14557 (RPL)P.O. BOX 1504 No. 14557
Building 40-320 �i is Solana LA QUINTA, CALIFORNIA 92253
Address
Owner T. i), Deserve Development
'Mailing[ BUILDING: TYPE CONST. OCC..GRP...
Address P.O. Box 1726 A.P. Number
City Zip Tel.
La Quirli.t ? E:A 9 5� 772=-T94� Legal Description .
Contractor. Project Description—_: -.0 -SM Spa .
Cali �t�lrnla Fools & Spas
Ades .-
�a2yiit I)@S@�t� Culp $2221 Tel340-9®0{1
State LiCity 6515128city 35. .
&Classif... . Lic. # Sq. Ft. No.. No. Dw.
Arch.,'Engr., -
Size Stories Units
Designer New ❑ Add ❑ Alter ❑ Repair ❑` -Demolition ❑
Address Tel.
City ( Zip ( State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I heietiyy-'affirm..that I am licensed�uoder:provisions of Chapter 9 (commencing with Section
7000) of'D'vision 3:ofthe;Bifsiness:and'Professiong Code, and my licens t m full'force a d
effect.„ •"^- t s.
J _SIGNATURE 'g�• i DATE
'9`
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, atter, improve, demolish,. or. repair any .structure, prior to its issuance also
requires 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 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 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 propertywhobuilds or improves, thereon, and who contracts for.
such projects with a contractors) pcensed pursuant to the Contractor's License Law.)
❑ It d S
am exemp un er ec. B. & P.C. for this reason
Driveway Enc.
. Date Owner.
Infrastructure
WORKERS' COMPENSATION DECLARATION
Estimated Valuation $8 000.00
PERMIT :,
AMOUNT
Plan Chk.. Dep.
Plan Chk. Bal.
64.35
Const. •
- a 0
Mech.-
24.00
Electrical
tis. 00
Plumbing
27.00
S:M.I.
Grading
-
am exemp un er ec. B. & P.C. for this reason
Driveway Enc.
. Date Owner.
Infrastructure
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I 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.)
Policy No. Company
❑ Copy Is filed with the city,. ❑ Certified copy is hereby furnished.
TOTAL
259.35
_
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
REMARKS
-
(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 th0 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 or Exemption you should become ••.
subjeci to the Workers' Compensation provisions of -the Labor Code;- you must forthwith
comply with such provisions or this permit shall be deemed revoked.
ZONE: BY:
• ' '
Minimum Setback Distances: •
Front Setback from Center Line
Rear Setback from Rear Prop. Line
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL, AND
' SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
Side Street Setback from Center Line
HUNDRED THOUSAND DOLLARS -($100.0D0), IN ADDITION TO THE.COST-OF COMPENSATION, -
Side Setback from Property Line
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 if work thereunder is suspended.for 180 days.
FINAL DATE
INSPECTOR
- I certify that'( 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
Issued by:
Validated by:
Date Per ,its
�.I D I�
JAN 2 0 1995
Mailing Address
Validation:
' City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING. FEES
1ST FL. SO. FT. ® $
UNITS
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
YARD SPKLR SYSTEM
2ND FL. SO. FT. ®
HEATING (ROUGH)
,
FORMS
MOBILEHOME SVC.
BAR SINK
FOR. SO. FT. ®
DUCT WORK
ROCK STORAGE
FOUND. REINF.
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
DRAINAGE PIPING
CARP. SO. FT.
WALL SO. FT. ®
WATER HEATER
DRINKING FOUNTAIN
SERVICE
FINAL INSP.
URINAL
SO. FT. ®
WATER SYSTEM
ESTIMATED CONSTRUCTION VALUATION $
GRADING
cu. yd.
$ plus x$
WATER PIPING
NOTE: Not to be used as property tax valuation
I
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
REMARKS:
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, 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
MESH
SO.FT.GAR ® 3/ac
HOUSE SEWER
INSULATIONISOUND
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
ROCK STORAGE
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.
I
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
_
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Q
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