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14511 (RPL)44 P.O. BOX 1504 Building 78-495 CALLE TAMPICO 'No.. 14511 Address . 0O—g0Q VI'sta $C3nits'i LA QUINTA, CALIFORNIA 92253 Owner ' :dill xam- J. 'Lyon Roden Mailing Address SaMe City Zip Tel. %a Quinta CA 2` r Sractor Mason Pools Address. 68-805 A Perez dela EV ...City _._ Zip Tel.: Cathedral Cit . CA 92234 324-1232 State Lic.c City & Classif.. A 5.74127 Lic: # 2044. . 11LDING: TYPE CONST:: OCC: GRP. P. Number !gal Description oject Description Pool and Spa Sq. Ft. No. No. Dw. Size Stories Units ' Designer New ❑ Add ❑ ' : Alter ❑ Repair ❑ Demolition 0 Address Tel. City Zip State Lic. # Rear Setback from Re r P o . Line - - -Line SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES'UP.TO ONE Side Street S.etb m Cen LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section . 7000) of Division 3 of the Business'and Pfrfesslons Code, -and my license is in full force d �j effect. ✓i'� '� �7i' S Side Setback, from P pe �e " DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. G SIGNATURE rX s DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License law for the following reason: (Sec. J031.5 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). 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, 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.) . - O 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) (lcensed pursuant to the Contractor's License Law.) 11I am exempt under Sec. B. fl P.C. for. this reason Estimated Valuation $16000.00 ! PERMIT - AMOUNT Plan Chk. Dep. I certify that I have read this application and state. that above informationis'correct. Plan Chk. Bal, i • Const. • Mebh. Electrical Plumbing • S.M.1. _ Grading 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. r TOTAL J IF 0• a 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 any arson -in any manner -so as to become subject to.the Workers' Compensation Laws of California REMARKS ate Owner NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become ZONE: BY: - - • subjectio the Workers' Compensation provisions of 'the Labor Code,. youmust forthwith comply with such provisions or this permit shall be deemed revoked. Minimum Setback Distances:' Front Setback from Center Line • WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND. Rear Setback from Re r P o . Line - - -Line SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES'UP.TO ONE Side Street S.etb m Cen • HUNDRED THOUSAND DOLLARS ($1D0,000), IN ADDITION TO THE COST.OF COMPENSATION, Side Setback, from P pe �e " DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. G FINAL DATE SPfR, - This is a'buildin g permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. �(QR I certify that I have read this application and state. that above informationis'correct. Issued by: Date41 I agree to comply with all city and county ordinances and state -laws relating 90 building construction, and hereby authorize representatives ±of this city to enter the above-. • • . for inspection } S / mentioned property purposes. jj Validated by: ..+ Signature of applicant Date .Mailing Address Validation: City, State, Zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ 2ND FL. SQ. FT. p POR. SO. FT. ® GAR. SO. FT. ® CAR P. 'SO. FT. WALL SQ. FT. SO. FT. ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING NOTE: Not to be used as property tax valuation BONDING FLOOR DRAIN MECHANICAL FEES FORMS WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APP./EQUIP. LAUNDRY TRAY AIR HANDLING UNIT CFM TEMP. POLE 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 SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/. c SEWAGE DISPOSAL SO.FT.GAR ® 3/ac HOUSE SEWER REMARKS: 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 lx 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./EQUIP. 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 REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL 71