15198 (RPL)P.O. BOX 1504
Building 41-875. Via Firenze 78-495 CALLE TAMPICO
Address LA QUINTA, CALIFORNIA 92253
Owners x" ialle3teros/century Homes
Mailing
Address— _1.535 South aDw. $t.
CityZip Tel.
San Bernardi.nla 6 92408 {909} 381-6007
Contractor
Ddds6i's Pool.
..Address . .
65-805 A Perez Pct. E--9
City - Zip Tel '
• ca6edr l city �� 92234 124-12332
State Lic. City
& Classif.. 574127 Lic. # 1044..
Arch.; Engr.,
Designer '
Address Tel.
City Zip State
No. 151498
BUILDING: TYPE CONST. OCC: GRP.-
A.P. Number
Legal Description
Project Description Pool and &pa
Sq. Ft. No. No. Dw.
Size Stofies Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Date Owner
NOTICE TO APPLICANT: N. after making this Certificate, of Exemption you should become ZONE: - •BY: -
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked. Minimum Setback Distances
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.
ATTORNEY'S FEES.
This is a building permit when property 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 theabove 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 purposes, ;
Signature of applicant— Date
Mailing Address
City, State, Zip
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 ,er t
r f�
Validated by: �
Validation:
C.
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 off the Busin Professions Code,
and and my license is in full force and
effect. c✓jigas r �.. t .Cry
SIGNATURE !' DATE
_
j OWNEWBUILDER DECLARATION
Estimated Valuation
I hereby affirm that I am exempt from the Contractor's cense Lafor the. following
9l V n
1 0^n
L
reason: (Sec. 7031.5,Businass and Professions Code: An c or countywhich requires a
permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to tile a signed statement that he is licensed pursuant to
V •0
V
I %.
PERMIT
AMOUNT
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Protesskms Code, or that. he is exempt therefrom, and the basis
for the Any Section 7031.5 by for
.Plan Chk. Dep.
alleged exemption. violation of any applicant a permit
subjects the applicant to a civil penaffy of not more than five hundred dollars ($500). -
-
Plan Chk. Bal,
07.75
❑ 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.
'13.5 . 00
Professions Code: The Contractor's. License Law does not appy to an owner of.property who
'
builds or improves thereon and who does such work himself or through his own employees,
Mech. -'.
i
. • 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 -budder will have the burden
Electrical
45.00
of proving that he did not build or knprove for the purpose Weals.)
O 1, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing
27.00
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
S.M,I,-
such projects with a contractors) frcensed pursuant to the Contractor's License Law.).
Grading
❑ I am exempt under Sec B. 8 P.C. for this reason
Driveway Enc.
Date Owner
Infrastructure
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
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL •
318. r5
CERTIFICATE OF EXEMPTION FROM
REMARKS
• 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: N. after making this Certificate, of Exemption you should become ZONE: - •BY: -
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked. Minimum Setback Distances
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.
ATTORNEY'S FEES.
This is a building permit when property 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 theabove 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 purposes, ;
Signature of applicant— Date
Mailing Address
City, State, Zip
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 ,er t
r f�
Validated by: �
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIWU FEES
1ST FL. SO. FT. @ $
UNITS
SLAB GRADE
2ND FL. SD. FT.
YARD SPKLR SYSTEM `
FOR. SO. FT. @
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. @
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT.
GAS (ROUGH) /� ?r /1� METER LOOP
DRAINAGE PIPING
WALL SO. FT.
OTHER APP./EQUIP.
DRINKING FOUNTAIN
SO. FT. @
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.
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(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
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 1 V. c
SEWAGE DISPOSAL
SO.FT.GAR @ 3/ac
HOUSE SEWER
MESH
GAS PIPING
PERMIT FEE
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 UNDERGROUN
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK ROUGH WIRING
DUCT WORK
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH) /� ?r /1� METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
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
�`
looe4�a000�,;7,rO
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 :::]