14974 (RPL)i 1 W
P.O. BOX 1504 No. 14974
el�f 4
Building o? - 060 DESER , LA OUINTA, CALIFORNIA 2253
� � �r+ �78-495 CALLE 9
Addre
Owner i •
ss,'
BODSON / TOPAZ
Mailing
Address 68—$05 PEREZ IRA
City - Zip
C.O. 92234
ODSON POOLS
BUILDING: TYPE CONST
A -P Number
OCC. GRP.:
Legal Description
Project Description
POOH. -& SPA
SAME
Side Street Setback from Center Line
City
Zip
Tel.:
HUNDRED THOUSAND DOLLARS ($10),000), IN ADDITION TO THE COST OF COMPENSATION,
Side Setback from. Property Line
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
State Lic.
City
ATTORNEY'S FEES.
& Classif.
Lic. # !, 1/
Sq. Ft. No.
No. Dw.
-
Size Stories
Units
Arch., Engr.,
Designer
New ❑ Add ❑j Alter ❑
Repair ❑ Demolition ❑
Address
Tel.
agree comply with all city and county ordinances and state relating to
construction, and hereby authorize representatives of this city to enter the above-.
mentioned property for inspection purposes"
4
Validated by:
0
City -,Zip
Signature of applicant Date
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
Validation:
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
A P FN Ai
• : effect.. • . - �/'i a ✓� =* %Y "—:> t j � -,T5
SIGNATURE 7 DATE
OWNER•BIIILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law for the following
Estimated ValUatlO12,000
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 rile a signed statement that he is licensed'pursuant to
PERMIT -
AMOUNT
• 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
'any for
-
Plan Chk. Dep. .
for the alleged exemption. Any violation of Section 7031.5 by� applicant a permit
' subjects the applicant to a civil penally of not more than rive hundred dollars (3500).-
Plan Chk. Bal.
❑ 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, Suisness and
Const.
+
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,
Mech.
_ 4 + U V
provided that such Improvements are not intended or offered for sale. If, however, the building
' or improvement is sold within one of completion, the owner -builder will have the burdenElectrical
5.
year
of proving that he did not build or inprove for the purpose of sale.)
27.00
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing
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
S.M.I.
such projects with a contractor(s) ycensed pursuant to the Contractor's License Law.)
Grading
❑ 1 am exempt under Sec. B. & P.C. for this reason
Driveway Enc.
Date owner
Infrastructure
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,- ❑ Certified copy is hereby furnished.
�'� ��
TOTAL
•
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This. section need not be, completed If the pemmlt-Is, .-for one hundred dollars ($100) valuation
or less.) '
I certify that in the performance. of thq 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 -
i Date Owner
NOTICE TO APPLICANT. ff, 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.
REMARKS
ZONE: IBY:
Minimum Setback Distances:.
Front Setback from Center.Line
Rear Setback from Rear Prop. Line
WARNING: FAI LURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL, AN D -
Side Street Setback from Center Line
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
HUNDRED THOUSAND DOLLARS ($10),000), IN ADDITION TO THE COST OF COMPENSATION,
Side Setback from. Property Line
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
FINAL DATE
INSPECTOR
INSPECTOR
This is a building permit when properly filled out, signed and validated, and is subject to
-
expiration it work thereunder is suspended for 160 days.
I certify that 1 have read this application, and state that the above information is correct.
' I to laws building
Issued by:
Date
-P
agree comply with all city and county ordinances and state relating to
construction, and hereby authorize representatives of this city to enter the above-.
mentioned property for inspection purposes"
4
Validated by:
0
Signature of applicant Date
y
Mailing Address
Validation:
A P FN Ai
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING. FEES
1ST FL. SQ. FT.® $
UNITS
COLL. AREA
2ND FL. SQ. FT.
ROUGH PLU
YARD SPKLR SYSTEM
FOR. S0. FT. ®
MOBILEHOME SVC.
BAR SINK �
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT. ®
ROCK STORAGE
DRAINAGE PIPING o
WALL SQ. FT.
DRINKING FOUNTAIN
SO. FT. ®
OTHER APP.IEOUIP.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
=$
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FINAL INSP.
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 Va c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
GAR. FIREWALL
GAS PIPING
PERMIT FEE
LATHING
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING 1 ELECTRICAL L HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUM
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLU
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR S C TANK
ROUGH WIRIN
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
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
FIN& INSP.
ROOFING
�_ 1
(�\
0. M'\
V \
IVN
/
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURE
INI IAIS
GARDEN WALL FINAL