14592 (RPL)-
P.Q. BOX 1504 No. 14592
Building 47-060 Via Lorca 78-495 CALLE TAMPICO
Address LA QUINTA, CALIFORNIA 92253
Owner Landrex ,
Mailing '
Address 47x345. Via Ravenna
City Zip Tel.
..La Quinta. CA' .92253 564.-5407
Contractor .
Calkfarzii Pools & Spas
Address
.4.1-=910 Boardwalk A-?
CPalm ityAp 922 1 Te340-9000
State Lic. City
& Classif.. -C-53 185102 Lic. # 335
Arch., Engr., _ .7—
Designer .Designer
Address Tel.
BUILDINGS TYPE CONST. OCC. GRP.
A.P. Number
Legal Description
Project Description Pool and Spa
Sq. Ft. No. No. Dw.
Size Stories Units
New ❑
Add ❑
Alter ❑
Repair ❑
Demolition O
City
.. .
Zip
State
Lic. #
LICENSED CONTRACTOR'S OECLiRATION
I hereby affjFmlthat I am licensed under provisions of Chapter 9 (commencing with Section .
4 3f000) of Div,'((slon 3 of the Business and Professions Code, and my license is in full force and,
7 effect• /! i
d
SIGNATURE6 ! DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: ,(Sec. 7031.5,Business .arid- Professions, Code: Any ,city or county which requires 'a
permit do construct, atter, Improve, demolish, or repair any structure,. prior. to its issuance- also.,
,requlres 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 3 of the Business and -Professions Code, or that. he is exempt therefrom, and the basis
for the alleged exemption. Any violation or Section 7031.5 by .any -applicant for a permit
subjects the applicant to a civil penattyof not more than rive hundred dollars (8500).
❑ 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 contracts for
such projects with'a contractor(s).(lcensed pursuant to the Contractor's License Law.)
❑ I am exempt under Sec. B.•& P.C. for this reason
Estimated Valuation f�
p��°� •�
-
PERMIT AMOUNT
-
Plan Chk: Dep. -_
Plan Chk. Bal. 700.. 20
COf1St. iL' . 00
Mech. '
2
y$,, I�iy
Electrical 45.00
Plumbing 27.00
-
S.M.1.
Grading
Driveway Enc.
Date
Infrastructure
pOwner
r 1 WORKERS' COMPENSATION DECLARATION
' I herebytiffimi that I have a certificate of consent to self -insure, or -a certificate of
Worker's �Corepgn6tion Insurance; or a certified copy thereof: (Sec. 3800, Labor Code.)
Policy(N'o.1,r Company
' Copy & 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 (S 100) valuation
or less.')
I certify that in the performance of thg-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., If, after making- this Certificate of Exemption' you. should, become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
with such provisions or this permit shall be deemed revoked.
-
TOTAL 274.20
REMARKS'
ZONE: BY: -
-MIf11R1Ur11 Setback Distances,.comply
Front Setback from Center Line
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.
Tt4 is a b0ding'permit when properly filled out, signed and validated, and is subject to
expiration if 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-.
mentioned property for Inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
Rear Setback from Rear Prop. Line
Side.Street Setback from Center Line' '
Side Setback from Property.Lin.e
FINAL DATE INSPECTOR
Issued by: - Date fy
Validated by:Zr I t� .
Validation: i I I ,
b
13Y
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
x'
2ND FL. SQ. FT.
BONDING
YARD SPKLR SYSTEM
POR. SQ. FT.
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CARP. SQ. FT.
GAS (ROUGH)
DRAINAGE PIPING
WALL SQ. FT.
OTHER APPJEOUIP.
DRINKING FOUNTAIN
SQ. FT. ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
GAR. FIREWALL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
LATHING
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
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH)
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.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING '
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION �Q S
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL