05916 (CP)P.O. BOX 1504 N o m 05916,
Building 54-421 Inverness78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner
S:3D,7i�8$ CQt7�lc'b�''� -
Mailing BUILDING: TYPE CONST. OCC: GRP.
Address 426100 Cook St. Saito 200
A.P. Number " PCA WeBC
City P • Zip 92260 Tel. -
, .., Legal Description
Contractor w
C R Pool4q Project Description Pool and. Spa
Address
6a-465 Perex Rd. -
City Zip Tela
Cat Cite 92234 328--2681
State Lic. City
& Classif. Lic. # 14 - - Sq. Ft. No. No. Dw.
Arch., Engr., ' Size Stories Units
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address' Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that.l am licensed under prpvisions of Chapter 9 (commencing with Section
7000) of Di�sion 3,i# the Business a�nvd Professions-Code,.and my license is in full force and.
ice%
SIGNATURE ' DATE
OWNER -BUILDER DECLARATION Estimated Valuation a
n-'1 hereby affirm that 1 am exempt from the Contractors License Law for the following ,3Q fV?.Q
reason: (Sec. 7031.5,Bushess and Professions Code: Any city or county which requires a
permit lo' contract, after, improve, demrmolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to fie 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) o/
Division 3 of the Bussress and Professiions 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 civi penally of not more than five hundred dollars ($500).
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. 4.55
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const.•
Professions Code: The Conhacrors License Law does not apply to an owner of property who
builds or improves thereon and who does such work hmtseff or through his own employees, Mech.24.00
provided that such improvements are not intended or offered for sale. If, however, the building
$ or improvement is said within ane year of completion, the owner -builder will have the burden Electrical
of proving that he did not build or itprove for the purpose of sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing
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. •!1t)
such projects with a contractorrs) f emed pursuant to the Contractor's License Law.)
" '❑: I am exempt under Sec_ R_ & P.C. for this reason Grading
., Driveway Enc.
Date owner Infrastructure
WORKERS' COMPENSATION DECLARATION
I herby
Insurance,
affirm that I have a certificate of consent to self�insure or a certificate of
Worker's Compance, or a certified cop�lhereof. (Sec° 3.800, Labor Code.)
Policy No Company
❑ Copy is filed with the city_ ❑ Certified copy is hereby furnished.
TOTAL
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be eovpered 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 penton in any manner so as to become subject to the Workers' Compensation
Laws of California
Date Owner
NOTICE TO APPLICANT: t, 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 property filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 100 days.
I certity that 1 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 Address
City,. State, Zip
REMARKS a{146( i ltaYi ; �rj�f1)Tdi�lt1 i� I FiS'4 rs c 4.#3
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 IINSPECTOR
Issued by: Date 6-15-89 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL SO. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB. BONDING
YARD SPKLR SYSTEM
2ND FL SO. FT.
FORMS
SEWER OR SEPTIC TANK ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
GAS (ROUGH) METER LOOP
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL) TEMP. POLE
DRAINAGE PIPING
CAR P. SO. FT.
GROUT
WATER HEATER SERVICE
WALL SO. FT.
FINAL INSP.
DRINKING FOUNTAIN
SO FT ®
WATER SYSTEM
URINAL
ESTIMATED CONSTRUCTION VALUATION $
=$
WATER PIPING
NOTE Not to be used as property tax valuation
FRAMING
FLOOR DRAIN
MECHANICAL FEES
/
7_ GiCi w
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTOXDISH)
APPLIANCE DRYER
VENTILATION
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FIRE ZONE ROOFING
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIREPLACE
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
SO. FT. ® c
WATER HEATER
MAX HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1% c
SEWAGE DISPOSAL
SO.FT.GAR ® 31'ic
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEESMICRO
FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
UND 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.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
/
7_ GiCi w
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
I