9935 (RPL)414
P.O. BOX 1504 No. 9935
Building 78-625 VILLBTA 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253 vvv
Owner
ROBERTO BRLASQUEZ
Mailing BUILDING: TYPE CONST. OCC: GRP.
Address SAME
A.P. Number.
CityZip Tel.
LA QUINTA J92253 - 13-566-1151 Legal Description
Contractor Project Description POOL AND SPA
UNIQUE POOLS
Address
74818 VELIR WAY 01
City Zip Tel.:
P.D. 92260 346-6395
State Lic. City
& Classif. 520432-053 Lic. # 132 6 6' Sq. Ft. No. No. Dw.
Size Stories Units
Arch., Engr.,
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ `
Address Tel.
City Zip State
Lic. #
�.'`` LICENSED CONTRACTOR'S DECLARATIO��
thereby affirm that I a tensed u epprovisions of Chapter 9Qcommencing with Section
/7000) 01 Division 3 of the Busin/ass nd,,fsrofessions Code, annd (�my license is, m/tu`114 rc/e and
S` .effect. lf.v_... � 1��4a�dO/ -
�GNATURE DATE
OWNER-BUILDER DECLARATION ' Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following $8,0()0
reason: (Sec. 7031.5,Business and Professions Code: Any cityor 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 PERMIT' AMOUNT
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 Plan Chk. Dep. -
subjects the applicant to a civil penalty of not more than five hundred dollars .($500). Plan Chk. BBI. 6 S
❑ I, as owner of the property, or my employees with wages as their compensation, will
do the work, and the structure is not intended or offered foe sale. (Sec. 7044, Buisness and Const. 99.00
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, Mech.' - �� 00
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 Electrical 4 e�
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- Plumbing 27.00
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 S.M.I. .80
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
D I am exempt under Sea B. 8 P.C. for this reason 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 Codi.)
Policy-No. Company vr $260.15 O� C py.is filed with the city.. ❑ Certified copy is hereby furnished. TOTAL Y 2 0 . 1
CERTIFICATE OF EXEMPTION FROM REMARKS K ,
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation {,j�r..``e!•"f'fj''.+;'` -", �.
or less.)
1 certify that in the performance of thg work for which this permit is issued, I shall not
employ any parson 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 ZONE: BY:
subject to the Workers' Compensation provisions of the• Labor Code, you must forthwith Minimum Setback Distances:'
comply with such provisions or this permit shall be deemed revoked.
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 thisapplication and state that the above information is correct. Issued by: Date Permit'
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. Validated by:
Signature of applicant Date
Mailing Address Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
SLAB GRADE
2ND FL. SO. FT.
BONDING
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO, FT, ®
POWER OUTLET
ROOF DRAINS
CAR P. SD. FT.
GAS (ROUGH)
DRAINAGE PIPING
WALL SO. FT.
OTHER APPJEOUIP.
DRINKING FOUNTAIN.
SO 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 y
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
AL INSP`,*4
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'
V
COMPRESSOR HP
POLE, TEM/PERM
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
GAR. FIREWALL
SQ.FT.GAR ® 3/sc
HOUSE SEWER
LATHING
GA PIPING
PERMIT FEE
PERMIT FEE
PERMIYFEE
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.
AL INSP`,*4
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