15506 (RPL)P.O. BOX 1504 No. 15506-
ilding 78-495 CALLE TAMPICO -
At�dr`ess-52�37fi L��'' s1i33Z LA QUINTA, CALIFORNIA 92253
W4ner
case .0
Meiling
BUILDING: TYPE CONST. OCC:.GRP.
Address Sartre as above
A.P. Number
City Zip Tel.'
ta_ Quinta 92253 - Legal Description
Contractor. f+ �; Pro pct Description
144' X 2711 Pool 8n1�
Master Poole a Spass i P -
Front yard Setback reduction to 3' , _.73
aid
Address �J -5.1 ill
City �.y T
Tel.: .Foam Dere : �92260 346--612
State Lic.:'_ City
&Classif°.0,533 238947 Lic.# i6
Arch:; Engr:,'
Designer
Address
City'"
I'hereb
iaffirm t tJf
A(I00) tof 5i o of tt
fec k
�.
GNAT
Tel.
Zip State
Lic. #
CENTRACTOR'S DECLARATION ..
minder provisions of Chapter 9 (comrpencing 4ith Section
;a j,P,r;"sions Code, and my licens 'a in pq fgrce and
'OWNER -BUILDER DECLARATION
I hereby affirm that, I am exempt from the Contractor's License Law for the following
reason: .(Sec.. 7031.5,Bustness 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
ni;res the applicant for such permit to file 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 Cade, or that. he Is exempt therefrom, ° and the basis
forthe- alleged exemption. Any violation of Section 7031.5 by 'any applicant for a •permit
.sl;bje'ots the applicant to a civil penalty of not more than rive hundred Collars ($500).
Z 1; as owner of the.property, or my employees with wages as their sole compensation, will
do;tfie•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
"tiailds or Improves thereon and who does such workhtmself or through his own employees,'
'
provided. that; such improvements are not Intended or offered for sale. It, however, the building
• or:)mprovement is sold within one year of completion,, the owner -builder will have the burden-
of
urden
of proving that he did not build or frnprove for the purpose of sale.) -
O; 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
d"oesugot apply to an owner of property who builds or Improves thereon; and who contracts for
)':such projects;with a contractor(s) (sensed pursuant to the Contractor's License Law.)
•x
0 I am'exempt Under Sec. B. 8 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�,,Co°'mpensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Pot cy:ir'' Company
eCopy 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
California parson in any manner so as to become subject to the Workers' Compensation.
Laws of
Date Owner -
pool equipment adjustment approve -41 -. Per.
95_328..:
Sq- Ft. No. No. Dw.
Size Stories Units
New ❑ Add Alter ❑ Repair ❑ -Demolition ❑ .
Permit does; Igo_ include blo' c S 4411s
REMARKS
NOTICE TO APPLICANT: N, after making this ,Certificate of Exemption you - should become '.
ZONE:
BY:
Estimated Valuation, -
Minimum Setback Distances:, • -
'
PERMIT ..
Front Setback from Center Line
AMOUNT
Plan Chk. Dep;
Rear Setback from Rear Prop. Line
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND8
Plan Chk. Bal.'Const.,,1
Side Street Setback from Cienter,Line
SHALL. SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
HUNDRED THOUSAND DOLLARS IN ADDITION TO THE COST OF COMPENSATION,
'
Mech.
Side Setback from Property Ll�fle
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF. THE LABOR CODE,. INTEREST, AND
Electrical
ATTORNEY'S FEES.
Plumbing
`
. f9'u'
S.M:I..
INSPECTOR\
� 1�,5
I certify that I have read this application and state that'the above information -is ' correct: -
Grading
Date n Permit
-agree to comply with all city and county ordinances•and-state laws relating to building.
Driveway Enc.
construction, and hereby authorize representatives .,of, this city to ,enter the-, above -
Infrastructure '
`\
men tioned property for Inspectio_ n purposes.
Validated by:
\ a
Signature of applicant Date
Mailing Address
VandatlOrl:
City, State, Zip
`✓ ...
TOTAL
REMARKS
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:, • -
'
Front Setback from Center Line
Rear Setback from Rear Prop. Line
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND8
Side Street Setback from Cienter,Line
SHALL. SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
HUNDRED THOUSAND DOLLARS IN ADDITION TO THE COST OF COMPENSATION,
($100,000),
Side Setback from Property Ll�fle
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF. THE LABOR CODE,. INTEREST, AND
ATTORNEY'S FEES.
i
' 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. . •
FINAL DATE
INSPECTOR\
� 1�,5
I certify that I have read this application and state that'the above information -is ' correct: -
Issued by:
Date n Permit
-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 -
`\
men tioned property for Inspectio_ n purposes.
Validated by:
\ a
Signature of applicant Date
Mailing Address
VandatlOrl:
City, State, Zip
`✓ ...
CONSTRUCTION ESTIMATE'
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
SLAB GRADE
2ND FL. SO. FT.
BONDING
YARD SPKLR SYSTEM
FOR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT.
GAS (ROUGH)
DRAINAGE PIPING
WALL SQ. FT.
OTHER APPJEQUIP.
DRINKING FOUNTAIN.
SO. 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.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
GARBAGE DISPOSAL.
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1+/e c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
MESH
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 -2
ECTRICAL HEATING & AIR COND. SOLAR
72-7.f r" •
SETBACK
GROUND PLUMBI, �J
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 APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
` /d
c�
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 /®a�
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
JUL-17—
d.
15 MuM 9:45 MASTER POOLS y. SPAS 6197765889
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CASE: - z i Locat�-oa
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Your s4tback ad;justmen� app]
the fo lowing Conditions;
Condit ons: I i
1. o twin a I builds g
Department. i
2. T�e other Zoning'Code
3 `• Y ground ' excavat ion ,
Sg rvice Alert (USA) at
c;iar e
provided IUSA.
nptice.
I1 I !
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4. Additionai Condi ions;:
I I
I
S
II
lT.
ication is her4by approved, subj&
! i
t to
!rmit Er m th� Building and �,arel:
+ 'I
Provisionq shall be met.
• i I ,
s required, pi ase contact Under'round
1-800-42ir4133 The service -is f ea.o�
Ls given at -'1 ast two working days!
cd that',
o Zonin' ..Id j4tMA-ht: fps co.nsiste,! 1int with the intent and pur ose of
tordinance.!
!
There are!specia� circumstance's app icable to the property,
including'such factors` as',.;dze, shape, topography, 1 c ion or
surroundings that justify appr'val o the adjustment. These
c'ir ances • are:
' �I .- i
u for your cooperation.
1y i; �'V
MIFIMIR
mmu ue ,°etopmen j;:Depeitt ent
Atitac, ments
cl'yrguil:dinc and Y :`'
3 Sa£ety,:: Depaktme.�t
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