9957 (RPL)■4 CV
P.O. BOX 1504 No. 9957
Building 5:-905 Calle Fatloma 78-105CALLEESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner
V.r urs. Merritt
Mailing
Address 5J--905 Calle Fa?,Ata
City Zip Tel.
La Quints 92283
Contratetpfl ffornia fools
BUILDING: TYPE CONST. OCC. GRP.
P. Number
Legal Description
Project Description POOL & Spa.
Add4or 910 Boardwalk, Suite
Clalm Desert
Zip 92260
1A-3
Te34u-90a.
State Lic.
City
& Classif. 185102
Lic. # 355
Sq. Ft.
Size
No. No. Dw.
Stories Units
Arch., Engr.,
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Designer
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
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect-._..._.-
SIGNATLnE
OWNER—BUILDER DECLARATION
I her afnrfn that I am exempt from the Contractor's License Law for the following
reason: [Sec. 7031.5.Buslnoss and Professkins Code: Any city or cutmly which requires a
Permit to construct, airer, "rave, damufth, or repair any structure, prior to Its issuance Also
requires the applicant for such permit to No a signed sratemenf that he is licensed pursuant to
the provisions of the Conlractor's License Law, Chapter s (cormnencfng with Section 70DOJ of
Dwiskm 3 of the Business and Professions Code, or that ho Is exempt therelrom, and the basis
Aar the a9nged exompfion. Any viofaflon of Section 7031.5 by any applicant for a pernaY
suWctg the appficanf to a civil penalty of not mora than live hunched doiars ($6 co).
1-1 1, as owner of the property, or my amptoyl!es with wages as their sots cam pensati on, will
Estimated Valuation
$12,000
PERMIT
AMOUNT
Plan Chk. Dep,
Plan Chk. Bal.
93 . 60
Const.
144. 00
do the work, and the structure Is not Intended in offerdd fur sale. (Sec. 7044, 6uienoss and
Profeswns Code: The Confraclor�3 License Law does not apply to an owner of properly who
Grbds or inproves thereon and who does such work hlmsaff or through his own employees.
pmvidt+d that such improvements ere not Intended or offered for sale. If, however, the buMft
or mrproverncrtf b sold within one year of completion, fhe owner -builder wilt have the burden
of proving that he did not build or improve for the purpose of sale.)
Mach.
{ . f)(]
Electrical
!� 5 QO
Plumbing
�' '� 7 00
❑ I, 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 contraclor(s) licensed pursuant to the Contractor's License Law.)
11 I am exempt under Sec. B. 8 P.C. for this reason —
S.M.I_
1 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
Workers 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.
TOTAL
:3 •
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
REMARKS
(Ibis section need not be completed if the permit is for one hundred dollars ($100) valuation
or fess.)
I certify that in the performance of thg work for which this permit is issued, I shill not
employ any pperson in any manner so as to become subject to the Workers' Compensation
Laws or Caltfomia_
Date—Owner _
NOnCE TO APPLICANT: lt, 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
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,
Side Street Setback from Center Line
Side Setback from Property Line
Lenders Address
FINAL DATE
INSPECTOR
,� S�
2 6 1
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.
1 certify that I have read this application and state that the above information is correct-
I agree to comply with all pity and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this city to enter the above-
mentioned property far inspection purposes.
Issued by:
Validated by:
date Permit
Signature of applican Date
Mailing Address'
Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT. @
POR. SO. FT. ®
GAR. SQ. FT. ®
CAR P. SQ. FT. ®
WALL SQ. FT. ®
SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION $
COLL. AREA
SLAB GRADE
UNITS
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
YARD SPKLR SYSTEM
FORMS
MOBILEHOME SVC.
BAR SINK
ROUGH WIRING
POWER OUTLET
ROOF DRAINS
FOUND. REINF.
DRAINAGE PIPING
METER LOOP
HEATING (FINAL)
DRINKING FOUNTAIN
REINF. STEEL
URINAL
TEMP. POLE
WATER PIPING
NOTE: Not to be used as property tax valuation
WATER HEATER
FLOOR DRAIN
MECHANICAL FEES
BOND BEAM
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
FINAL INSP. � I (
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
r r Ao' f5
FRAMING
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
n � S �r rt,ti �n / � ,/�
LAUNDRYTRAY
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
LATHING
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1% c
SEWAGE DISPOSAL
INSULATION/SOUND
SO.FLGAR ® Vic
HOUSE SEWER
FINISH GRADING
GAS PIPING
PERMIT FEE
FINAL INSPECTION G A
"L
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 6 AIR COND. SOLAR
SETBACK
GROUND PLUMBING ;q
WUNDERGROUND�
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) Sl,2-q(OI
METER LOOP
HEATING (FINAL)
OTHER APP.IEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP. � I (
GRADING
cu. yd.
$ plus xS
=S
LUMBER GR. 1 Gt
f
r r Ao' f5
FRAMING
FINAL INSP.1 /
ROOFING
n � S �r rt,ti �n / � ,/�
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION G A
"L
CERT. OCC.
FENCE FINAL
INSPECTOR'S 51G14ATURESIINIT[ALS
GARDEN WALL FINAL