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15331 (RPL).. .. ., a .-. i • j�� P. 78-495 44 0. BOX 1504 CALLLE TAMPICO Address Building ��78-815 SPYGLASS LN LA OUINTA, CALIFORNIA 92253 Owner i4O RITSON Address S moz City 112253 Contractor Address PWL & -SPA 28--.070 AVENIDA PRIMAVERA City Zip Sq. Ft. Size. Tel.: C.0 New ❑ Add ❑ 192234* Repair- ❑ Demolition ❑ 3.25-238 State Lic. & Classif.. C—'53 690775 City Lic. # 1$88 -Arch., Engr., ' Designer Address Tel. City IZip I State Lic. # LICENSED CONTRACTOR'S DECLARATION I -hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec.. 7031.5,Susiness 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 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 civii penally of not more than five hundred dollars (5500). ❑ 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. ff, however, the building orImprovement is sold within one year of completion, the owner -builder will have the burden of proving that he did not build or unprove 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 contractor(s) flcensed pursuant to the Contractor's License Law.) O 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. Company ❑ Copy is filed with the city. O 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 person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT., ff, alter 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. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL .FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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-haye 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 No. 15331 LDING:- TYPE CONST. OCC: GRP. A.P. Number ,Legal Description Project Description PWL & -SPA Sq. Ft. Size. No. Stories No. Dw. Units New ❑ Add ❑ Alter ❑ Repair- ❑ Demolition ❑ Estimated Valuation 14,000.00 I PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. a 0!5.-3{ - Const. •- U Mech. . v Electrical 47 . 00 Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL �% •-�� REMARKS 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 Permit Validated bv: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBINii FEES IST FL. SO. FT. ® $ UNITS SLAB GRADE ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL. SO. FT. FORMS SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SO. FT. ® GAS (ROUGH) METER LOOP GAR. SO. FT. ® POWER OUTLET ROOF DRAINS GAS (FINAL) TEMP. POLE DRAINAGE PIPING CAR P. SO. FT. GROUT WATER HEATER WALL SD. Ff. •_FINAL INSP. DRINKING FOUNTAIN, SO. FT. ® WATER SYSTEM URINAL ESTIMATED CONSTRUCTION VALUATION $ =$ WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED VENTILATION LAUNDRY TRAY AIR HANDLING UNIT CFM FIRE ZONE ROOFING 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 BATH TUB LATHING SO. FT. ®c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1+A c SEWAGE DISPOSAL SO.FT.GAR ® 3/4c 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 APPJEOUIP. REINF. STEEL' GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE •_FINAL INSP. BOND BEAM WATER SYSTEM tGRADING cu. yd. $ plus x$ =$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIONATURESlINITIALS GARDEN WALL FINAL ' •• • • , j— ST. ��d `.k%• _ . L� •'s . I �I � M M 'yi /' _,y ^ • • � FiI WIN P-1644 Ville W. N4-7 Vi S o t 76, Roo d4_ Z. J. fRA 14, ' - a J Y 4 / . � •; != •. ,,, t, }.t �ih � y i' �....,.-.., ,,. ter..-•ir .,... _ " ' •i i' F POOL AREA SCALE 1/8,1' r ti 9 PLOT PLAN -NO -SCALE POOL SIZE %.. DEPTH TO PER . SO. FT. . TEMPL NO. , 16 FILTER N0. "y Z000 NOTE; • �% / . SGiU IQIZ �-Q14 '• �� SHAPELggjt._NO. RETURN LINES X47 ACCESS LD FT. FENCE 8 uJ MOTOR ivr- HP (�i= AJV N LACI) ' LIGHT/�fJT1SYPHON YES 4U.T'V M6 2 ,;9z= 7( ELECTRICAL 1Q_S FT. BONDING YES GFt ' GAS OD FT. TILE J COPING NO. ?n D/� ��'7Qa//C� ` 1 ' DATE-PALM"_:L� �•/ •• t JOB ADDRESS �.5�`�IS sd�Y��s�;..=� i POOL/SPA CONSTRUCTION COMPANY TRACT -i ��' s� CITY + 61 9-�Z5-218% BUS. PHONE CITY LIC. NO. CONTRACTOR NO. C53:591925 SALESMAN lt PLAN NO. �c�/ JOB NO.