14408 (RPL)44
P.O. BOX 1504 No. 14408
Building 78-495 CALLE 45-150 Desert, Fox Dr. LA QUINTA, CALIFRNP
ICO
Addres,'�1 A 92253
Owner 1 Century Crowell. Development �
BUILDING: TYPE CONST. OCC: GRP.-
Mailing.:•
Address 1535 So. *D" St: Ste. #290
A.P. Number
City . Zip Tel. '
San 3Lrnard4 CA 92413. . 014) 381-.6007 Legal Description
Contractor/ Project Description Fool and Spa
Dodson Construction51' ..apt 4' high ret+ mint. wall
68-805 A Perez did. Ste. E--9
r
06 - Zip �, Tel
thedral Cit,ti.s 3223 324-1231
State Lic. City
& Classif. A 574127 Lic. # 1044
Arch., Engr.,
Designer
Address Tel.
City Zip 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
SIGNATURE DATE
OWNEWBUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following.
i 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 to its issuance also
i requires the applicant for such permit to file a signed statement that he is -licensed pursuant to
! the v1sions of the Contractor's License Law, Chapter 9 (commencing. with,Section 7000) of
Dlvlslon 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 penaltyof not more than rive hundred dollars ($500). -
.0 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 knprovements.are not Intended or.offered for sale. ff, 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 snprove for the purpose of sale.) .
a. ❑ 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.)
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.I. filed with the city;.. ❑ Certified copy is hereby furnished. _
CERTIFICATE OF EXEMPTION'FROM
WORKERS'COMPENSATIONINSURANCE
(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. If, 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 Iso building permit when properly'filled out; signed and validated, and is subject to
expiration It work thereunder is suspended for 180 days:
I 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. tof this city to. enter the, above-.
mentioned property for inspection purposes.--
Signature
urposes.-Signature of applicant ''K'� - r t �C �._ Date f 4 a
Melling Address
City, State, Zip
REMARKS \
ZONE: BY: '
Minimum Setback Distances:
Front Setback from Center -Line '
Rear Setback from Rear Prop: Line
Side Street Setback.from Center Line
Side SetbaNrom Property/Vince
FINAL DATE INSPEC 1FY
Issued by: Date r rmit
Validated by: �i.
Sq. Ft.
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ . Repair ❑
Demolition ❑
.•
Wall'$934.00
Fool $11,900.00
Estimated Valuation$12v834.00.
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk_ Bal.
87 „7 rj
Const.
135.25
Mech.
24.00
Electrical '
45.00
Plumbing
27.00
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
319.00
REMARKS \
ZONE: BY: '
Minimum Setback Distances:
Front Setback from Center -Line '
Rear Setback from Rear Prop: Line
Side Street Setback.from Center Line
Side SetbaNrom Property/Vince
FINAL DATE INSPEC 1FY
Issued by: Date r rmit
Validated by: �i.
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
1ST FL. SO. FT. ® $
UNITS
SETBACK
GROUND PLUMBING
Y
ARD SPKLR SYSTEM
2ND FL. S0. FT. p
A.C. UNIT
COLL, AREA
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
BONDING
GAR. SO. FT.
POWER OUTLET
ROOF DRAINS
SEWER OR SEPTIC TAN
DRAINAGE PIPING
CAR P. I SO. FT. ®
DUCT WORK
ROCK STORAGE
WALL SQ. FT. ®
GAS (ROUGH)
DRINKING FOUNTAIN y
SO. FT. ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
REINF. STEEL
WATER PIPING
NOTE: Not to be used as property tax valuation
TEMP. POLE
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
WATER SYSTEM
LAUNDRY TRAY
AIR HANDLING UNIT CFM
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.
SQ. FT. @ c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1% c
SEWAGE DISPOSAL
FIRE ZONE ROOFING
SO.FT.GAR p 3/ac
HOUSE SEWER
FIREPLACE
GAS PIPING
PERMIT FEE
PERMIT FEE II
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE TUMB. 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 TAN
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
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 LY ^�
/001
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REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION ! I
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIONATURESIINITIALS
GARDEN WALL FINAL