11420 (RPL)P.O. BOX 1504 r N o . 11420
Building i0 Desert Ct 78-105CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner
74dVi.
`topaz
Mailing BUILDING: TYPE CONST. OCC: GRP.
Address 45275 Desert Eagle A.P. Number
City Zip Tel.
La Quinta 92253 Legal Description
Contractor Project Description
Steve Dodson Construction Pool and Spa
Address
68805A Perez Rd #E9
City' Zip Tela
Cat City 92234 324-.x.232
State Lic. City
&Classif. A 574127 Lic.# 1444 Sq. Ft. No. No. Dw.
Size Stories, Units
Arch., Eng.,
Designer New ❑ Add ❑ Alter ❑ Repair -Demolition.❑
Address Tel-
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm hat I am licensed under provisions of Chapter 9 (commencing with Section
r _7000) of Div��i�s�ioq 3 f IlFie Business and Professions Code, and my license is in full force and
effect.
SIGNATURE ':•'J f DATE
u► I i OWNER -BUILDER DECLARATION Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License law for the followingj�
reason: (Sec. 7031.5,Buslness and Professions Code: Any city or county which requires a P
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 hes ficensed 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 bass
for the alleged exemption. Any violation of Section 703.1.5 by.'any appficarit for 'a permit Plan Chk. Dep. .
subjects the applicant to a civil penalty of not more than five hundred dollars ($500)-
O I, as owner of the property, or my employees with wages as their sole compensation, will Plan _ Chk. Bal. 99. 4.5
do the work, -and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. �� 3• �{�
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, Mech24.00
provided that: such improvements are not intended or offered for sale: If, however, the buddarg :
or improvement Is sold within one year. of completion, the owner -budder wiu have Me burden Electrical• 00'
of proving that he did not build or improve for the purpose of sale.)
b 1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 27.00
struct the project. (Sec. 7044, Business and Professions Code: The Comracto's License Law.
does not apply to an owner of property -who builds or improves thereon, and who contracts for S.M.I. 1.40
such projects with a,contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
O 1 am exempt under Sec. B. & P.C. for this reason
Driveway Enc.
Date Owner Infrastructure
WORKERS' COMPENSATION DECLARATION
i 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.)
Pol-ri y No. Company
�Q Copy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL 349.85
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS'. COMPENSATION INSURANCE �' I
(This section need not be completed if the permit .is for one hundred do8ars ($100) valuaticmtil W ;,�.i�'� 3?r,r "'� Y+8t1
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 ZONE: BY:
subject *to the Workers' Compensation p provisions ofthe Labor Code, you must fordiwith
- Minimum Setback Distances:
comply with Such provisions or this permit shall be deemedd revoked. '
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line
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 cove.) - Side Setback from Property Line
Lender's Name
Lender's Address FINAL DATE INSPECTOR
This Is a.building permit when properly filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 180 days.
. 1 certify that I have read this application and state that the above information is correct Issued by: Date Permit
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. Validated by:
Signature of applicant Date
Mailing_Address Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
COLL. AREA
2ND FL. SO. FT.
ROUGH PLUMB.
YARD SPKLR SYSTEM
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
SEWER OR SEPTIC TANK
ROUGH WIRING.
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. I SO. FT.
GAS (ROUGH)
DRAINAGE PIPING
WALL SO. FT.
HEATING (FINAL)
DRINKING FOUNTAIN.
SO FT ®
GAS (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
WATER HEATER
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GRADING
cu. yd.
$ -plus-x$_=$
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
FINAL INSP.
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEWPERM
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 Y< c
SEWAGE DISPOSAL
SPARK ARRESTOR
SO.FT.GAR ® 3Ac
HOUSE SEWER
GAR. FIREWALL
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PLCK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. 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 TANK
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
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
/
/2-3
��r
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL