14735 (RPL)ti
P.O. BOX 1504 No. 14735
Building 48-•305 Paso T6&.npo Lane 78-495 CALLE TAMPICO .
Ad&ess LA QUINTA, CALIFORNIA 92253
Owner T. D. Desert Development
Mailing BUILDING: TYPE CONST. OCC: GRP.
Address - P;.O. Box 1715 "
A.P. Number
. City Zip 7_771-1941
La nuinta, CA.X2253 Legal Description
,Contractor Project Description Pool ant` 'Spa
Cal brnia' Pools a Spas
Address
41-910 Boardwalk A-2
Palm Desert, Ci zlp 92211 T3140-9400
State Lic. City
& Classif. C-53 55512€3 Lic. # 355 Sq. Ft. - No. No. Dw.
Arch., Engr., Size Stories Units
Designer New ❑ Add O Alter ❑ Repair ❑ : Demolition ❑
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
hereby affirm that 1 am:Iicensed under provisions of Chapter 9 (commencing with Section
000) of Diyision;3 of the'Business and Professions Code, and my license is,in full force and
,) 4
$1GNA7URE F A` DATE
OWNER -BUILDER DECLARATION Estimated Valuation lc��Sflt• Q4
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 whichrequires a
permit to construct, after, improve, demolish, or repair any structure, prior -to 1W issuance also
requires the applicant for such permit to frle.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) of '
Division 3 of the Business and Professions Code, or Mat. 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 Five hundred dollars ($500). • .
❑ I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. 134.55
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const.207.00
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 wiMfn one year of completion, the owner -builder will have the burden Electrical
of proving that he did not build or improve for the purpose of sale.) +
00
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 23.00
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 contractors) pcensed 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 hereb !affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's pensation Insurance, or a certified copy thereof. (Sec. 3800; Labor Code.)
Policy Company
Copy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL 437.55
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation - - -
o"..) I
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. r .
Date Owner
NOTICE TO • APPLICANT. N, 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: • ,
w Front Setback from Center Line
Rear Setback from Rear Prop; Line
WARNING: FAILURE To SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE Side Street Setback AND/, Center Lyne
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, Side Setback fromiPro /erty;L'in�
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND �w/p
ATTORNEY'S FEES. / �e��
This is a building permit when properly filled out, signed and validaled,-and'is subject to FINAL DATE I/N/SPE O�' r • �'
expiration if work thereunder is suspended for 180 days. //U
I certify that I have read this application"and state that the above information is correct. fssued.by: Date Kermit /11 I
I agree to comply with all city and county ordinances and state laws relating to building d 190 / f.
construction, and hereby authorize representatives .of this city to enter the" above-.
mentioned property for inspection purposes. Validated by: r r
Signature of applicant Date
Mailing Address • Validation: I
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW FEES
1ST FL. SQ. FT. ® $
2ND FL. SO. FT. ®
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. SO. FT.
WALL SQ. FT. ®
SO. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN.
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
ROUGH PLUMB.
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GAS (ROUGH)
LAUNDRYTRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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.
SQ. FT. ® c
BATH TUB
BOND BEAM
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1+/a c
SEWAGE DISPOSAL
LUMBER GR.
SQ.FT.GAR ® 3/ac
HOUSE SEWER
FRAMING
FINAL INSP.
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 ELECTRICAL 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 SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
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 SIGNATURES/INITIALS
GARDEN WALL FINAL