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06220 (RPL)din Addrress 77-780 Chillon Owner P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 State Lic.I City & Classif. 522044 Lic. # 1361 Designer ' Address City IIZip State I Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section =01 Division 3 of the Business and Professions Code, and my license is in full force and SIC,NATIfHE _ DATE OWNER -BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License law for the following reason: (Sec- 7031-5,8uiress and Professions Code: Any city or county which requires a permit to construct, after, improve, demolish, or repair any structure, prior to its issuance also requires 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 Llvisierh 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis Ibr the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit subjects the ap'piprd to a ami penaty of not more than five 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, Bussness and P►olessions Code: The Contractor's License Law does not apply to an owner of property who bilis or improves thereon and who does such work himself or through his own employees, provided that such inprovements are not intended or offered for sale. If, however, the building or improvement is sold wfthin one year of completion, the owner -builder will have the burden of provrg that he dol not buil 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 contractor(s) licensed pursuant to the Contractor's License Law.) 0 1 am exempt under Sem B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION 1 hereby affirm that 1 have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No Company ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (11rs section need not be completed if the permit is for one hundred dollars (S 100) valuation or less.) I certify that in the performance of the 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: ff, after making this Certificate of Exemption you should become sutr%ect to the Nbrkers' Compensation provisions of the Labor Code, you must forthwith comply with such prmdsions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I 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.) L.ender's Name Lenders Address This is a building permit when property filled out, signed and validated, and is subject to expiration it work thereunder is suspended for 180 days. 1 certify that I have read this application and state that the above information is correct. 1 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 properly for inspection purposes. Signature of applicant Date Mailing Address City, State, Tip No. 06220 BUILDING: TYPE CONST. __ OCC. GRP._ A.P. Number 774-171-024 Description Project Description Pool, R Sinn Toa Vveit Mailing Address No. No. Dw. Stories Units City Alter ❑ Repair ❑ Demolition ❑ Zip Tel. TA n+, t�f+ r• a2 S� Contractor Bluo Dolphin Pools Address $12.000 PERMIT 70-825 0erald Porti City Rauebo tiirage Zip 1 92270 Tela P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 State Lic.I City & Classif. 522044 Lic. # 1361 Designer ' Address City IIZip State I Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section =01 Division 3 of the Business and Professions Code, and my license is in full force and SIC,NATIfHE _ DATE OWNER -BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License law for the following reason: (Sec- 7031-5,8uiress and Professions Code: Any city or county which requires a permit to construct, after, improve, demolish, or repair any structure, prior to its issuance also requires 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 Llvisierh 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis Ibr the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit subjects the ap'piprd to a ami penaty of not more than five 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, Bussness and P►olessions Code: The Contractor's License Law does not apply to an owner of property who bilis or improves thereon and who does such work himself or through his own employees, provided that such inprovements are not intended or offered for sale. If, however, the building or improvement is sold wfthin one year of completion, the owner -builder will have the burden of provrg that he dol not buil 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 contractor(s) licensed pursuant to the Contractor's License Law.) 0 1 am exempt under Sem B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION 1 hereby affirm that 1 have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No Company ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (11rs section need not be completed if the permit is for one hundred dollars (S 100) valuation or less.) I certify that in the performance of the 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: ff, after making this Certificate of Exemption you should become sutr%ect to the Nbrkers' Compensation provisions of the Labor Code, you must forthwith comply with such prmdsions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I 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.) L.ender's Name Lenders Address This is a building permit when property filled out, signed and validated, and is subject to expiration it work thereunder is suspended for 180 days. 1 certify that I have read this application and state that the above information is correct. 1 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 properly for inspection purposes. Signature of applicant Date Mailing Address City, State, Tip No. 06220 BUILDING: TYPE CONST. __ OCC. GRP._ A.P. Number 774-171-024 Description Project Description Pool, R Sinn Sq. Ft. Size No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $12.000 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. $ 93.80 Const. 144.00 Mech. 24.40 Electrical 30.00 Plumbing 27.00 S.M.I. 91 Grading Driveway Enc. Infrastructure TOTAL REMARKS :tt .rr?1^Fi1t+:. hlrth?.tom i'rh•. .i ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date 8124/89 Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SQ. FT. ® $ UNITS ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK YARD SPKLR SYSTEM 2ND FL. SQ. Ff. DUCT WORK ROCK STORAGE FOUND. REINF. MOBILEHOME SVC. BAR SINK POR. SQ, Ff. ® REINF. STEEL GAS (FINAL) TEMP. POLE GAR. SO. FT. ® POWER OUTLET ROOF DRAINS WATER HEATER SERVICE FINAL INSP. DRAINAGE PIPING CAR P. I SQ. FT. WATER SYSTEM GRADING cu. yd. $ plus x$ WALL SQ. FT. LUMBER GR. DRINKING FOUNTAIN FRAMING FINAL INSP. URINAL FT @ REMARKS: ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO(DISH) APPLIANCE DRYER SPARK ARRESTOR GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED GAR. FIREWALL LAUNDRY TRAY AIR HANDLING UNIT CFM LATHING 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 SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1+/4 c SEWAGE DISPOSAL SO.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)4/� f 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 � / � � � _ VL l.T�t✓ /// /�� / y." 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