13230 (RPL)Tity/ 4 4 QU14a
P.O. BOX 1504
Building 44-910 Seely Drive 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
0 e i
gnt6e Cardinale
Address Same
City zip Tel.
La ouinta, CAI 92253 1
Contractor
Master Pools & Soas
___[S-;:_547 Hwy Ill . I
City Zi Tel,
Palm Desert, 11 92260
State Lic. Ci - tyf.
& Classif. 238947 C-53 /Ibc.#
Arch., Engr., K:Z--
Designer
Address T Tel.
City Zip State
I I Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby Rffirm that I am licensed undpr provisions of Chapter 9 (commencing with Section
7000, of-Bivision 3' 1 th Busines's and Professions Code and my license is in.ful'I fords and
eff.c
7-
V DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Business 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 file 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 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 theapplicant to 6 civilpenally ofnot more than five hundred dollars ($500).
0 1, 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
ofproving that he did not build or improve forthepurpose ofsale.)
0 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.)
0 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 C pensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy pa y -
E�op?yis filed with the city.omO 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 (S100) valuation
or less.)
I certify that in the performance of thp 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.
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.
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. 309 7, Civil Code.)
Lender's Name
Lender's Addres
This is a buildi'n permit when properly filled out, signed and validated, and is subject to
expiration it work 4reunder is suspended for 180 days.
I car tify 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.
Signature of applicant -Date-
Mailing Addres
City, State, Zip
No. 13230
BUILDING: TYPE CONST.—OCC'. GRP.-
A.P. Number
Legal Description
Project Descript I ion Pool
Ft.
tize
No.
Stories
No. Dw.
Units
New El Add 0
Alter E)
Repair 0 Demolition 0
Estimated Valuation
$12t000.00
PERMIT
AMOUNT
Plan Chk. Dep.,
Plan Chk. Bai-111'12�.`
(87.75
Const.
135.00
Mech.
24.00
Electrical
45.00
Plumbing
.S.M.I.
Grading
Driveway Enc.
Infrastructure
A I IC 4) Q
17" Ty/7 'I
27.00
TOTAL
318.75
REMARKS
ZONE:
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— 4
INSPECTOR
Issued by: —Date—Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. @ $
UNITS
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
YARD SPKLR SYSTEM
2ND FL. SO. FT. @
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. @
DUCT WORK
ROCKSTORAGE
GAR. SO. FT. @
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
DRAINAGE PIPING
CAR P. I SO. FT. @
GAS (FINAL)
TEMP. POLE
WALL SO. FT. @
I
DRINKING FOUNTAIN
SO. FT. @
WATER HEATER
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
WATER SYSTEM
FLOOR DRAIN
MECHANICAL FEES
GRADING
cu. yd.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOIL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
P/Ul-
13
1., 1,4
LAUNDRY TRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HIP
POLE, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. @ c
BATH TUB
SO. FT. @ c
I WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR @ 3/4c
HOUSE SEWER
INSULATION/SOUND
GAS PIPING
PERMIT FEE
PERMIT EE
PERMIT FEE
DBIL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
I CONST. FEE ELECT.FEE
SMIFEE
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
ROCKSTORAGE
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
$—Plus—x$—=$
GRADING
cu. yd.
.LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
P/Ul-
13
1., 1,4
REMARKS: q
A"
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
mll 14ze
SPARK ARRESTOR
Am/ low,
rlg�l A*Ae
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES11NITIALS
GARDEN WALL FINAL 71