10379 (RPL)4
P.O. BOX 1504 N 0. 10 3 7 9
Building 44-150 CAMINO AZUL LA QUINTACCALIFORNIA92253
Address
Owner Y6`/
/y
CRAIG FLASS
Mailing BUILDING: TYPE CONST. OCC. GRP.
Address 44-150 CAMINO AZUL
A.P. Number
City Zip Tel.
LA QUINTA 92253 Legal Description
Contractor Project Description POOL AND SPA
RICK COCKRANS POOL
Address
4531 B SUNNY DUNES, #A
City' Zip Tela
PALM SPRINGS 92262 320-2030
State Lic. City
& Classif. 312674 Lic. # 4 Sq. Ft. No. No. Dw.
Size Stories Units
Arch., Engr.,
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
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 1 e Buusiness and°Pofessi ns Code, and my license is in full forceand
effect
SIGNATURE -t"y Y r rDATE
OWNER -BUILDER DECLARATION Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following �+ �5 000
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a V
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 be is licensed pursuant to PERMIT AMOUNT
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 . plan Chk. De
for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit p
subjects the applicant to a civil penalty of not more than five hundred dollars ($500). Plan Chk. BBI. 105.30
❑ 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 Const. 162 . 00
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, Mech. 24.00
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 Electrical .5 • U
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 2.7.00
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 S.M.I. • S
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
❑ 1 am exempt under Sec. B. & P.C. for this reason
Driveway Enc.
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
Copy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL � 3 6 4. 8 U
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS'COMPENSATIONINSURANCE
(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 1 �� r ��>ti K A -1 iJ I yt
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California.
Dale Owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become ZONE: BY:
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Minimum Setback Distances:
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 Side Street Setback from Center Line
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 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 if work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct. Issued by: Date 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
ateMailing Address Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
ROUGH PLUMB.
2ND FL. SO. FT.
HEATING (ROUGH)
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. Fr. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT. ®
HEATING (FINAL)
DRAINAGE PIPING
WALL SO. FT. ®
GAS (FINAL)
DRINKING FOUNTAIN.
SO FT ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
SERVICE
WATER PIPING
NOTE: Not to be used as property tax valuation
BOND BEAM
FLOOR DRAIN
MECHANICAL FEES
GRADING
cu. yd.
$ plus x$
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
ROOFING
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
VENTILATION
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.T.U.
SO. FT. ® c
BATH TUB
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1Vi c
SEWAGE DISPOSAL
SO.FT.GAR ® 116c
HOUSE SEWER
MESH
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEEMECH.FEE
j',,'
PLCK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE LUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING �-lP (UNDERGROUND j� ?o a
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
``
FORMS 1
SEWER OR SEPTIC TANK ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REIN .) (
AS (ROUGH)wMETER
GAS(ROUGH)Z2(
LOOP
HEATING (FINAL)
OTHER APPIEQUIP.
REINF. STEEL t
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
y//4y� y
/�
,I
7—
AFIREPLACE
, 7 I c.
REMARKS:
VENTILATION
FIRE
FIRE ZONE ROOFING
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION -
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL