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15163 (RPL)Building Address 45a-095 DESERT HILLS Owner DORIS HORFLAW© Mailing Address SA City LA QUINTA 1ZiP 92253 Contractor DODS014 POOLS 4 P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 . . Address 68--805-A PEREZ ISD CityC.0 IZW92234 •Tel.324-1232 State Ljc. City # 1044 Classif.. 57412? �Ca3 • Arch.; Engr., Designer Address Tel. City ( Zip ( State Lic. # LICENSED CONTRACTOR'S DECLARATION 1 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 1 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, atter, 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 civil penalty of not more than five hundred dollars ($500). ❑ 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 contractors) Pcensed 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, Laboi Code.) Policy No. Company ❑ Copy is filed with the city. O 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: d, after making this Certificate or 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, i DAMAGES AS PROVIDED FOR IN SECTION 37DB OF THE LABOR CODE, INTEREST, AND ' ATTORNEY'S FEES. This is a building permit when property 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 tocomply with all city and county ordinances and state laws relating to'buitding 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. 15163 BUILDING: TYPE CONST: OCC: GRP.- A.P. Number Legal Description Project Description POOL A SPA Sq. Ft. No. No. Dw. Size Stories • Units New ❑ Add❑ Alter ❑ Repair•❑ 'Demolition ❑ ;timated Valuation 14,000 .00 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Z4 . U0 Electrical J . 6 Plumbing 27.00 S.M.I. Grading Driveway Enc, Infrastructure TOTAL D 3.3U REMARKS ZONE: BY: Minimum Setback Distances: Front Setback f nter ' Rear Setback�f m Rear Prop. ie Side Street,SAt,back f o,*nyCente Line Side Setback_.f�om Property%1e FINAL DATE IN ECTOR /90 Issued by- Date Permit Validated by: Validation:_ CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBINi3 FEES 1ST FL. SO. FT. ® $ UNITS SLAB GRADE ROUGH PLUMB. `ji BONDING YARD SPKLR SYSTEM 2ND FL. SO. FT. @ FORMS SEWER OR SEPTI RANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SO. FT. ® GAS (ROUGH) METER LOOP HEATING (FINAL) POWER OUTLET ROOF DRAINS GAR. SO. FT. ® TEMP. POLE GROUT DRAINAGE PIPING CAR P. I SO. FT. ® FINAL INSP. WALL SO. FT. ® WATER SYSTEM DRINKING FOUNTAIN GRADING cu. yd. $ plus x$ =$ URINAL SO. FT. ® FRAMING FINAL INSP. ESTIMATED CONSTRUCTION VALUATION $ i I / 1 G� '\j ,�+ V 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 WASH ER(AUTO)(DISH) APPLIANCE DRYER FIREPLACE GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM KITCHEN 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. SO. FT. ® c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID @ 1'A c SEWAGE DISPOSAL SO.FT.GAR ® 3/ac HOUSE SEWER FENCE FINAL GAS PIPING PERMIT FEE INSPECTOR'S SIGNATURES11NITIALS PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING i ,V ELECTRICAL /A HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND / d A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. `ji BONDING tq HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTI RANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP./EGUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM FINAL INSP. GRADING cu. yd. $ plus x$ =$ LUMBER GR. FRAMING FINAL INSP. ROOFING i I / 1 G� '\j ,�+ V REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES11NITIALS GARDEN WALL FINAL