10282 (RPL)•4 "
P.O. BOX 1504 No. 10282
Building78-105 CALLE ESTADO
A(1tlrc+7cc ` 9-335 Desert Rock Ct LA QUINTA, CALIFORNIA 92253
Owner
Topaz Homes
BUILDING: TYPE CONST.
A.P. Number
OCC: GRP.
Mailing
Address 45--305 Desert Eagle Ct
City
Zip
Tel.
La Quinta
92253
772-3336
Legal Description
Project Description
Pool and Spa
Contractor
Steve Dodson Construction
Address
68805 A Perez Rd #E9
City
Zip
Tela
Cat City
92234
3241232
State Lic.
City
& Classif. A 574127
Lic. # 1044
Sq. Ft.
No. No. Dw.
Size
Stories Units
Arch., Engr.,
Designer
New ❑ Add ❑
Alter ❑ Repair ❑ -Demolition ❑
Address
Tel.
City r
Zip
State
z
Lic. #
I LICENSED CON TRACTO 's,6ECLARATION
{I hereby affirmUgat I am licensed under. provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the BSsiness�andd P`rofesss'ions Code, and my license is in full force and
effect. 7 i��t ) -A #,/
,r t
/SIGNATURE •" , DATE
t _
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt frJA 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, alter, 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.)
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to torr
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. 8 P.C. for this reason
Estimated Valuation
15 000
-PERMIT
AMOUNT
-
Plan Chk. Dep.
Plan Chk. Bal.
• C
Const.
i1b 2 . 00
Mech.
Y4. 0 0
Electrical
45. ail
Plumbing
27. 00
S.M.I.
1 . 50
Grading
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
J.E] Copy is filed with the city. ❑ Certified copy is hereby furnished.
Sr ti r, _ r
`�'
TOTAL
J b 4• 8U
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
REMARKS ,
(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.
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
Ihereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Side Setback from Property Line
Lender's Name
FINAL DATE
Issued by:
Validated by:
INSPECTOR
Date Permit
Lender's Address
This is abuilding 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 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 Dale -
Mailing Address
Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
COLL. AREA
SLAB GRADE r
ROUGH PLUMB.
YARD SPKLR SYSTEM
2ND FL. SO. FT.
STORAGE TANK
FORMS ��
MOBILEHOME SVC.
BAR SINK
POR. SD. FT. ®
ROCK STORAGE
FOUND. REINF.(
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
METER LOOP
HEATING (FINAL)
DRAINAGE PIPING
CAR P. I SO. FT.
GAS (FINAL)
WALL SO. FT.
DRINKING FOUNTAIN
SO FT ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
GRADING
cu. yd.
E plus x$
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP. h 1
'i /
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
REMARKS:
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEMIPERM
LAVATORY
HEATING SYSTEM FORGED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER S.T.U.
SO. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11% c
SEWAGE DISPOSAL
SO.FT.GAR ® 3Ac
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 PLUMBINGI(It
UNDERGROUND) (3 (40
A.C. UNIT
COLL. AREA
SLAB GRADE r
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS ��
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.(
GAS (ROUGHyitL�(�
(((((( ll
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
REINF. STEEL NIA
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
E plus x$
_$
LUMBER GR.
FINAL INSP. / qj��
c
FRAMING
FINAL INSP. h 1
'i /
ROOFING
to CCA -/ / �1
Ij� (/ -((
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
71