POL 1014277465 Loma Vista
10142
Fleming - BUILDING: TYPE CONST: r: • OCC: GRP.
Mailing
Address same
A.P. Number
CityZip Tel.
Lai ini to 92253 Legal Description
.Contractor
Calift�i'i9i Pools Project.Description
Address POOL X3D SPA
41910 Boardwalk
City Zip
Palm �ese�t +322619
State Lia
& Classif. IW3 185$52
Arch., Engr.,
Designer
Address
344-93196
City
Lic. # 355
Tel.
Sq.;Ft.
Size
No: No. Dw.
Stories Units
❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
CityZip
State '
Lic. #
' LICENSED CONTRACTOR'S DECLARATION
hereby affirm 4that I am licensed under provisions of Chapter 9 (commencing with Section
000) of D'iviisidn,33 of the Business and Professions Code, and my license is in full force and '
effect••
• �S GNATU �`i -" /' DATE
'
OWNER-BUILDERDECIARATION
?'J .ereby affirm ithat I am exempt. from the Contractors License Law for the following
Estimated Valuation 9 B
15 0is0 n�q
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 permitto rile a signed statement that he is licensed pursuanrto
- PERMIT- - AMOUNT
the provisions of the Contractor's License Law, Chapter. 9 (commencing with Section.,7000) of
' Division 3 or the Business and, Professfonns 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
�•-Plan-Chk'.'Dep: -
subjects the applicant to a civilpenalty of not more than rive hundred'd6llars.(8500):' -
• - Y+
Plan Chk. Bal. V
O I, as owner of the property, or my employees with wages as their sole compensation, will
a
i 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 riot apply to. an owner of property who
COr1Sti - 162.00
0
builds or improves thereon 'and who does such work filrnself or through his own employees,
- that improvements intended
Mech. '
provided such are not or offered for sale.. If, however, the building
or improvement is sold within one year of completion; the owner -builder will have the burden-'
-ElectrlCal 'i t*' ' A
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-
Plumbing
'
struct the project. (Sec.- 7044, Business and,Proressions Code: The Contractor's License Law
does not apply .to an owner of property* who builds or improves thereon, and who, contracts -for
• S; M. 1.
suchprojectswith a contractor(s) licensed pursuant to the Contractor's License. Law.).
Grading
❑ I am exempt under Sec. • B."& P.C. for this reason -
Driveway Enc.
Date owner "� -, h •-
Infrastructure x"
WORKERS' COMPENSATION DECLARATION
1 hereby affirm that,l 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. Com any `
Copy is filed with the city.. ❑ Certified copy is hereby furnished.
'
TOTAL
' CERTIFICATE OF EXEMPTION FROM;
WORKERS'COMPENSATION INSURANCE
cREMARKS; ` . ,: ,.,k„• .,� ,
�
(Thissectionneed not be completed if the permit is /or one hundred dollars (8100) valuation
' � � • Cr�V! �, i �� �3'1� � �. •��� •:�51
or less.)
I certify that in the performance of the 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.
Datewner
NOTICE TO APPLICOANAPPLICANT:If, `after making this Certificate of Exemption you should become—
•"'to
'ZONE: BY.
subject the Workers' Compensation provisions of the Labor 'Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
Minimum Setback Distances: " '
Front Setback from Center Line
'
Rear Setback from Rear Prop. Line
CONSTRUCTION' LENDING AGENCY
Side Street Setback from Center.Llne
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 C_ ode.) •
Side Setback from Property Line
Lender's Name
+
Lender's Address
FINAL DATE INSPECTOR
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..
1 certify that I have read this application and state that the above information is correct.
Issued by: Date ry Permit
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.
Validated by:
Signature of applicant Date
Mailing. Address
Validation:
City, State, Zip
-
r
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FES
1ST FL. SO. FT. ® $
2ND FL. SQ. FT. ®
POR. SQ. FT. ®
GAR. SQ. FT, ®
CAR P. SQ. FT.
WALL SQ. FT. ®
SQ 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
STORAGE TANK
FLOOR DRAIN
MECHANICAL FEES
DUCT WOR*jtW'jf,0
g
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
REINF. STEEL
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FINAL INSP.
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
SO. FT. ®c
IWATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/. c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ic
HOUSE SEWER
SPARK ARRESTOR
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PLCK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBIN Q UNDERGROUN!69 -(
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK ROUGH WIRING.
DUCT WOR*jtW'jf,0
g
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH) Q METER LOOP
[
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL) TEMP. POLE
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP. �'(
FINAL INSP. /l C C+1 L
GRADING
cu. yd..
$ plus x$
_$
LUMBER GR.
FRAMING
ROOFING
� v� ice{ C�
(Ca
evt
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION -
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES11NITIALS
GARDEN WALL FINAL