14812 (RPL)Building
Address 48-»2610 Via Solana
Owner Spalli.6rc
44
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253.
Mailing
Address 5114 Blackbawk Dr.
CityZip Tel.
Datk'��.�.le - 94546 (530) 249-5100
Contractor
Cali forpl a Pools & spa:
A dressf. .
E.e-Ya.0 Soardt ales: A-•2 . .
City Zip Tel.:
Palm Desert, 92211 340-9000
State Lic.C53"b56i�.2� City 3
& Classif. • Lic. #
55
Arch., Engr.,
Designer
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under.provisions of Chapter 9 (commencing with Section
7000) of;Dlvision.3-of the -Business aFid-Protessions.Code, and my license is in full fort -e and
SIGNAru iE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: - (Sec.. 7031.5,Busfness and Professions. Code: Any city or county which requires a.
Permit to construct, after, Improve, demoffsh, or repair any structure, prior to its•Issuance also
requires the applicant for such permit to file a signed statement that h& 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 fora permit
subjects the applicant to a civil penalty of not more than five 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, Suisness 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 cnprove for the purpose of sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
- Strutt 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 contractar(s) (caned 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
Wo is Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) ,
Pofio� No. Company
M 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 the work for which this permit is issued, I shall not -
employ'anyparson in any -manner so as to become subject to the Workers' Compensation
Laws of California
Date " Owner
NOTICE_ TO APPLICANT: ff, after making this Certificate of Exemptions 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 FOWIN 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'adree to comply with all city.and,county ordinances.
rdinances 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. 148112-'
BUILDING: 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 ❑
stimated Valuation $17r200.00
PERMIT
AMOUNT
Plan Chk::Dep. "
Plan Chk. Bal.
122.85
Const.
189.00
Mech.
24.00
Electrical
45.00
Plumbing
27.00
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
407.85 .�
REMARKS .
ZONE: BY:
Minimum_ Setback'Distances:
Front Setback from Center Line
Rear. Setback from Rear Prop. ,'ne
Side Street Setback from C L' e' '
Side Setback from Propefoo--
_
FINAL DATE I N S P
Issued by: - Date��P>i ,
Validated by:�
Validation: .d�
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUVIW FEES
J
1ST FL. SQ. FT. ® $
UNITS
COLL. AREA
2ND FL. SQ. FT.
ROUGH PLUMB.
YARD SPKLR SYSTEM
BONDING
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
SEWER OR SEPTIC TANK
ROUGH WIRING
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (ROUGH)
DRAINAGE PIPING
CAR P. SQ. FT. ®
OTHER APP.IEQUIP.
REINF. STEEL
WALL SQ. FT.
DRINKING FOUNTAIN
SQ. FT. ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
�) /
1
— G_
/
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® IA c
SEWAGE DISPOSAL .
GAR. FIREWALL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
LATHING
GAS PIPING
PERMIT FEE
MESH
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
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEQUIP.
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
�) /
1
— G_
/
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIONATURESIINITIALS
GARDEN WALL FINAL
UFo MEMORANDUM
. CASE: aS- Locations) 6, (its
Request(s):, e�LwcA ,�cc� o^d.47
Your setback adjustment- application is hereby approved, subject to
the following..conditions:
'Conditions:"
Obtain* a- building permit" from the Building and, Safety
Department. F .
2.. The "other Zoning f'Code- provisions -shall be met. '
3. If'ground excavation is,required, please.contact Underground
Service Alert (USA)-at`i-:800-422-4133. The service is free of.
- charge provided USA is given at least two working days'
notice.
4. Additionai Condi.tions:l
'After review it was determined -that:''
1. This adjustment is consistent.with.the-'intent.and purpose of
the Zoning Ordinance: -
2. There are special circumstances applicable to -the property,
including *such factors•,as`- size,. shape, topography,, location or
surroundings that justify approval of the adjustment. These
circumstances' are: �iw�.4� �-,r
Th k yo o your cooperation:
S erel ,
coldu D velopment.Department
:Attachments
c: Building and Safety.Department
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