14409 (RPL)4
P.O. BOX 1504 No. 14409-
B u i I d i n 9,?# 44;-005 Camino Zava,rda 78-495 CALLE TAMPICO
Address LA QUINTA, CALIFORNIA 92253
Owner Century Crowell Development
RUILDING- TYPF CONST- OCC- GRP_
Mailing
Address 1535 $o. St. Ste. E-9
ci .an Beranardin o;. CA 9240 Te( 710 381-600'
Contractor
Dodson -Pools
Address
68-805 A Perez Ted. Ste. R--9
Ci�athedral Ci zi* CA 92234Tel. 324-1232
State Lic. A 574127 City 1444
& Classif. Lic. #
Arch., Engr.,
Designer • -
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section,
7000) off",D(ivision 3 of the Business and Professions Code, and my license is in full force and
effect�d/�•LA(z,�c,v t; It
SIGNATURE 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, atter, improve, demolish, or repair any structure, prior to its issuance also . .
requires the applicant for such permit to rile 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 the applicant to a civil penalty of not more than five 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.)
❑ 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 of property who builds or Improves thereon, and who contracts for
such projects with a contractor(s) ricensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec B. & P.Q 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 Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No.Company
�iiCopy is filed with the city, ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
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
employ any pperson in any manner so as to become subject to the Workers' Compensation
laws of California
Date - Owner
NOTICE TO APPLICANT: •d, 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 IN SECTION 3706 OF. THE LABOR CODE; INTEREST, AND
ATTORNEY'S FEES.
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.
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 Address
City, State, Zip
A.P. Number
,Legal Description
Project Description
Pool and •
Spa
Sq. Ft.
Size.
No.
Stories
No. Dw.
Units
New ❑ Add ❑
Alter ❑
Repair ❑ Demolition ❑
Estimated Valuation
*10,000.00
I
PERMIT-
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
76.05
Const.
117.00
Mech`
24-01)
Electrical
45.00
Plumbing
27.00
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
289,05
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
FINAL DP
Issued by
Validated
Validatior
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
IST FL. SO. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. SO. FT.
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
FOR. SO. Ff.
GAS (ROUGH)
METER LOOP
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. I SO. FT.
TEMP. POLE
DRAINAGE PIPING
WALL SO. FT. @
GROUT
DRINKING FOUNTAIN
SO. FT. ®
FINAL INSP.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
WATER PIPING
NOTE: Not to be used as property tax valuation
_$
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
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 ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR Q 3/ac
HOUSE SEWER
INSULATIONISOUND
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING #ILECTRICAL 1 J d) EATING & 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 APPJEOUIP.
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
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIONATURESIINITIALS �-
GARDEN WALL FINAL
1 :
Pte" SPA SPECS. GENERAL SPECIFICATIONS
I' ' SIZE 7 SIZE 1 X /130 AREA 368
30 -0 RAISED DEPTH 3'6" 5 3'6"
LITE 100 WATTS SHAPE C PERIMETER 83
TRI LEVEL SEATS TILE SIZE
22" 24" 27" TILE COLOR
DAMWALL WIDTH 12" COPING by centu
118,-6,. 18'-6" i SPILLWAY SIZE 12 X 3'" COPING COLOR
POOL CAPACITY GALS
} i SPILLWAY PUMP CAPACITY 100 GPM
i OPEN XX CLOSED MOTOR HP HP
FILTER 300 SQ FT
R6'-0" FILTER RATE 102 GPM
6" RAISED I TURNOVER HRS
SUNNING AREA
VACUUM LINE & 2
SKIMM5ER 2 "
MAIN DRAIN 2 "
\ 4 SKIMMER MODEL AM
CHECK VALVE
HEATER LAARS SIZE 250 BTU
GASLINE BY `
POOL LIGHT 400 WATT
SPA LIGHT 100 WATT
+ CLOCK 220 V.
l ELECTRIC BY S.D.C.
3'-0" ELECTRICAL BONDING BY:
TILE AND COPING
DECKING BY CENTURY
=- 691 SQ. FT. COLOR SALT.
16'-0'-k CONTRACTOR cannot assume
responsibility for damage to
9,_51,
{ curbs, sidewalks, driveways,
i — — cement slabs, sewers,
j --
lawns,trees, fences, retaining
1 walls, sprinklers, telephone lines
2-14.4444'
— I or shrubs. When access is made
through a neighbor's property it is
l; I understood -that you, the owner,
have that neighbor's permission
9.4463'
LOT#7 and assume full responsibility.
OF'LA I TA.
Name.: CENTURY CROWEI.I, DEV.
-box `_ ■ ■ , BUIL INN & SAFETY DEPARTMENT Address: RANCHO OCOTILLO
CO DITIONALLY
250 LA QUINTA
CEPTED OR CONSTRUCTION
LIGHT SWITCH 'UWECT TO NSTALLATION AS PER
W.
RFSTDA gib..
Avogfsoll
NIALL PPLICABLE DES _„
LOT # 7 POO/S
�7
SHOW ROOM
DATA.. 68-805-A PERZ RD. STE. E-9
CATHEDRAL CITY CA. 92234
PHONE (619) 324-1232
LIC # A-574127
l