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10106 (RPL)P.O. BOX 1504 N o . 10106 Building���� ���, 78-105 . 44^^24 f• J/ Address LA QUINTA, CALIFORNIA 92253 Owner Hen Schwartz !BUILDING: TYPE CONST. OCC: GRP. Address same A.P. Number City Zip Tel. L aQuintr'3. 92253 Legal Description Project Description POOL � ��� Contractor Dodson Pooh. .Address 6$305 A Perez Rd City Zip Tel.: Cat City 92234 324-1232 State Lic. City & Classif. 574127 A Lic. # 1044 Sq. Ft. No. No. Dw. Size Stories Units Arch., Engr., Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolitiori• ❑ 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 77}000) of Division 3'of,tfie Business and,Professions Code, and my license is in full force and y SIGNATURE DATE 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, 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 ProfessionsCode, .or that. he is exempt therefrom, and 'the basis . for the alleged exemption. Any v?olation 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). D 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`.emfiloyees, provided that•such improvements aye not intended or offered for sale. N however, the buildingVV Estimated Valuation 12,100 - s PERMIT t. ; AMOUNT Plan Chki' Dep:�- , v� - Plan Chk. Bal- 931 . 6 0 CpnSt..� . ♦�©' Mech. � 24. A P1 Electrical .'�-•' ' ` . $ 00of or improvement is sold within one year of completion, the owner -builder will have the burden proving that he did not build or. improve for the purpose of sale.) Plumbing 27. 00 D 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.) . D I am exempt under Sec. B. 8 P.C. for this reason S.M.I. g 1 e 30. 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 -� e c0copy is filed with the city. D Certified copy is hereby furnished. TOTAL 334.90 CERTIFICATE OF EXEMPTION FROM WORKEBIS' 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 person in any manner so as to become subject to the Workers' Compensation Laws of California. REMARKS �S 4M9. r3�'tA'.71tF^`t1�."" r -n 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.' 'ZONE:- BY: _ Minimum Setback Distances: - - Front Setback from Center Line Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line 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.) Side Setback from Property Line Lender's Name Lender's Address FINAL DATE INSPECTOR 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. Issued by: Validated by: Date Permit' Signature of applicant Date Mailing Address Validation: City, State, Zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS SLAB GRADE 2ND FL SQ. FT. BONDING YARD SPKLR SYSTEM POR. SQ. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. SQ. FT. GAS (ROUGH) O.3 (//l v DRAINAGE PIPING WALL SQ. FT. OTHER APPJEQUIP. DRINKING FOUNTAIN. SQ FT ® TEMP. POLE URINAL ESTIMATED CONSTRUCTION VALUATION $ GROUT WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SYSTEM WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER C6JNAL INSP,49 ! f- GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE,TEM/PERM 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 ® 1V4 c SEWAGE DISPOSAL GAR. FIREWALL SQ.FT.GAR ® V4c HOUSE SEWER LATHING 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 LIND PLUMBIN 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) O.3 (//l v METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ =$ LUMBER GR. C6JNAL INSP,49 ! f- FRAMING FINAL INSP. ROOFING pG�� REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL