12775 (RPL)P.O. BOX 1504 No., 12775
Building 'ie- 011.' '47illeta •78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253 ,
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Owner " j?C)EiiC DiCarlo
Mailing
BUILDING: TYPE CONST: f' OCC: GRP.
- ,
Address :'am'
A.P. Number
City Zip- Tel. " t
I
La QtFjtAta,,'•. C14. 9.2253 Legal Description
Contractor_ 0061, --cared Spa Y
�sesstdkn Pools t , Project Description _
Address-3..'5. `4- adifaCin Street t
3
cityanci�.a; ,:, ►' zip 922'61 Tel.. 47--595
State Lic. City
& Classif. C53`` 3 5. 6 Lic. # �:5 • ' Sq. Ft. No No. Dw. •'
Arch., Engr.. ~.
Size Stories. 'L -Units .'
Designer ." New ❑ Add ❑ ` Alter:❑. Repair ❑ Demolltiori'❑ _-.
Address ., Tel.TI
CityZip . State '
+ to Lic. #
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LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section Y
7000) of Division 3 o he4.Business.and r fessions Code, and my license is in full force and
.-effect d:6=. `'
_SIGNATURE w„ DATE
OWNER-BUILDER DECLARATION v aT
Estimated Valuation;2��� ~
I hereby affirm that I am exempt from the Contractor's License Law for the following •' P •
reason: (Sec. 7031.5, Business, 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 ; , - + t.
requires the applicant'/or such permit to file a signed statement that he is licensed pursuant to PERMIT* AMOUNT
the provisions o/ 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 o/ 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 (S500). Plan Chk. BBI. • _15
-
❑ 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 Const. 135 s 0 -
Professions Code: The Contractor's License Law does not apply to an owner o/ property who -
builds or improves thereon and who does, such work himself or through his own empfDyees, Mech. - - -24.010
i'•
provided that such improvements are not intended or offered for sale. I/, 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 o/ sale.) EleCtrlCal :� '''-
>
O 1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing : , .00".
struct the project. (Sec, 7044, Business and Professions Code: The Contractor's License Law
does not apply to anownerof property who builds or improves thereon, and who contracts for .S.M.I. • •� - - „
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) r
❑ 1 am exempt under Sec.' B. k P.C. for this reason Grading.
Driveway Enc. r`
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, ora certified copy thereof. (Sec. 3800, Labor Code.; '
Policy No. .Company.:.
, lft6dpy ,std with the city.. ❑ Certified copy is hereby furnished.
TOTAL.
CERTIFICATE OF EXEMPTION FROM' REMARKS
WORKERS'COMPENSATIONINSURANCE
(This section need not be completed i/ the permit is for one hundred dollars '($100J valuation,_4 • - -
or less.) - -
certify that in the performance of th0 work for which this permit is issued,'I shall not p:
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California.
ONOTICE TO APPLICANT .1/, after making this Certificate of Exemption you should become ZONE: BY:•-
subject to the Workers' Compensation provisions o/ the Labor Code, you must forthwith Minimum Setback Distances:
`•,,;:�.,• -
comply with such provisions or. this permit shall be dnacs
_ deemed revoked. '
Front Setback4rom Center Line
Rear Setback from Reaf Prop. Line
CONSTRUCTION LENDING AGENCY Side Street Setback fr rf�i Gen r ine
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 Prope y Li
Lender's Name
Lender's Address / la
FINAL DATE 1NSj3 CTOR
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. C/J�
I certify that I have read this application and state that the above information is correct. Issued by: Date //� '
I agree to comply with all Pert�lnIt�'
city and county ordinances and state laws relating to building i n
construction, and hereby authorize representatives ,of this city to enter the above. J9il
mentioned property for inspection purposes.
,Validated by: n 7
Signature of applicant Date i:. '
Mailing Address 4 Validation: 1
City, State, Zip '
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. @ $
UNITS
SLAB GRADE
e
BONDING
YARD SPKLR SYSTEM
2ND FL. SO. FT.
FORMS
SEWER OR SEPTIC TANK
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. @
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT.
OTHER APP./EQUIP.
DRAINAGE PIPING
WALL SQ. FT.
TEMP. POLE
DRINKING FOUNTAIN.
SQ. FT. @
_
URINAL
E• kTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation _
i _ ? _
FLOOR DRAIN
j MECHANICAL FEES
=$
WATER SOFTENER '
VENT -SYSTEM. - FAN _ EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
t
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
r
"
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
SPARK ARRESTOR
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID @ 11/4 c
SEWAGE DISPOSAL
LATHING
SO.FT.GAR @ 3/ac
HOUSE SEWER
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
FENCE FINAL
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 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
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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
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