14380 (RPL)t
T-itif 4 "
P.O. BOX 1504
Address 48-330 Paso Ti mpo Lane LA QUINTA, CALIFORNIA 902253
Owner T.D.' =Desert. D.—velopment I .
Mailing
Address P.O. Box 1716
City Zip T
La 2uinta,.CA 92253
Contractor
C41iforn a Pools aria Spas
Ad
d1r-010 Boardwalk A -2 -
City 4IR
p T
Palm Deserir 92253
State Lic. GSl KIZA1 70 C
& Classif.•.
-Arch., Engr.,
' Designer
771--1.941
Lic. #
19)340-9000
355
No. 14380
11LDING: TYPE CONST. 'OCC. GRP.
P. Number
.gal Description
oject Description Pool an Spa
Sq. Ft. No. - No. Dw.
Size- Stories Units, -
I New ❑ Add ❑ Alter ❑ ' Repair ❑ Demolition ❑
Address
Tel.
f
WORKERS' COMPENSATION DECLARATION
!
City
Zip
State
Lic. #
Policy Company
LICENSED CONTRACTOR'S DECLARATION
Il.heCeb ,affirm that,l am lice rtAeipPov,IsiOgg of_CIulpter 9 (commencing with Section
X000) of, rvi8ior�3 of-the,B_usin 'Rrofessions CodQ-and t`pynse is in full force a d
Copy is filed with Ile city, O Certified copy is hereby furnished.
_
TOTAL/r.6.30
SIGNATURE DATE
OWNER -BUILDER DECLARATION `
I hereby affirm that 1 am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,8usness and Professions Code: Any.cfty 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 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 rive 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 appy 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.)
❑ 1, 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 coniraclor(s) [rcensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec B. &-P.C. for this reason
Estimated Valuation 1°31 ISO.�j�'
- .• PERMIT
• -
AMOUNT
-
.Plan Chk.. Dep..
- - '
Plan Chk. Bal.
A 7f�
i r3.: 3 Q
Const..
162. �
Mech.
Q . 00
Electrical
A -
45 �V
Plumbing
27 ii,00
S.M.I.
Front Setback from Center Line
Grading
Rear Setback from Rear Prop. Line
Driveway Enc.
Side.Street Setback from Center Line '
Date owner
Infrastructt7f
WORKERS' COMPENSATION DECLARATION
!
1 hereby affirm that I have a certificate -of consent to self -insure, or a certificate of
Workerpensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy Company
`I lJ
Copy is filed with Ile city, O Certified copy is hereby furnished.
TOTAL/r.6.30
CERTIFICATE OF EXEMPTION FROM
REMARKS7V " ��
WORKERS' COMPENSATION INSURANCE
(This section need 'not be .completed f1 the pemrit is for one hundred dollars ($100) valuation
or less.) '
I certify that in the performance of thg 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: If, 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 ISUNLAWFUL;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.
This is a building permit when properly filled out, signed and validated, and is subject to
FINAL DATE INSPECTOR
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.
-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 Address
Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT. ®
POR. SQ. FT. ®
GAR. SO. FT. ®
CAR P. SQ. FT.
WALL SQ. FT. ®
SO. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK i .
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR ` SUSPENDED
OTHER APPJEOUIP.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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 ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
REMARKS:
VENTILATION
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
ROCKSTORAGE
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
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL