14610 (RPL)tIG�Ct/
w b (:i�4 414
P.O. BOX 1504 No. 14610
Building78-495 CALLE TAMPICO.
Address :47 _ 050 , via Lorca LA OUINTA, CALIFORNIA M53 .
Owner aandrex, Homes
Mailing
BUILDING: TYPE CONST. OCC: GRP...
Address 78-710 Via Avante
A.P. Number
City Zip Tel.
eta . Qumist CA 92253 564 -5407 -'Legal Description
ContractorPOLI and Spa
Cc" 1ifbtn Pool -s * fi Spas Project Description
Address Lake Sia: Quin a .. -..
43-910 Boardwalk t-2
City Zip Te
Pa'�1Eii De.�ertg 9.22$0 0-9000
State Lic. City
& Classif.. t-53 185102 Lic. # 355 Sq. Ft. No. No. Dw.
,.
Size = Stories ..-Units
-Arch., Engr.,
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition'❑
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION -
I hereby affirmlthat t,am licensed under. provisions of Chapter.9 (commencing with Section
e000) of DNisipon 3 ofdhe Busfoeas.and�Professions Code, and my'Iicense.is in full force and.
ffect..
ff'�� SIGNATUREr J ! DATE
OWNER BUILDER DECLARATION.
;i Estimated Valuation �` f►A
I hereby affirm tha_ I gm•exempt from the Contractor's License Law for the following - r ♦ v vo .-00
reason: (Sei! 7031; 5,Ruslness. and Professions. Code:.Any city or county_ .which- requires's ,
permit to construct, afteWimprove, 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 ds 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 civit penalty of not more than rive hundred dollars ($500).. Plan Chk. BBI. 70.20
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will yA
do the work, and the structure is not intended or offered for sale. (Sec: 7044, Buisness and Const:1 Oey • 0AA
Professions Code: The Contractor's License Law does not apply .to an owner, of property -who v
builds or improves thereon and who does such work himself or through. his own employees, Mech. a
provided that .such improvements are not. intended or offered for sale. It, however, the building ' -
00
or improvement is sold within one year of completion, the owner -builder will have the burden EleCtrlCaf4-5.00
of proving that he did not build or enprove for the purpose of sale.) .. . .
❑ I, as owner of the property, am exclusively contracting with.licensed contractors to con- Plumbing 27 . 00-
struct the project. (Sec. 7044, Business and -Professions Coder The Contractor's 'License Law - -
does not apply to an owner of propertywho builds. or improves thereon, and who. contracts for S.M.I.
such projects with a contractor(s),(lcensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec > • B. & P.C. for this reason Grading
Driveway Enc.
Date owner Infrastructure
/y WORKERS' COMPENSATION DECLARATION .
I hereby afft tri tal/kive a:certificate of consent to self -insure,' or a certificate.of
Worker's Compe�}� ion Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.).
Policy No-.--, .Company '
[Joldopy is_d4d with the city, .. ❑ Certified copy is hereby furnished.
' f TOTAL 274, Tse
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.- ft, after making this' Certificate of Exemption you should become _ ZONE: BY:
subject' to the 'Workers' Compensation provisions of the • Labor Code, .you •must forthwith - MInImUfTI Setback Distances:
comply with such provisions or this permit shall be deemed revoked.
Front Setback from-CenterLine
Rear Setback from Rearoine
WARNING: FAILURE To SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND N
SHALL SUBJECT AN EMPLOYER TO CRIMINAL'PENALTIES AND CIVIL -FINES UP TO ONE Side Street Setback/fl Gente Line
HUNDRED.THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, Side Setback fro6�PropertyI
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, .INTEREST, AND
ATTORNEYS FEES.
This is a building permit when properly filled out, signed and -validated, and is subject to FINAL DATE INSPEC�D�fi
expiration if work thereunder is suspended for 180 days. �y
I certify that I have read this application and'state that the above Information is correct Issued b Dates r^erR3J;
I agree to comply with all city and coup y' - iy
9 P Y h e ordinances f this acct 'to relati r the
building \ 19s
construction, and hereby authorize representatives got. this .city 'to' enter .the .above-.; - \\
mentioned property for inspection purposes. Validated by:
Signature of applicant Date
Mailing Address Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
IST FL. SO. FT. ® $
UNITS
SLAB GRADE
2ND FL. SQ. FT.
BONDING
YARD SPKLR SYSTEM
STORAGE TANK
MOBILEHOME SVC.
BAR SINK
FOR. SQ. FT. ®
DUCT WORK
ROCK STORAGE '
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
OTHER APPJEQUIP.
DRAINAGE PIPING
CAR P. SQ. FT.
TEMP. POLE -
WALL SD. Fr.
GROUT
DRINKING FOUNTAIN
SQ. FT. ®
FINAL INSP.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
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
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
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
GAR. FIREWALL
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1+/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ic
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE HPL.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)
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.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION IJJs
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIONATURESJINITIALS
'
GARDEN WALL FINAL