15103 (RPL)QUM&
• �� �' � P.O. BOX 1504 No. 5103
Building 78-495 CALLE TAMPICO
Address 47-995 Via Firenze LA QUINTA, CALIFORNIA 92253 fCt;
Owner ,
Salnatcy
BUILDING`
e Coastarce.xzi
Mailing .' TYPE CONST. • OCC: GRP.
Address 4'7--995 Via Firenze
. A.P. Number
Tel:
City Zip
La ainta' 9.2253 360-7064 Legal Description
Contractor Project Description' Poor fi .Spa
Dodson Pools
Address
6$4805 A Perez Rd E9-
city.Zip
Tel.:
Catherdral City
92234
324-1.232
State Lic.
City
&C
5743.27
Lic. #
1044
Sq. Ft. No. No. DW.
Arch:, Engr.;
Size Stories Units ,• '
"
R
Designer
New ❑ 'Add O . Alter D. Repair O . 'Demolition ❑
Address
TeL
' City "
Zip
State" '
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed undeyprovisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business Professions Code,
and and my license is in -full force and
'effect. LL--�.� (5M1,-
,.,--41 ,.y¢
SIGNATURE A' - DATE
OWNER -BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License law for the following
Estimated Valuation
$16.000.00
- reason: (Sec. 7031.5,Sustness 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 rile 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
- 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 penally of not more than rive hundred•dollars ($500)" --
Plan Chk. Bal.
p 1, 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
COr1St. 12.'00
'
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. X24., (j
. provided that such improvements are not intended or offered for sale. If, however,. the burlding
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 or sale.)
• v
O'I, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing $27.00'
struel the project.- (Sec. 7044, Business and .Professions Code: The Contractor's License Law
does notapply to an•owner of propertywhobuilds or improves thereon, and, who contracts for
such projects with a contractors) pcensed pursuant to the Contractor's License Law.)
.
Grading
❑ F am exempt under Sec - B. 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 C 5
CERTIFICATE OF EXEMPTION FROM
REMARKS'7i
WORKERS' COMPENSATION INSURANCE
(This section need "not be completed it the permit is for one. hundred dollars ($100) valuation
f4-
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., ff, 'after making ,this Certificate or 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. - -
ZONE: " BY:
Minimum Setback Distances:.
Front Setback from,C r Line
Rear Setback fr ` ar Pro e.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND
Side Street S back fronrT Cente Ine
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,.
Side Setback ffgm Propee6t
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
Ine
y
ATTORNEY'S FEES.
/ f
This is a building
g permit when'properly filled out, signed and validated; and is subject to
expiration if work thereunder is suspended for 160 days.
V
FINAL DATE PECTOR
r iyQ
• I certify that I have read this application and state that the above information•is correct:
j
ISSued.by: Date f PerrrFjr
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
r
.•above•:
mentioned property for inspection purposes . -
Validated by-
Signature of applicant Datey
Mailing Address
Validation:
City, State, Zip '
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
1ST FL. SO. FT. ® $
2ND FL. SQ. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. SQ. FT.
WALL SQ. 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. BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP.IEOUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
GAS (FINAL) TEMP. POLE
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
FRAMING
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 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 PLUMBING S, g UNDERGROUND9�
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) S/�� 9s METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
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
�/ �
7/g f
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIONATURESIINITIALS
GARDEN WALL FINAL
u s.
440
of MEMORANDUM
,y n+�
CASE: 95= 319 Locations) . «7� ��`i5,�.f iti :.ran'/�dl<< L.• C"�
Request(s):
Your setback adjustment application is hereby -approved subject to
the following conditions:
conditions
1: Obtain a building permit ' from the. Building and. Safety
Department.
2. The other Zoning Code provisions shall be met.
3. If ground excavation is required, please contact Underground,.
_Service Alert (USA) at 1-800-422-4133: The service is free of
charge 'provided USA is given at least two. working days'
notice.
4. Additional Conditions: h�••,��n sal-b�,�1c. sl.� .
After review it was determined that: ;
1. ~This adjustment is consistent -with the intent and purpose of
the Zoning Ordinance.
2.. There are special circumstances applicable�to the property,
including such factors as size, shape, -topography, location or
surroundings that justify approval of the adjustment. ':These
circumstances are: rY Yeo,r-
.Thank you your cooperation.
sirke
_ y=chments Comm it
CommDevelopment•Department
A ,
c: Building and Safety Department '
U_ OUT INTMA,
2 & i) T �'.,OP':+F2.'T DEP
.3 r i'P?rNT
�PPL,1, X11"ON. POR. SETMP%M� A:J�;s�MrN�
,%sE
FSE: 5100.00
�.� i5 �
T*
..r►: a�`u;::�l'1 t7'formLrl�h two COD;e5 f a scared -i-e
^_Lilcri,
=raw:: to adequately depica .the nature of _he reuuast. narxefuna:.ie
fee cf 1=00 is requi. ed chen the kpp'_ caticn is Sul-, T 't -ted. Check be
make parable to the "Cts° 'of La k,uin
If the Applicant is not. the Darer of the rC,;�~-y jet-,Ze.r �+._ s +-.
surxr-: =L the c ne. aut'hlor 1Z_ng the i pU; icart to exe. }? ~ �t
1 c •.
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LEGAL DESCRIPTION OF PROPERTY: LC:'
ASSESSOR'S Pei RCEL h'UILYMER:
Ar-T.U.C2.71=4T U
REQESTED: CK )
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REAjON FOR REQUEST: avA 2R� i.� Mc r-
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**.*************************•************x****'**x***********ri.71 ***K******9***
,T'JSTIFICATION: No request for a Setback Adjust' mert shill be granted
unless it is determined that it is consistent with the int:and and purpose
of this orainan.ce; that -here are,speciai circumstances applicable to .the
property, including suc:: factors as size, shape, tonography, location or
sur-roundings that justify the approval of the adjustment of the setback
requirement, and that the. adjustment wsll not be detrimental to the
health, safety, and general welfare of the community or be detr{mertGI to
property in'the- P.rea of the parcel for which 'the adjus`merit is requested.
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STREET' hDiF SS or PROPER.—Ln LI) - 9Ci5yiq Fr.2F..� 1 �P� aAk�e Ce F
LEGAL DESCRIPTION OF PROPERTY: LC:'
ASSESSOR'S Pei RCEL h'UILYMER:
Ar-T.U.C2.71=4T U
REQESTED: CK )
A Ac)ST--n Th
-�^ r, S �'VI i ,✓i w. M S F �'ki _ A l Cp...) '
- SDA L --i SN OZ,4[L 91vCi L—A It
REAjON FOR REQUEST: avA 2R� i.� Mc r-
**.*
**.*************************•************x****'**x***********ri.71 ***K******9***
,T'JSTIFICATION: No request for a Setback Adjust' mert shill be granted
unless it is determined that it is consistent with the int:and and purpose
of this orainan.ce; that -here are,speciai circumstances applicable to .the
property, including suc:: factors as size, shape, tonography, location or
sur-roundings that justify the approval of the adjustment of the setback
requirement, and that the. adjustment wsll not be detrimental to the
health, safety, and general welfare of the community or be detr{mertGI to
property in'the- P.rea of the parcel for which 'the adjus`merit is requested.
rOptN. 013/CS