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9401 (RPL)w Ttty/ 4 P.O. BOX 1504 No 9401 Building•7&105 CALLE ESTADO Address 77-350Pvd. Potrero. LA QUINTA CALIFORNIA 92253 (% " Owner ✓� MOX - DODCO CONST., BUILDING: TYPE CONST: OCC: GRP.' Mailing I Address • A.P. Number City Zip ? Tel. 564-6478 Legal Description Contractor Project Description - F & F POOLS r POOL ONLY Address 80975 �ndio Blvd. City Zip Tel.: Ind-© 92201 345--5070 State Lic. City & Classif. -1125.3 470807 Lic. # 130 Sq. Ft. No. No. Dw.. Arch., Engr.; - Size Stories Units • - Designer New ❑ Add'❑ Alter ❑ Repair ❑ Demolition- ❑ Address Tel. City Zip • State Lic. # LICENSED CONTRXCTOR'S DECLARATION I hereby affirm that."" licender'provisions 9-LChapter-gicommencing w'!h Section 7000) of Division 3 -of.the Business�ahs dd'6ffd Professions Code, and : ­n) license is in full force an effect. / ��✓iCr�" nr' T /fir Z. SIGNATURE .r _ .ice-.+.� f DATE - /� OWNER -BUILDER DECLARATION Estimated Valuation I hereby affirm that I am exempt from.the Contractor's License Law for the following 8000.00 reason: (Sec. 7031.5,Buslness 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 AMOUNT` requires the applicant for such permit to file a signed statement that he is licensed pursuant to PERMIT the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) o/ 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 applicantfor a permit Plan Chk. Dep. - subjects the applicant to a civil penalty of not more than five hundred dollars.($500). , • - - " . ' - O I, as.owner of the property; or my emplPlan Chk. Bal. oyees with wages as their sole compensation, will .64.35 - do thework; and the structure Is not intended or offered for sale. (Sec. 7044, Bussness and Const.y+ �U 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.V- ' -.provided that such improvements are not Intended or offered for sale. If, however, the •building ••+;pr. improvement is sold within one year of completion, the owner -builder will have the burden Electrical ' 30.00 =''•_ o/ proving that he did not build or Improve for the purpose of sale.) r O owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 21.00 ,xq,stiuct 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. .56 - -' : such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading O 1 am exempt under Sec.' B. & P.C. for this reason r Driveway Enc. Date owner Infrastructure WORKERS' COMPENSATION DECLARATION I hereby affirm that l have's certificate of consent to self -insure, .or a certificate of ,.. . Worker's conDe to I sujance, or a certified copy thereof.,(S e. 3800, Labor Code.) Policy No. 'q� ``Company i g7r1t C.'L° IESLi ❑ Copy Is filed with the city. ❑ Certified copy is hereby furnished TOTAL 23t3.9� CERTIFICATE OF EXEMPTION FROM ' ' REMARKS t .i WORKERS' COMPENSATION INSURANCE (This section need not be completed i/ the permit 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. 4Atrii i -i `4!t371}"4 1A3G W-(iO4"'4>{ ''6.-i " Date Owner - NOTICE TO APPLICANT: If after making this Certificate o/ Exemption you should .become ZONE: BY: subject to the Workers' Compensation provisions of the Labor Code,you- must forthwith Minimum Setback. Distances: . ' comply with such provisions or this permit shall be deemed revoked. - _ - ' Front Setback from Center Line Rear Setback from Rear Prop. Line Y CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line Ihereby'affirm that there is a construction lending agency for the performance of the .- work for which this permit is issued. (Sec. 3097, Civil Code.) Side Setback from Property Line Lender's Name Lender's Address FINAL DATE t INSPECTOR 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 I have read this application and state that the above information is correct. Issuedby: " 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 r , Date , Mailing Address Validation: .City, State, Zip ' CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMWNG FEES 1ST FL. SQ. FT. ® $ 2ND FL SQ. FT. POR. SO. FT. ® GAR. SQ. FT. ® CAR P. SQ. FT. WALL SQ. FT. ® SQ 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 SLAB GRADE FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER ROUGH WIRING. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED DUCT WORK LAUNDRYTRAY AIR HANDLING UNIT CFM GAS (ROUGH) 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 WATER HEATER SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL BOND BEAM SQ.FT.GAR ® 3/ac HOUSE SEWER $ 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 7 REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESJINITIALS GARDEN WALL FINAL