15340 (RPL)A 4
P.O. BOX 1504
Flildin78-495 CALLE TAMPICO
iaddr244-330 INO LAVINDA LA QUINTA, CALIFORNIA 92253
Mailin
Address44l330 CAKI +tO LAVANDA
City Zip Tel.
LID 192253
DODSON :POOH
Address
68-305 A pERVEZ 29
.O "9122341� 4—x.232
State Lic. City
& Classif.' a-53 574127 iLic.# 1044
Arch., Engr.,
Designer a '
Address Tel.
CityI Zip I State I
Lic. #
LICENSED CONTRACTOR'S DECLARATION
T• 1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
V 7000) of Division 3 of the Business and Professions Code, and my license isinfull force - and
•effect. d/� {1^ All h„ ''1
SIGNATURE q DATE
OWPER-BUILDER DECLARATION
I hereby affimm that 1 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 knprove 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) licensed pursuant to the Contractor's License Law.)
❑ I am exempt under Sec. B. & P.C. 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 Vo..Company
opy is filed with the city. ❑ Certified copy is hereby furnished.
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 pperson in any manner so as to become subject to the Workers' Compensation
Laws of Cali omnia.
Date Owner
NOTICE TO APPLICANT. N, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions or 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 1 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
LDING: TYPE CONST
Number
No. 15340
OCC: GRP.
Legal Description
Project Description 2001, & SPA
m
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: Date ' ; e mit
j�Validated by:
Validation: JUN 0. 1
Sq. Ft.
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑ ,
Estimated Valuation
18,000.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
•
Const.`
Mech.
• 4 • UU
Electrical
4 • �%
Plumbing
..i�
S.M.I.
Grading
Driveway Enc.
A
Infrastructure
TOTAL
4 Q'I • W)
REMARKS
m
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: Date ' ; e mit
j�Validated by:
Validation: JUN 0. 1
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
DUCT WORK
ROCK STORAGE
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
DRAINAGE PIPING
CAR P. I SQ. FT.
GAS (FINAL)
TEMP. POLE
WALL SQ. FT.
DRINKING FOUNTAIN
SQ. FT. ®
WATER HEATER
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
WATER SYSTEM
FLOOR DRAIN
MECHANICAL FEES
GRADING
CU. yd.
$ plus x$
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
X13
U ii
LAUNDRYTRAY
AIR HANDLING UNIT CFM
I
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
SPARK ARRESTOR
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/. c
SEWAGE DISPOSAL
LATHING
SQ.FT.GAR ® 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
ERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE,
MECH.FVPL.CK.FEE.
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING JECTRICAL ] HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING141
UNDERGROUND
)
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC T NK
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
X13
U ii
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION IX P
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
P.L.
, spa raised +18':
.31611,U
I
KOOL DECK
KC 123 y
13'
28'
30, to
SPA & POOL
LIGHT SWITCHES
i�,-,7 ��'� i
i
4 .1 LaiW
RANCHO OCOTILLO PLAN 2 "CHAPARRAL"
Bufl
c -'s'.` `°",n f„4,a`r10TE: FURNITURE ND I
,,T �,. �,ARES OWN
1�1; , t �,.1.E4 T "'s �,`_` FOR I�, USTRATI ' -
;_S. < d O ONLY,
�::alEvT TO Iia `q` s`i F ("AND'A E NOT INCL.d
ED.
! .d — A
AND ALL APPLIDABLE
DATE �l
POOL AREA -0 BE. 044- 'SED L y
MINIMUM 5 FT: HIGH Ftft '
ALt GATS t0,6'E
CLOSING
AND SELF-LATCW Ms ,
ul
18'+
bobcat
access
thrn
garage
doors
door
gm
em
gate
SPA SPECS. GENERAL SPECIFICATIONS
SIZE _fix 45sqft SIZE 16' X 28' AREA 382
RAISED +18” " DEPTH -3'6" TO -6'
LITE 100 WATTS SHAPE MIR. PERIMETER 80
TRI LEVEL SEATS TILE SIZE GROUP 3
22" 24" 27" YES TILE COLOR SF 95
P.L. DAMWALL WIDTH 6" RAISE BEAM 6' OF +18" W/TILE
SPILLWAY SIZE 12" X COPING CANTILEVER
OPEN XX CLOSED POOL CAPACITY 14,400 GALS
PUMP CAPACITY 90 GPM,
JETS.# 4 _ — MOTOR HP STA MAX 2 HP 1.5
FILTER SYSTEM 3 300 SQ FT
FILTER RATE. 100 GPM
KREEPY KRAULY TURNOVER 3 HRS
KREEPY KLEAR RETURN LINES. YES
2 SPRAYHEAD FOUNTAINS
MAIN DRAIN YES "
I SKIMMER MODEL DUAL PORT
CHECK VALVEFOR SPA
HEATER LAARS SIZE 250,000 BTU
GASLINE BY S.D.C. 53'
POOL LIGHT 40OW
SPA LIGHT 10OW
CLOCK24HR 220V
-` - ELECTRIC BY S.D.C. 176'
ELECTRICAL BONDING BY: S.D.C.
TILE AND COPING S.D.C.
DECKING BY S.D.C. 900SQFT
KC 123 KOOL DECK
CONTRACTOR cannot assume
responsibility for damage to
curbs, sidewalks, driveways,
cement slabs, sewers,
lawns,trees, fences, retaining
walls, sprinklers, telephone lines.
or shrubs. When access is made
through a neighbor's property it is
understood that you, the owner,
have that neighbor's permission
and assume full responsibility. .
Name -MA GEE
Address.44330 Cam.Lavanda
cu- La Quinta, Ca.
'Rancho Ocotillo"
6d450Jn
S
Pools
SHOW ROOM
68-805-A PEREZ RD. STE. E-9
CATHEDRAL CITY CA. 92234
PHONE (619) 324-1232
LIC # A-574127 Jeff lamb