15595 (SATT)P.O. BOX 1504
Building 78-495 CALLE TAMPICO
Address 48-0i5 Via Va11arta LA OUINTA, CALIFORNIA 92253
OWneeVeLl. vesert ueveioUment~
Mailing
Address P.O. BOX 1716
City Zip Tel.
La Quint�I, CA 9225319} 771-1.911
ContractorlunUrrucr-1011a ritSJr2ager
Sparks Construction, Inc.
Address
P.C. Box 1716
CityZip Tel
,La Quintap Cid 91-2.53 [619)771-1,94l
State Lic. City
& Classif. g 674074 Lic. # 2996
-Arch., Engr.,
Designer Pekarek Crandell. Inc.
A:GY$S 12 Birtchar Drive 171_1 01337-9050
City Zip State
Lake Forest, ;A 92630 Lic. #
iLICENSED CONTRACTOR'S DECLARATION
I hereby affirm thafl am 1'icensed undeiprovisions of Chapter 9 (commencing with Section
7000) o ,,
f Division'3 of the Business and Professions Code, and my license is in full for6era`nd
teffedt:i Yl� 4 -
SIGNATURE -ii"" r J J 47 f Pz^"wz, 4r"' 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 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 rile 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 of Section 7031.5 by 'any applicant for a permit
subjects the applicant to a civil penalty or 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
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
orimprovement is sold wither one year of completion, the owner -builder will have the burden
of proving that he did not build or 'reprove 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) Pcensed pursuant to the Contractor's License Law.)
O 1 am exempt under Sec B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worke ps Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
PorlicyfNo. Company
E L'Copy 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 thF 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.
Oati 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 mus" 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 180 days.
I certify that I Have read this application and state, that the above information is cored.
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
No. 15595
BUILDING: TYPE CONST. -VN � OCC. GRP. R3
A.P. Number 64.9'380--001
Legal Description Lot'l Trait 27835
Project Description SPA "Caritas" Duplex Pian A
Rancho La Quinta
Sq. Ft.
Size 1725
No. No. Dw.
Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation $146,192.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
664.29
Const.
$04.30
Mech..
68.50
Electrical
133.22
Plumbing
156.00
S.M.I.
14.62
Grading
20.00
Driveway Enc.
00
Infrastructure
3,229.44
Arts in Public Place 115.48
TOTAL
5.205.55
REMARKS
ZONE: - BY:
Minimum Setback Distances:
Front Setback from Center.Line
Rear Setback from Rea�P op. Line
Side Street Setback from Center Line
Side Setback from fProperty Line'
FINAL DATE-INSPECTORy
Issued by: Date ^ , ` �vPermit
Validated by:
Validation:
r .•' r
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW FEES
1ST FL. SO. FT. @ $
UNITS
SLAB GRADE ,q </
2ND FL. SO. FT.
YARD SPKLR SYSTEM
POR. SO. FT. @
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. @
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT.
AS (ROUGH) a - (j, 1' Q1S METER LOOP '
DRAINAGE PIPING
WALL SQ. FT.
OTHER APPJEQUIP.
DRINKING FOUNTAIN.
SQ. FT. @
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.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
/
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
i