhen properiy filled out, signed and validated, and is subject to. "\ `yam., /� y•� -
expiration if work thereunder is suspended for,100 days.
I certify that l have read this application and state that the' above information is correct. Issued by: Date /Permit
-Iagree to comply with all city and county ordinances and state laws. relating to building
construction, and hereby: authorize representatives .of this City Jo enter the . above-:\
mentioned property se
for inspection purposes. Validated by:
' Signature of applicant Date
Mailing, Address Validation:
-City, State, Zip • 1
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
2ND FL. SO. FT.
BONDING
YARD SPKLR SYSTEM -
POR. SO. FT.
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT.
GAS (ROUGH)
DRAINAGE PIPING
WALL SO. FT.
OTHER APPJEOUIP.
DRINKING FOUNTAIN
SO. FT. ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
ROOFING
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
VENTILATION
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.
SO. FT. ® c
BATH TUB
GAR. FIREWALL
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
MESH
SO.FT.GAR @ 3/+c
HOUSE SEWER
INSULATIONISOUND
GAS PIPING
PERMIT FEE
FINISH GRADING
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMB y%
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEW R QR SEPTIr TANK
ROUGH WIRING
DUCT WORK
ROCKSTORAGE
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
FINAL INSP.
FINAL INSP.
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FRAMING
ROOFING
-
��sU✓�s �����
`
REMARKS:
VENTILATION
%'f�/LS/T70�1%
FIRE ZONE ROOFING
r
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTIONA���/
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESHNITIALS
GARDEN WALL FINAL
144, BUILDING DEPARTMENT w
,CITY OF LA QUINTA:
OFFICE: (619) 777-7012 INSPECTION REQUESTS: (619) 777-7153
TO: DATE:
ADDRESS: /
CORRECTION NOTICE
W7ki
PERMIT NO.
l/ Al
&moi Z7I
a�
y
:C
Inspector
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