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11857 (RPL)r Building Address 77-'424 viaba Rosa Owner Terry Moores Mailing Address Slarve, City Zip La Quinta, CA 92253 ` 'Contractor "JDS. Constructgftm Address 73--426 1rontree Dr. c;tIn Desert, Or ip 92260 State Lic. & Classif. 5292.31 —Arch., Engr., • i44Q . P.O. BOX 1504 N O . 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 BUILDING: TYPE CONST. OCC: GRP.: A.P. Number Legal Description Project Description Pooh ,dna Spa Te568-4989 City Lic. # Address I Tel. City (Zip (State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm thaPl,am licensed under provisions of Chapter 9 (commencing with Section 70 000)fecof.Division 3 oo.Gt_he Business and Professions Code, and my license is in full force and eft _SIGNATURE DAT 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 ori 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 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.) ❑ 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 improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's. License Law.) ❑ I am exempt under Sec. B. & P.C. for this reason Date ' Owner 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.) Policy No. Company 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 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: 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 permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address 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. 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 ateMailing Address City, State, Zip 1.857 ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Sq. Ft. Size No. Stories No. Dw. .. Units a New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: Estimated Valuation 2p0©Q.Cfi PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. 140.40 Const. 236..03 Mech. 24.40 Electrical 45.00 Plumbing 27.00 S.M.I. 2.10 Grading Driveway Enc. Infrastructure TOTAL 454.50 .REMARKS C;iV2.401 it'd. r,'14r'S I Y3 PT 7 +ti V ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUM BING,�EES 1ST FL. SQ. FT. ® $ UNITS ROUGH PLUMB. BONDING t* 2ND FL. SQ. FT. STORAGE TANK YARD SPKLR SYSTEM FOR. SQ. FT. ® MOBILEHOME SVC. BAR SINK GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS OTHER APP.IEQUIP. REINF. STEEL DRAINAGE PIPING CAR P. I SQ. FT. ® GROUT WALL SQ. FT. FINAL INSP. DRINKING FOUNTAIN. SO FT ® WATER SYSTEM FINAL INSPIL—Z1 -1,3t$--:::Ius-x$-=$ FINAL INSP. ��Z URINAL ESTIMATED CONSTRUCTION VALUATION $ LUMBER GR. WATER PIPING NOTE: Not to be used as property tax valuation ��/x ��yA� / 2 /� ^c� 3 tf� l FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER r GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FIREPLACE LAUNDRY TRAY 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. SQ. FT. ® c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER FINAL INSPECTION G- Zl dl[3 GAS PIPING PERMIT FEE PER FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING y'014DERGROUND O. -".mss 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) / -60 c y�j METER LOOP HEATING (FINAL) OTHER APP.IEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM FINAL INSPIL—Z1 -1,3t$--:::Ius-x$-=$ FINAL INSP. ��Z GRADING cu. yd. LUMBER GR. FRAMING ROOFING9 ��/x ��yA� / 2 /� ^c� 3 tf� l REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL- - LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION G- Zl dl[3 CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL