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10118 (RPL)Building Address 5 4!45 9 2 ©oregon Owner ,Kenyon Janes Mailing ° . Address same .City Zip . LaQuinta 92.253 Contractor Dodson Pools Address 68 805A Perez Rd City Izip State Lic. & Classif. ' A- 574127 Arch., Engr., . Designer Address - P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Tel. Tel.: City Lic.# 1044 BUILDING: TYPE CONST A.P. Number. Legal Description Project Description POOL AND SPA Sq. Ft. No: No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolitiori ❑ 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 e . ect. . `o' SIGNATURE - DATE :^ c OWNER -BUILDER DECLARATION t- -+ I hereby affirm that I am exempt from the Cantractofa License Law for the following reason: (Sec. 7031.S,Buslness and Professions Code: Any city or county whlcA requites a " S; permit to construct, alter, Improve; demolish, or repair any structure, prior to hs issuance also ,i•g;requlros the applicant /or such permit to file a signed statement that he is .licensed pursuant to • a the provisions o/ the Contractor's License Law, Chapter 9 (commencfng with Section 7000) o/ Division 3 of the Business and Professions Cade• or that. he is exempt there/rom, and the basis /or,'he ^alleged exemption. Any vlolatton o/ Section 7031.5 Dy 'any applicant for a, permit subjects the applicant to a c1v11 penalty of not more Nan five hundred dollars.($,0,). .. ❑ 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. It, however, the.building ' or Improvement is'sold' thin one year o/ completion, the owner -builder will have the burden of proving that he did not build or Improve for, the purpose of sale.) Estimated Valuation q ' �. �'®� IJ PERMIT - •. AMOUNT,. ' Plan Chk. Dep. Plan Chk. Bal. 70.20 . OOrISts e (� _ Mech. ---- „ Q 4'• ' Electricala 00 + Plumbing 27. NO' ❑ 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 o/ 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 S•M•I. 'go Grading — y " Driveway Eno. 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, or a certified copy thereof. (Sec. 3800, Labor Code.) - -- Policy No. Company Ci Copy is filed with the city. .❑ Certified copy is hereby furnished: • ^ r p c r\�4 �-?wEAT �f hs .J.r 1- �. 4 s'� 9' 4 TOTAL 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 any person In any manner so as to become subject to the Workers' Compensation - Laws of California. REMARKS 1 •'' x = "-, ~• -- ' ' Date ' Owner ZONE:- BY: - Minimum Setback DISt8r1C8S: NOTICE,TO APPLICANT: If; after making this Certificate o/ 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. - Front Setback from Center Line Rear Setback from Rear Prop. Line ' 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.) _ _ Side Street Setback from Center Line Side Setback from Property Line Lender's Name FINAL DATE INSPECTOR ' Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration it 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 Inspection purposes. Issued by: Date Permit - - - Validated by: Signature of applicant Date Mailing Address Validation: City, State, Zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ 2ND FL.SQ. FT. POR. SQ. FT. ® GAR. SO. FT. ® CAR P. SQ. FT. @ WALL SQ. FT. SQ FT ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET w� YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN. URINAL WATER PIPING NOTE: Not to be used as property tax valuation SLAB GRADE FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER ROUGH WIRING. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED DUCT WORK LAUNDRYTRAY AIR HANDLING UNIT CFM GAS (ROUGH) 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 WATER HEATER SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1+/4 c SEWAGE DISPOSAL BOND BEAM SQ.FT.GAR ® V4C HOUSE SEWER $ GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PLCK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FES 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 APPJEQUIP. 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 VV REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION - CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL :d