9766 (RPL)Address 50-910 NECTARO:
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TA
ulttc�
P.O. BOX 1504 ' N o .
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
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.976-6.
Owner RANCHO CAP31PSTRAN10
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�8Fe88—$Hili
POOL�SF
BUILDING: TYPE -CONST.. �CiC: GRP:
Mailing
Address SAME
.
A.P. Number
City
Zip
Tel.
LA QUIRTA
92253.
564-0705
Legal Description
Contractor
Project Description
POOL APt SPA '
_ CALIF. POOLS
Address
41-910 BOARDWALK
City. '
Zip
Tel...
. ;
PALMI DESERT
922613
.340-900t}
State Lic.•,
City
& Classif" C53 . 185102
Lic. # 355
Sq: Ft.
No. No. Dw.
Size r^
Stories Units
Arch., Engr.,
Designer
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Address ''
Tel.
:+•
'.City. ..
Zip
State
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Lica#..
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LICENSEWCONTRACTOR'S DECLARATION
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I hereby affirm"that I am licensed under provisions of Chapter 9 (commencing with Section
' 7000) of Division 3 of the Bu/sineess Professions Code,
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.
and and my license is in full force and
:•effect.
r
. SIGNATURE ! DATE'.
F OWNER -BUILDER DECLARATION
I hereby I from 'following
Estimated Valuation
$20,000 1 '
affirm�lhat am exempt the Contractor's License Law for the
reason:*(Sec, 7031.!,Business Professions Code: Any requires
and city or•county which a
permit to construct, atter, improve, demolish, or repair any structure, prior to Its Issuance also
-
-
requires the applicant for such permit to r.a lesigned 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 that. he Is exempt therefrom, and the basis-
for the alleged.. exemption. Any. violation of- Section r7031.5 by'any *applicant for a permit
Plan:Chk. Dep.
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subjects the applicant to a civil penalty or not more than five hundred dollars.($500). " - • .•-
Chk..Bal.
S 34-:.'5
0 I, as owner of the property; or my employees with wages as their sole compensation, will _
..Plan -
_
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Bulsness and
-Contractor's
Const.
2 ' . ()
Professions Code: • The License Law does not apply to an owner of property who
~builds or Improves thereon and who does himself through his
such work or own employees,
Mech.
provided. that' such Improvements are not Intended or offered for sale: If, however, the building
or Improvement Is sold within one year of completion, the owner -builder will have the burden
Electrical
3.. (iU
or proving that he did not build or improve for the purpose of sale.)
❑'I, as owner of the property, am exclusively contracting with licensed contractors to con- .
Plumbing..
n ' 2 7�' OU
- . • struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does
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. not apply to an owner of property who builds or improves thereon, and who contracts for
such projectswitha contractor(s) licensed pursuant to the Contractor's License Law.)*
S.M.I.
Grading
-
O 1 am exempt under Sec. B. 8. P.C. for this reason
Driveway Enc.
Date Owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
' I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
W r er's•Compensatlon Insurance, ora certifiegco ereof. (Sec. 3800, Labor Code:)
Polly No)
'
Company+
Co
Copy Is filed with the city. ❑ Certified copy is hereby furnished..
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TOTAL
A V' - '• 3. s i rra Y
,
CERTIFICATE OF EXEMPTION FROM
REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not, be completed If the permit is for one hundred dollars ($ 100). valuation
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or less.)
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I certify that in the performance of the work for which this permit is issued, I shall not
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employ any parson 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 shallbe deemed revoked
� �
Minimum Setback Distances: - •" "
Front Setback from Center Line t -
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from. Center Line `
• 1 hereby 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
This is a building permit when properly filled out, signed and validated, and Is subject to
FINAL DATE
^ .m
INSPECTOR`
expiration if work thereunder Is suspended for 180 days.
I.cer Illy that I have read this application and state that the above information 1s 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. PLUMBING FEES
19T FL SO. FT. ® $
2ND FL SO. FT. ®
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. Q. 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
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
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.
SO. FT. ®c
1BATH TUB
BOND BEAM
SO. FT. ® c
WATER HEATER
MAX HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11% c
SEWAGE DISPOSAL
LUMBER GR.
SQ.FT.GAR ® V4c
USE SEWER
FINAL INSP. (c7(q 1,9
ROOFINGPf
G
PERMIT FEE
PERMIT FEE
EIPEREMITE
DBL
TOTALFEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE I ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR GOND. SOLAR
SETBACK
GROUND PLUMBING 7C Gr,
UNDERGROUND l 6 <W
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.
� U'1
GAS (ROUGH q( [/
ll ll
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP. G�
$
GRADING
cu. yd.
plus x$
=$
LUMBER GR.
FRAMING
FINAL INSP. (c7(q 1,9
ROOFINGPf
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REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
I
FINAL INsPEcnONj
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL