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P.O. BOX 1504 No. 15543
Building 78-495 CALLE TAMPICO
Address 48-045 Via Vai.le_rta LA QUINTA, CALIFORNIA 92253
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Mailing
Address P.A. Box .1716
City Zip Tel.
La Quintalf CA 92253 619)771-x941
Contractor i onstrucrca.cn manaiger
Construction, Inc,
Address
P.O. Box 1
city La Quinta, C& zIp 92253[619)771-1941
State Lic. City
& Classif. B 674074 Lic. # 2996-
Arch.,
996.Arch., Engr., - .
Designer Pekarek Crandell Inc.
Ad2d gST2 Butcher Drive1710837 -9050
City Izip State
Lake Forest, VA 92630 Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with. Section,
700% of Division 3 of -the -Business and -P fessions Code, and my license is in full force and
effect �.: J A -t'.
RsIGNATURE-`1 7 A .t'4 77 1T 9tiii[ A DATE
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License law for the following
reason: (Sec. 7031.5,8usiness and Professions Code: Any city or county which requires a
permit to construct, after, 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 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 inprove 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) licensed pursuant to the Contractor's License Law.) . .
❑ 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
er
Work's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
M opy Is filed with the city. ❑ Certified copy is hereby furnished.
r CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed If the permitis for one hundred dollars ($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: M, 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 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 ($100,000), IN ADDITION TO THE.COST OF COMPENSATION,
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
This is a building permit when properly filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 180 days.
I. certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this city to enter the above•:
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
BUILDING: TYPE CONST. VN OCC: GRP. R3
A.P. Number ..649-6380-001
Legal Description Lot 1 Tract 27835
Project Description SPA "C$sit$S* Duplex Plait A
Rancho La' Quinta
Sq. Ft. No. No. Dw.
Size 1725 Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation $146o192.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
664.29
Const.
804.00
Mech.
68.50
Electrical
133..22
Plumbing
156.00
S.M.I.
14.62
Grading
20.00
Driveway Enc.vtri
Infrastructure
3o229.44
Arts in Public Places
115.48
TOTAL -- - -- -
- 5,205.55
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Lin`
Side Setback from Property Line
FINAL DATE INSPEC OR -� I
tee% r�
Issued. by: Date Permit.,
Validated by: -� ( --
Validation: ZZO
O%
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES-
EES1ST
ISTFL. SO. FT. ® $
UNITS
COLL. AREA
2ND FL. S0. FT.
ROUGH PLUMB.
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT.®
POWER OUTLET
ROOF DRAINS
CAR P. S0. FT.
ROCK STORAGE
DRAINAGE PIPING
WALL S0. FT.
/y
AS (ROUGH) ,—k l
L ry
DRINKING FOUNTAIN.
SO. FT. ®
OTHER APP./EQUIP.
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
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
WATER SYSTEM
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
RAMINGINAL
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
FIRE ZONE ROOFING
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1 Ya c
SEWAGE DISPOSAL
SPARK ARRESTOR
SO.FT.GAR ® 3/ac
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 ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
qAT OUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
B GRADE _
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
'
EW OR SEPTI 3
ROUGH WIRING
DUCT WORK
ROCK STORAGE
�AUND. REINF _
_ {/Y
L
/y
AS (ROUGH) ,—k l
L ry
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
CU. yd.
$ plus—x$—=$
LUMBER GR.
AL INSP. 6
RAMINGINAL
INSP
ROOFING!
- 0
1Q. w.✓ �I-�.C.
01�� 6'�l
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
THING 3-
MESH
SULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL