14948 (SFD)t'
Atyl 4
P.O. BOX 1504 -
Building 78-495 CALLE TAMPICO
Address 47•'9616 Via Firenze LA OUINTA, CALIFORNIA 92253
Owner @ itt'& SG1i�S ;4.4
"'& I.rAT- W2
11LDING: TYPE CONST. ` - OCC: GRP.
R. Number $17— 9.0-010
LOt 10 tract 26152
:gal Description
oject Description
Spinnaker .Cove At rake La Quin a
No. 14948
Address 1535 South "D" Street
City Zip Tel.
.flan Bernardino CA 92:488 (909) 391-5007
Contractor
Sante
Address
City
Zip
Tel.:
employ any parson in any manner so as'to become subject to the Workers' Compensation
Laws of California.
State Lia
City "
& Classif. • B 3.144.73
Lic. # 2120 .
Arch., Engr.; �L"Ei>Ik . �vtln?.a eS t
-Designer .
ASSOCiates
tyns za'st ChApI�n Are.
Tel
City
Otanige, AJ'
Zip
92666
State
Lia #
„ I/ LICENSED CONTRACTOR'S DECLARATION .
I here affirm that I am Iicensed�url'der-0f- sions of Chapter 9 (comiPencing with Section
7000) of Divisjori the BqN€€sss and` Professions Code, and my liceffse is iri full force -and
bWNEWBUILDER DECLARATION
I hereby affirm that am exempt from the Contractor's License Law for the following
'reason: (Sec. 7031:5,Bustness and Professions Code: Any city or county which requires a
permit to construct, atter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to rite 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 that: he 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 rive hundred dollars ($500).
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
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. !f, 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.)
b 1, 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 contractors) (tcensed pursuant to the Contractor's `cense Law.)
❑ 1 am exempt under Sec. B. & P.C. for thid reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's�mpensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Poll cy� Company
®!Copy is filed.with the city; . O 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 )
Sq. Ft. No. No. Dw.
Size • l040 Stories -Units
New ❑ Add O Alter O Repair O Demolition p.
Estimated Valuation$110,124.00
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
Arts -in Public '11
TOTAL
REMARKS
AMOUNT
578.35
�7�•v 00
f 62.00
•138.32
144. via
. v w
2.477.79-
.
I certiry that in the performance of the work for which this permit is issued; 1 shall not
-
employ any parson 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 becoma
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:"
Front Setback from Center Line
Rear Setback from Rear Prop. L'
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL, AND
•SHALL
Side Street Setback from Ce ne
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP. TO ONE
' .HUNDRED THOUSAND DOLLARS ($100.000), IN ADDITION TO THE COST OF COMPENSATION,
Side Setback from Propert
DAMAGES AS PROVIDED FOR IN SECTION 3706.OF THE LABOR CODE, INTEREST, AND
Q
ATTORNEY'S FEES.
This is ti building permit when properly filled out, signed and validated, and is subject to
FINAL DATE
INSP QTOR '9
expiration if work thereunder is suspended for 180 days..
I that I have
O•
certlfy read this application and state that the above information is correct.
Issued by:
Date Permit
1 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 for inspection
/
\
property purposes.
Validated by:
U'
Signature of applicant Date
Mailing. Address
Validation:
City, State,. Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW FEES
IST FL. SO. FT. ® $
UNITS
COLL. AREA
2ND FL. SQ. FT.
ROUGH PLUMB.
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. I SQ. FT.
DUCT WORK
DRAINAGE PIPING
WALL SO. FT.
GAS (ROUGH) �a3
DRINKING FOUNTAIN
SO. FT. ®
HEATING (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GAS (FINAL)
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER HEATER
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
WATER SYSTEM
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GRADING
Cu. yd.
-Plus-X$-=$
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FINAL INSP. .3
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.
SQ. FT. ® c
BATH TUB
FIRE ZONE ROOFING
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SPARK ARRESTOR
SQ.FT.GAR Q 3/ac
HOUSE SEWER
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 PLUM
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS l�
EWER 0 S
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.�I�J L)
vv
GAS (ROUGH) �a3
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. .3
FRAMING �
FINAL INSP.
ROOFING 9S
✓
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04)
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING /7
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL