14950 (BLCK)Building
Address 79-51.5 ilandarina
Owner Dara Hayes
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Mailing Same
Address
City
Zip
Tel.
La Quinta, CA
92253
25.00
Contractor
Hamilton Masonry
Address
P.O. Bozo 1771
City Quinta, CA
ziP92253
T345-7659
Statei. C29 59:1534
& Classit.
city 1631
Lic. #
Designer
Address Tel.
City I Zip I State
Lic. #
LICENSED CONTRACT WS.DECLARATION
I hereb .affirm that I a i` 1`i epse'd und%g nd
pter 9 (commencing with Section
Sof the Bus'n "s and my liPense isin full force and
ffe t.GNA r DATE
OWNER -BUILDER DECLARATION
I hereby affirm that 1 am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,Suslness and Professions Code: Any city or county which requires a
permit to construct, alter, Improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to (le 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 or 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
subjects the applicant to a civil penalty of not more than rive hundred dollars ($500).
❑ 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
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,
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
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-
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 contractor(s) 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 Cgmpensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Poli y 6 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 thg work for which this permit is issued, I shall not
employ anyperson 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
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND
SHALL SUBJECT AN EMPLOYER -TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
'HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
:. DAMAGES AS PROVIDED FOR INISECTION 3706 OF THE LABOR CODE, INTEREST, AND
.ATTORNEY'S FEES.
-This is a building perml 'wtien properly filled out, signed and validated, and is subject to
expiration if work I ereunder,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 ordid°ances 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, Zlp
i
No. 14950
BUILDING: TYPE CONST. . OCC. GRP.
iA.P. Number
,Legal Description
Project Description 20G* of 2'80 high retaining
wall, and 25' of 6' high 4arden wall
1
Sq. Ft. ; No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ 'Demolition ❑
Estimated Valuation $625.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
-
Const.
25.00
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
4 2 .O in
REMARKS
` r` , ffA %
' 1
ZONE: BY: V
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. SO. FT. ®
GAR. SO. FT. ®
CAR P. I SQ. FT.
WALL SO. FT. ®
SO. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
COLL. AREA
FLOOR DRAIN
MECHANICAL FEES
ROUGH PLUMB.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FORMS
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
DUCT WORK
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.
SO. FT. ® c
BATH TUB
TEMP. POLE
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 1 V. c
SEWAGE DISPOSAL
WATER HEATER
SQ.FTAAR ® 3/.c
HOUSE SEWER
FINAL INSP.
GAS PIPING
PERMIT FEE
WATER SYSTEM
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
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
4,,
tt
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
/
fk MAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIG NATURES/INITIALS
GARDEN WALL FINAL