9405 (RPL)'Building 43-43# SAN VICENTE
Address
Owner
TOYI CARNEY
Mailing
Address 56m02U rI1IERA
City
Tel.
LA QUII%TTA,CA
JZ91P2253
771 -1419
Contractor
T014 CARNEY
Add ress
55-02C RIVIERA
City
LA QUINTA, CA
F92253
Tel:
SAME
State Lic.
City
& Classif. 18 7 719
Lic. #
Arch., Engr„
DeNjOr B ERNARD ANAMS
Address Tel.
11022 ACACIA 1'iCiiY.
City Zip State
GARDEN GROVE Lic. #ISs.7..7_L_qa
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I atn 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.
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,Buslness and Professfons Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any slrnCfura, pwr to its issuance also
requires the appileanl for such parml! to Me 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 Prolesslons Code, or that. he is exempt fheralram, and fha basis
for the alleged exemption. Any violation of Socilon 7031.5 by 'any applicant for a perm'!
subjacls the applicant to a civil penalty at ngl more than five hundred doAars ($500).
U 1, as owner of the property, oT my employees with wages as their sole compensation, will
do the work, and the sfru-it, ]s not intended or offered for sale. (Sec- 7044. Buisness and
Professions Code: The Conbactor's License Law does not apply to an owner of property who
builds or vnproves thereon and who does such work hirrrrsll or thmugh his own employees,
provided that such improvamenls era nor intended or offered for sale. tl, hbwaver, !ho btdiding
of improvement is said within one year 01 cbmpletion, the owner-buHder wiry have the burden
of proving that he did not build or improve for the purpose of sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and Prolessians 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 contrac(ors) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
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 certified copy thereof. (Sec. 3800, Labor Code.)
Policy No- Company
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' 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 pparson In any manner ap as to become subject to the Workers' Compensation
Laws of Califamia.
Date�Owner
NOTE TO APPLICANT.- 9, after making thia Cerbriicare of Fxerriotlon you should become
subjecl to the Workers' Compensafion provisions of the tabor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked_
CONSTRUCTIONLENDING 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 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 inspectlon purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
POOL AND
SPA
BUILDING: TYPE CONST. OCC. GRP
A-P. Number
No. 9405
Legal Description
Project Description
POOL AND SPA
Sq. Ft.
Size
No. No. Dw.
Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Val 'ation
� 15 , 500
PERMIT
AMOUNT
Plan Chk. Dep-
Plan Chk. Bal-
$ I 1 . 5
Const.
Mech.
24
Electrical
45.00
Plumbing
2 7
S. M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
$ _ .2
REMARKS
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 INSPECTOR
Issued by: Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO.
ELECTRICAL FEES
NO.
PLUMBING FEES
1ST FL. SQ. FT. ®
2ND FL. SQ. FT. ®
POR. SQ. FT. ®
GAR. SO. FT. ®
CAR P. SO. FT. ®
WALL SQ. FT. ®
SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION
$
UNITS
YARD SPKLR SYSTEM
MOBILEHOME SVC.
BAR SINK
POWER OUTLET
I ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
$
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
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.I.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
SQ.FT.GAR ® 3Ac
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
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK 'i,
UHUUNU PLUMBING qz'(JK1t11a
UNDERGROU14D
" s
A.O. UNIT
COLL. AREA
SLAB GRADE / L'.
�n
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH) # L �G«W
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.
LUMBER GR.
FINAL INSP Dj ]G
FRAMING
FINAL INSP. 5
ROOFING
(ft� 7 /7/q [ G ICJ
j
��
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION q
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINlTIALS
GARDEN WALL FINAL