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13720 (RPL)r 7 Tdy P.O. BOX 1504 No., 137 20 Building78-105 CALLE ESTADO Address 79-79A Tangelo LA QUINTA, CALIFORNIA 92253 Owner Ingram Address Sane City Zi p Tel. La Quinta,{ C 2253 Contractor Dodson Pools Adddps,05 Perez Road Ci y :athedra2 Cit.0Ca �'p9223. Tel . 324--,232 Electrical s . 00 Plumbing7.Oi� State Lic. 574127 City 1044 & Classif. Lic. # Arch.;' Engr., Designer Address Tel. ityI Zip I State Lic. # � LICENSED CONTRACTOR'S DECLARATION I hereby ..Iffirm� fiat l am licensed under provisions of Chapter 9 (commencing with Section 000) oViiisizr 3 of the isinels�nd. Professions Code, and my license is in full force and 1foc1 • OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior lo its issuance also requires the applicant for such permit to file a signed statement that he is rcensed 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 five hundred dollars ($500). O 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 apply 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.) ❑ 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 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.). ❑ 1 am exempt under Sec. B. & 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 Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy. No. -- o. Company Co sled 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 thg work for which this permit i3 issued, I shall not employ any person in any manner so as to become subject to the Wor'kers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT., If, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions 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.) Lender's Name Lender's Address 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. 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. Signature of applicant Date Mailing Address City, State, Zip r BUILDING: TYPE CONST. OCC: GRP. A.P. Number Legal Description . Project Description Pool- and Spa r' t Sq. Ft. No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolitio■ ❑ stimated Valuation $22 t opo, oo PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. 146.25 Const. 225.00 Mech. 24...00 Electrical s . 00 Plumbing7.Oi� .S.M.I. Grading Driveway Enc. Infrastructure TOTAL 4 _67_._;T5_ REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from C Rear Setback from R ( Side Street Setback' Side Setback fromJPr, FINAL DATE Issued by: Validated by: Validation: nter Line Il Prop. Cine )m CeK.terLOine perty Line QfT00 9 l Permit 994 CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. @ $ UNITS n I BONDING YARD SPKLR SYSTEM 2ND FL. SQ. FT. @ FORMS SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SQ. FT. @ GAS (ROUGH) METER LOOP HEATING (FINAL) POWER OUTLET ROOF DRAINS GAR. SO. FT. @ TEMP. POLE GROUT DRAINAGE PIPING CAR P. SO. FT. @ FINAL INSP. BOND BEAM WATER SYSTEM DRINKING FOUNTAIN. WALL SQ. FT. @ LUMBER GR. FINAL INSP. URINAL SQ. FT. @ ROOFING ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING_ NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES VENTILATION WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FIREPLACE GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM I IKITCHEN 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. SQ. FT. @ c BATH TUB SQ. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID @ 11/4 c SEWAGE DISPOSAL SO.FT.GAR @ 3/ac HOUSE SEWER CERT. OCC. 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 I REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING F AL INSPECTION Z —/ CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL Fel ts-p_:A LF BE ENCLOSED By POOL AREA TO I C TO MINIMUM M�7 E MINIMUM5 FT. HIGH FENCE-- i . I _ a LF.CLOSING �TO 13E SELF�CLOSING ALL GATE, AND SELF -LATCHING, FILTER STARITE 300 sQFT SPA SPECS. GENERAL SPECIFICATIONS 3 8 SIZE 7r VACUUM LINE & 2' �DU RAISED SKIMMSER Z SIZE x DEPTH AREA MAIN DRAIN SKIMMER MODEL HAYWARU LITE WATT -S CHEATER SHAPE PERIMETER LAARS SIZE 40U BTU TRI LEVEL SEATS YES 2111 2_71' TILE SIZE .- *nLE COLOR POOL LIGHTZix 4UU-VVA FF_ DAMWALL WIDTH _ Et, Cry � COPING C 0 FLATS SPA LIGHT U U CLOCK SPILLWAY SIZE xCOPING „CO COLOR _[5 ELECTRIC BY SI)c CO nA-1 AE_OPEN ELECTRICAL BONDING BY: SPILLWAY POOL CAPACITY , GALS DECI(ING BY 6DU- PUMP CONTRACTOR cannot assume X. CLOSED CAPACITY GPM MOTOR HP 2HP HP 1 ts-p_:A LF BE ENCLOSED By POOL AREA TO I C TO MINIMUM M�7 E MINIMUM5 FT. HIGH FENCE-- i . I _ a LF.CLOSING �TO 13E SELF�CLOSING ALL GATE, AND SELF -LATCHING, curbs, sidewalks, driveways, �`� cement stabs, sewers, lawns,trees, fences, retaining walls, sprinklers, telephone lines or shrubs. When access is made trough a neighbor's oranertv it is understood that you, the owner, have that neighbor's permission and assume full responsibility. CI I Y. -0 T\/ - 4-A F�E-PARTMPN 1' BUILDIN(13 & 8 -Al E. 0 i -ED ACCEP 1 V Si,jBjE_CT —10 !NSTAILLA, i ON PS FF-L:R �A NF_A_ L AF_CJ_67AKE C09ES DATE Name: It_1%zr\JJUVI Address. 79790 TANGELO LA QUINTA -.0 Dodson Pools' ROOM 68-808-A PERZ RD. STE. E-9 CATHEDRAL CITY CA. 92234 PHONE (619) 324-1212 LIC r"r A-574127 FILTER STARITE 300 sQFT FILTER RATE 4!) GPM TURNOVER e_ HRS VACUUM LINE & 2' SKIMMSER Z MAIN DRAIN SKIMMER MODEL HAYWARU A�, CHEATER CHECK VALVE Y LAARS SIZE 40U BTU GASLINE BY SDC POOL LIGHTZix 4UU-VVA FF_ 1 WA77 Et, Cry SPA LIGHT U U CLOCK ELECTRIC BY SI)c ELECTRICAL BONDING BY: TILE AND COPING SDC DECI(ING BY 6DU- CONTRACTOR cannot assume responsibility for damage to curbs, sidewalks, driveways, �`� cement stabs, sewers, lawns,trees, fences, retaining walls, sprinklers, telephone lines or shrubs. When access is made trough a neighbor's oranertv it is understood that you, the owner, have that neighbor's permission and assume full responsibility. CI I Y. -0 T\/ - 4-A F�E-PARTMPN 1' BUILDIN(13 & 8 -Al E. 0 i -ED ACCEP 1 V Si,jBjE_CT —10 !NSTAILLA, i ON PS FF-L:R �A NF_A_ L AF_CJ_67AKE C09ES DATE Name: It_1%zr\JJUVI Address. 79790 TANGELO LA QUINTA -.0 Dodson Pools' ROOM 68-808-A PERZ RD. STE. E-9 CATHEDRAL CITY CA. 92234 PHONE (619) 324-1212 LIC r"r A-574127