9985 (RPL)a 4.4 0
P.O. BOX 1504
Buildin 7&105 CALLE ESTADO
g 7�3-9?S II�iDYAI [ro'�iD C�
Address LA OUINTA, CALIFORNIA 92253`
Owner
DOCTOR CHRIN
Mailing BUILDING: TYPE CONST.
Address SAME A.P. Number
City
Zip
Tel.
LA QUINTA
92.253
243.00
Contractor
CALIFORNIA POOLS
Address . .
41-910 BOARDWALK
CityZip
Z7. 00
Tel.:
PALM DESERT
92260
.340—$000
State Lic.
City
& Classif. C53-185102
Lic. # 355
Arch., Engr.,
Designer
Address
I Tel.
City( Zip ( State
Lic. If F
LICENSED CONTRACTOR'S DECLARATION w,, 1
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section'
y 7000) of Division 3 of the Business and Professions Code, and my license is in full force and
`effect.
$LGNATURE DATE
OWNER -BUILDER DECLARATION,'
I hereby affirm that I am exempt from the Contractors License law for the following
reason: (Sec:.. 7031. 5, Business 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 rife a signed statement that he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) or
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 rive 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. fl, however, .the building
or improvement is sold within one year of completion, the owner -budder will have the burden
of proving that he did not build or improve 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
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.)
❑Tam exempt unjer Sec. B. & P.C. for this reason
!i 11 / e
Data fT Owner t A
WORK COMPENSATION COMPENSATION DECLARATION
I hereby affirm that I ha a certificate of consent. to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Pollcy.No. Company
fx&cgpy 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 lhg 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. 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 car Illy 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
No. 9985
_OCC: GRP.
Legal Description
Project Description PO®L, .SPA AND FOUNTAIN
Sq. Ft.
Size
No.
Stories
No. Dw.
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
tstlmateo valuation $230750 .
PERMIT AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
15 7 •
Const.
243.00
Mech.
Z 4 . U U
Electrical
4S.00
Plumbing
Z7. 00
S.M.I.
2.40
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
-0
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 by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. r PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SQ. FT. ®
CAR P. SQ. FT.
WALL SO. 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
ROUGH PLUMB.
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
S (ROUGH) i
011 !/
LAUNDRYTRAY
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
JAMPERES SERV ENT
SHOWER
BOILER. B.T.U.
SQ. FT. ® c
BATH TUB
BOND BEAM
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1% c
SEWAGE DISPOSAL
LUMBER GR.
SO.FT.GAR ® 3/ic
HOUSE SEWER
FRAMING
FINAL INSP.
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.001-'GROUND
PLUMBIN
UNDERGROUND G
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.
S (ROUGH) i
011 !/
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
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
/
REMARKS:
VENTILATION
FIRE ZONE ROOFING :
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
NAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL