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14964 (RPL)I � r -13u ilding Address 44 P.O. BOX 1504 No. 14964 78-495 CALLE TAMPICO Camino Layanda LA QUINTA, CALIFORNIA 92253 - _ John Drury BUILDING: TYPE CONST. OCC. GRP. Mailing Address Sams A.P. Number City Zip Tel. La Quinta r CA 92253 Legal Description Project Description Pool ACS Spa Co 1VT VYre Pools Address PO. ,Box 1.751 CityZip La Qninta, CA -` 9'2253 Tel.: 342-33-5221 State Lic.. & Classif. C53-61,4611 City Lic. # 1945 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 hereby affirm that I am licensed'un�der provisions of Chapter 9 (commencing with Section 000) of-Divislon 3 of the• ZSIn"ess-and Professions Code, and my license is in full force and - ilGNATURE ' 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 or 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 knproves 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 reprove 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 contractors) pcensed pursuant to the Contractor's License Law.) O I am exempt under Sec B. & P.C. for this reason Estimated Valuation $14"000.00 I PERMIT - AMOUNT - Plan plan Chk. De Plan Chk. Bal. r g Const. ,,, Mech. 24.06 4 • V.. Electrical - 5 00 - Plumbing "' S.M.I. Grading 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 Com n`sation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy ✓���Is Company ' ^ Copy is filed with the city. ❑ Certified copy is hereby furnished. 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 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 Date Owner NOTICE TO APPLICANT., ff, after making this Certificate of Exemption you should become subjectto the Workers' Compensationprovisions 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 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. Signature of applicant -Date- Mailing ateMailing Address City, State, Zip REMARKS ZONE: BY: 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 INSPECTOR Issued by: Validated Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBIW FEES IST FL. SO. FT. ® $ UNITS • 2ND FL. SO. FT. SLAB GRADE YARD SPKLR SYSTEM MOBILEHOME SVC. BAR SINK ) POR. SO. FT. ® STORAGE TANK FORMS GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. SO. FT. FOUND. REINF. DRAINAGE PIPING WALL SO. FT. HEATING (FINAL) DRINKING FOUNTAIN SO. FT. ® GAS (FINAL) URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation SERVICE FLOOR DRAIN MECHANICAL FEES BOND BEAM WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FINAL INSP. LAUNDRY TRAY AIR HANDLING UNIT CFM J / J , / e , /-''•'A`/ A�/!v0'A_/� D 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 SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1+/e c SEWAGE DISPOSAL GAR. FIREWALL SO.FT.GAR ® 3/ic HOUSE SEWER LATHING GAS PIPING PERMIT FEE MESH PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL Al HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBINt UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB.Ail BONDING I HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC ANK 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 J / J , / e , /-''•'A`/ A�/!v0'A_/� D REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL