15578 (RPL)P.O. BOX 1504 No. 15578
Building78-495 CALLE TAMPICO
Address 47-555 Via Houteasa LA QUINTA, CALIFORNIA 92253
Owner Byres
Mailing BUILDING: TYPE CONST. OCC: GRP.
Address same
A.P. Number
.City Zip Tel. - -
La Quinta, C 92253
Contractor
California Fools &- Spas
Address
41-910 Boardwalk Ste. A-3
CAf. Desert, alp 92260 TeJ_ 0-9000
State Lica
City
& Classif.- . ' 655178
Lic. # :355
Arch., Engr.,
Designer
Address
Tel.
City
Zip
State
No. Dw.
Units
New ❑ Add ❑ Alter ❑
Lic. #
T; LICENSED CONTRACTOR'S DECLARATION
I hereby affirrti<that 1 am licensed under provisions of Chapter 9 (commencing with Section
D00) of Division 3 of the Business and Proffessiohq Code, and my license is in full force and
ffeCL N7 t o t `4.o i.f'T ,�E+11", 7
. OWNER -BUILDER DECLARATION '
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason:. (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish; or repair any structure, prior to Its issuance also
requires the applicant for such permit to file a signed statement that he Is licensed pursuant to
the provisions -of the Contractor's.Ucense Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that. he is exempt therefrom, Viand the basis
for the alleged exemption. Any violation of Section 7031.5 by any applicant ,for a permit
subjects the applicant to a civil penally of not more than five hundred dollars ($500).
❑ 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. 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.)
❑ I, 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 c:mtracts for
such projects with a contractors) #caned pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
1 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. 3600, Labor Code.)
Policy No.: Company
[a,Gepy is filed with the city, ❑ 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.)
I certify that in the performance of the work for which this permit is issued, I shall not
employ any pperson in any manner so as to become subject to the Workers' Compensation
Laws of Calnfornia-
Date Owner
NOTICE TO APPLICANT: -g, alter 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 property filled out, signed -and validated; and.is subject to
expiration if work thereunder is suspended for 160 days.. . •
I certify that l 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-.
mentioned property for inspection purposes. _
Signature of applicant Date
Mailing Address
City, State, Zip
Legal Description
(Project Description
Foal and .Spa
Sq. Ft.
Size -
No.
Stories
No. Dw.
Units
New ❑ Add ❑ Alter ❑
Repair ❑ Demolition ❑'
Estimated Valuation
$10 00.40
PERMIT
AMOUNT -
Plan Chk.'Dep..•
Plan Chk. Bal.
76.05
Const.
'V17.00
Mech.
24.00
Electrical- ,f
45.00
Plumbing
27,00
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
289., 05
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback4rom=Center Line
Side Setback From PropertyLine,
FINAL
L ne-
FINAL DATE %ECTO
Issued by: `Date Perm
i�
Validated by: o \ Z
Validation: \ ��`s/l/
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW FEES
1ST FL. SQ. FT. ® $
UNITS
ROUGH PLUMB. BONDING
2ND FL.SQ. FT.
STORAGE TANK
YARD SPKLR SYSTEM !
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. I SQ. FT.
REINF. STEEL
DRAINAGE PIPING
WALL SQ. FT.
DRINKING FOUNTAIN
SQ. FT. ®
FINAL INSP.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
FINAL INSP.
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
LUMBER GR.
FLOOR DRAIN
MECHANICAL FEES
/ 96>1
/U L
I
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FIRE ZONE ROOFING
LAUNDRYTRAY
AIR HANDLING UNIT CFM
FIREPLACE
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
MESH
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1'A c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3yac
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 EtTRICAL HEATING & AIR COND. SOLAR
9 1 30
SETBACK
GROUND PLUMBIN 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) METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
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
/ 96>1
/U L
I
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL