15240 (RPL)`^ P.O. BOX 1504 N o . 152-40
Building 78-495 CALLE TAMPICO
Address 44-185 C=ino }+avanda LA QUINTA, CALIFORNIA 92253
Ow ,er Tom Dade Grutz
Mailing BUILDING: TYPE CONST. OCC. GRP.
Address ,write A.P. Number
City Zip Tel.
La Qui -ata, ePi 92253 Legal Description
Contractor Project Description' Pool and Spa
Sunair Pools
.Address
P.O. Hogs 935
City Zip Tel.:
Palm Desert,, 92260 569-40141
State Lic. City
& Classif. C53 397252 Lic. # 529 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 the Business and Professions Code, and my license is in full force and
effect.
SIGNATURE DATE
OWNER -BUILDER DECLARATION Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License law for the following �3 !s •}
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 PERMIT AMOUNT
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) or i
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 Plan Chk. Dep.
subjects the applicant to a civil penalty of not more than rive hundred dollars ($500). 99.45
0.1, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal.
00
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const.
' _ �'_'
Professions Code: The Contractor's License Law does not apply to an owner or property who
builds or improves thereon and who does such work himself or through his own employees, Mech.
•
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 4 •
of proving that he did not build or knprove for the purpose or 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.
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ I am exempt under Sec. B. 8 P.C. for this reason Grading
Driveway Enc.
Date Owner Infrastructure
r
WORKERS' COMPENSATION DECLARATION JI,
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of 1
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company 1
❑ Copy is filed with the city, O Certified copy is hereby furnished. X
TOTAL r� i �'` • ��
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed If the permit is for one hundred dollars ($100) valuation _4t-\%
or less.) crtify that in the performance of the work for which this permit is issued, I shall not t' j .�� , -J �f F
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California E A
O
NOTICE TO APPLICANT. tt, after making this Certificate of Exemption you should become ZONE: BY:�``�
subject to 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
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND Side Street Setback from Center Line
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, Side Setback from Property Line
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES. FINAL DATE INSPECTOR
This is a building permw
it hen properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days. -
I certify that 1 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. PLUMBIW FEES
1ST FL. SO. FT.—@ $
UNITS
SLAB GRADE
2ND FL. SQ. FT. @
-
YARD SPKLR SYSTEM .
POR. SO. FT. @
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. @
POWER OUTLET
ROOF DRAINS
CAR P. I SQ. FT. @
GAS (ROUGH)
DRAINAGE PIPING
WALL SQ. FT.
OTHER APPJEOUIP.
DRINKING FOUNTAIN
SQ. FT. @
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
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, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. @ c
BATH TUB
SQ. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID @ 11/4 c
SEWAGE DISPOSAL
GAR. FIREWALL
SQ.FT.GAR @ 3/ac
HOUSE SEWER
LATHING
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 N ELECTRICAL if 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 SEPTI 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 I SP.
ROOFING
e
REMARKS:
VENTILATION
FIRE ZONE ROOFING '
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIONATURESlINITIALS
GARDEN WALL FINAL
GENERAL SPECIFICATIONS
size I'7 x 3a Code 39 D
Snaps Gy S
Depth 3 to 6 to —
nw Cola (g R -1O 3rL
Caping +2' Cantilewer Llt? S
Pool Capadty /2-40 00 Gals.
Pump Capacity G.P.M.
Filter VAP -V C -(-'W /(f Sq. Ft.
Pump QvA- r -t J H.P. 1
Filler Rete 7 Z O.P.M.
Tirmover $ j Hm
Vacuum Une 6 Skimmer / t�
Return Une 2 — ( •
Main OnMn I %
Swmnw 14 la'' -t W fFwt-,9 /Y •
Backwah to �-
An6,qyphonvalw g Acu a rL GtC
Healer C;wlAR`YLS Sim L 5-0
400 BT'.u.
Gosline by 5 (/ A/44 k EI@Mt by5 V A.,* -r &
ager 7= yo 0 !—! 0 0
Time sock T / .0!
:ec.na Cojor��_
S - Set...A.. _
A -a
a� -A-t,
Name T29r►-A } P iey z
Addross i a' s Com . ti -o I P V )4ud,9
city L A- f 60-1 ( ;4
cross Streets /2 -A-M. LJ Vk I L2*+ ,
Phone 3 11 o () S f (fl
Dale Drawn by-
SCALE I fir - t O"
1
wNaia
POOLS
SINCE 1974
Fa salt eM
R" 1011 A CA t1Q2e1
""a A� SeDdON
saw MOM ass- w