14693 (RPL)Building
Address
1
P.O. BOX 1504
78-495 CALLE TAMPICO -
47-515 *Tia FinrAnna LA QUINTA, CALIFORNIA 92253
Maili%Fa;ls Dr.Addr,Ani
.City Zip Tel.
Palm Deserts - Q 92260 340-
Contractor
40-
Contractor
l ;Boa'... dvaInt
City Zip
Palm Desert., C A
State Lic.
&'Classif: .
-Arch., Engr.,
'Designer -
Address
Tel.:
32260 34
City
Lic. #
Tel.
City Zip State
No. 14693
BUILDING: TYPE CONST. OCC: GRP
A.P. Number
Legal Description .
Project DescriptionPool and Spa*
Sq. Ft. No. No. Dw.
Size - Stories • Units
New ❑ Add ❑ Alter ❑ Repair' ❑ Demolition ❑
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 thg work for which this permit is issued, l 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: If, 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
ATTORNEY'S FEES.
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-.
mentloned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
AMOUNT
70.20
108.00
24.00
45.00
27.00
274.20
REMARKS
ZONE:
BY:
Ic.
LICENSED CONTRACTORS DECLARATION...
I hereby affirm that I am licensed u�r der provisions of Chapter 9 (commencing with Section. .
.�)�77000) of Division 3 of tfie Business and Professions Code; and my license is in full force and
Iigffect:.
Rear Setback from Rear Prop. Line
SIGNATURE .F ell DATE
Side Street Setback from Center,Line
` OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5•8uslness and Professions Code: Any city or county, which requires a
permit to construct, alter, improve, demolish, or repair any structure; prior to itsissuance also
requires the applicant for such permit to file 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 9 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). -
.O 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
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.)
O 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) #tensed pursuant to the Contractor's License -Law.)
O I am exempt underSecr B. & P.C. for this reason
Side Setback from Property/Gine
INSPE O11 �� 1
Date Pe mit. v
/A ! /_
Estimated Valuation. $-9,,000.00
-
-
PERMIT '
_
Plan Chk., Dep. -
Plan Chk. Bal.
Const.
Mech.' - -
EIBCtfICal
Plumbing
S.M.I..
Grading
Driveway Enc.
Date Owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
,affir that I have a certificate of consent. to self -insure, or a certificate of
I hereby�6r
Workers or a certifiedcopy thereof. (Sec.•3900, Labor Code.)Policy Npany
op❑ Certified copy is hereby furnished.
I
TOTAL
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 thg work for which this permit is issued, l 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: If, 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
ATTORNEY'S FEES.
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-.
mentloned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
AMOUNT
70.20
108.00
24.00
45.00
27.00
274.20
REMARKS
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/Gine
INSPE O11 �� 1
Date Pe mit. v
/A ! /_
FINAL DATE
Issued by:
Validated by:
Validation:\
CONSTRUCTION ESTIMATE r
NO. ELECTRICAL FEES
NO. PLUMBIW FEES
1ST FL. SO. FT. ® $
UNITS
COLL. AREA
2ND FL. SD. FT.
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. @
POWER OUTLET
ROOF DRAINS
ROUGH WIRING
DUCT WORK
DRAINAGE PIPING 7
CAR P. SO. FT. ®
GAS (ROUGH)4'A1, 4�
WALL SO. FT.
HEATING (FINAL)
DRINKING FOUNTAIN
S0. FT. ®'
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GRADING
cu. yd.
$ plus x$
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
�JyJ / p
��.{I� Zf 7� INAL INSP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
ROOFING
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.
SO. FT. ®c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SPARK ARRESTOR
SO.FT.GAR Q 3/ac
HOUSE SEWER
GAR. FIREWALL
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
UNDERGROUND
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)4'A1, 4�
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
�JyJ / p
��.{I� Zf 7� INAL INSP.
FRAMING
FINAL INSP. 3�P/0
ROOFING
L� �
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