14418 (RPL)Building i7-2105 -Via Lorca
Address
T4hf 4
P.O. BOX 1504 No. 14418.
78-495 CALLE TAMPICO'
LA OUINTA, CALIFORNIA 92253
Owner
Land eX Nomes
AMOUNT
-
'
MailinAddress
P.O. B'OX $504
Plan Chk. Bal.
.City
Palm"
Desert,
Zip
CA 9226.
Tel. '
346-4289
Contractor
California' Poa3a & Spas
builds or improves thereon..and who does such work hbnself 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-bufider will have the burden
of proving that he did not build or improve for the purpose of sale.) .
AddrfL910 Bodrdwalk A-2' .
,
�y ��
•
city2'alm
Desert:,
% 92213
Te1340
0y90 0
State Lic.
& Classif..
Cr53 185102
City
Lic. # 35.5 -
Arch., Engr.,
Designer
Date owner
Address
Tel.
City Zip State
Lic. #-
LICENSED CONTRACTOR'S DECLARATION,
I hereby aff) m that I ambicensed under provisions of Chapter 9 (commencing with Section
7000) of Div'§ion 3 obtfie Business and Professions Code, and my license is in full force and
effect. fA� /
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number
Legal Description
Project Description P0161 and Spa
Sq. Ft. No. No. Dw.
Size • . - - - ' Stories- -Units
New ❑ Add O Alter q: Repair.0 . Demolition ❑
t! � f "OWNER -BUILDER DECLARATION - '
I hereby affirm than 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
Estimated Valuation,.10 00•00
permit to construct, alter, irprove, demolish, or repairany structure, prior to. its issuance .also
requires the applicant for such permit to file a signed statement -that he is.licensed .pursua-it 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 of Section 7031.5 by 'any applicant for a permit
subjects the applicant to a civil penalty 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 thestructure is not intended or offered for sale. (Sec. 7044, Buisness and
Professions Code: The Contractor's License Law does not .appy to an, owner of property who
PERMIT
AMOUNT
-
'
Plan Chk. Dep.
Plan Chk. Bal.
-
76.05
Const.
117.00 '
McCh:'
- 2_0��
builds or improves thereon..and who does such work hbnself 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-bufider will have the burden
of proving that he did not build or improve for the purpose of sale.) .
EI2CtrICdl
,
�y ��
•
Plumbing
27.00
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 lmproves•thereon, and who contracts. for
• - such projects with a contractor(s) P.censed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec. B. & P.C. for this reason
S.M.L.
_
Grading
Driveway Enc.
Date owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
I hereby affirm that 1 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.)
Pol�'cy if o. Company
6 copy Is filed with the city. ❑ Certified copy is hereby furnished. .
TOTAL
289.05
r
CERTIFICATE OF EXEMPTION FROM ,.
WORKERS' COMPENSATION INSURANCE -
REMARKS
-
-
(This section need not be completed if the permit isfor one hundred dollars -($100) valuation
of 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: 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 peen shall be deemed revoked.' -
ZONE: BY:
- -
Minimum Setback Distances • - .
Front Setback from Center Line
Rear Setback from Rear Prop ..ine
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,
Side Street Setback from Cerner' e
LI
Side Setback from Property LlfTe� .
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
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-.
mentioned property for inspection purposes.:
FINAL DATE
Issued by:
Validated by:
INSPEC�TO \'
Date /permitC
Signature of applicant Date
Mailing Address
Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW FEES
1ST FL. SO. FT. ® $
UNITS
_
SND FL. SO. FT.
ROUGH PLUMB.
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. Ff.
DUCT WORK
DRAINAGE PIPING
WALL SO. FT.
GAS (ROUGH)
DRINKING FOUNTAIN
SO. FT. ®
HEATING (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GAS (FINAL)
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER HEATER
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
WATER SYSTEM
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GRADING
cu. yd.
$ plus x$
LAUNDRYTRAY
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
SO. FT. ® c _
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
SPARK ARRESTOR
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
ROUND PLUMBI
ERGROUND
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 APP.IEOUIP.
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
//''/ (/
QV V_ ( 2 —12 � G�
/
�(��.� ss
REMARKS:
VENTILATION
FIRE ZONE ROOFING '
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL