15556 (RPL)P.O. BOX 1504 No. 15556
Building 78-495 CALLE TAMPICO
Ad -dress 79-305 i0esert Stream LA QUINTA, CALIFORNIA 92253
Owner Lavelle J
Mailing BUILDING: TYPE CONST. OCC. GRP.
Address Same A.P. Number
City Zip Tel.
La Quin �� , 92253 $ Legal Description
ContractorPool and Spa
Project Description
i Sunrise Pools
Address
P.O. Box 12573 E
City Zip Tel.'_ �.
Palm Desert, X22553405;21
11 State Licity556236 City �
& Classif. Lic. #\ Sq. Ft- No. No. Dw.
Arch., Engr., Size Stories Units
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
I City Zip State
Lic. #
i
LICENSED CONTRACTOR'S DECLARATION
' F I hereby affirr7f that I am licensed under provisions of Chapter 9 (commencing with Section
-7000) t. of Div'slon 3 of he.Business and Professions Code, and my license is in full force,(` nd
• effec€
SIGNATURE Y DATE
OWNE BUILDER DECLARATION Estimated Valuation 7jQj e n
I hereby affirm that 1 am exempt from the Contractor's License Law for the following V V
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
j requires the applicant for such permit to rile a signed statement that he is licensed pursuant to PERMIT AMOUNT
the provisions o/ 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 bast
for the alleged exemption- Any violation o/ Section 7031.5 by 'any applicant for a permit Plan Chk. Dep- 105.30 q 1�
subjects the applicant to a civil penalty 1 V o/not more than five hundred dollars ($500). Plan Chk. BSI. 5.30
❑ 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 Const. 162.00
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. 24.00
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 Electrical 45.00
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 con- Plumbing 27.00
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.1-
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 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.)
PolicR�Vo Company
❑ Copy is filed with the city, O Certified copy is hereby furnished. 1
TOTAL n 3f T. 30
CERTIFICATE OF EXEMPTION FROM REMARKS ,. /+
WORKERS'COMPENSATIONINSURANCE
(This section need not be completed i/ the permit is for one hundred dollars ($100) valuation
or less.) i f;
I certify that in the performance of thg work for which this permit is issued, I shall not �j l
employ any person in any manner so as to become subject to the Workers' Compensation l
Laws of California
Date Owner `
NOTICE TO APPLICANT., ff, after making this Certificate of Exemption you should become ZONE: BY: f
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Minimum Setback Distances: f
comply with such provisions or this permit shall be deemed revoked.
Front Setback from CenterlLine
Rear Setback from Rear Prop. Line
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL, AND Side Street Setback from Center Line
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, Side Setback from Property Line
DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
This is a building permit when properly filled out, signed and validated, and is subject to FINAL DATE INSPECTOR
expiration i1 work thereunder is suspended for 180 days.
I 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. PLUMBIW FEES
1ST FL. SO. FT. ® $
UNITS
COLL. AREA
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL. SO. FT. p
BONDING
HEATING (ROUGH)
STORAGE TANK
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
ROUGH WIRIN
DUCT WORK
GAR. SO. FT.
POWER OUTLET
ROOF DRAINS
GAS (ROUGH)
METER LOOP
DRAINAGE PIPING
CAR P. I SO. FT. ®
REINF. STEEL
WALL SO. FT. ®
TEMP. POLE
DRINKING FOUNTAIN
SO. FT. ®
GROUT
URINAL
ESTIMATED CONSTRUCTION VALUATION $
SERVICE
WATER PIPING
NOTE: Not to be used as property tax valuation
BOND BEAM
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INPP. re
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
U
/
LAUNDRYTRAY
AIR HANDLING UNIT CFM
REMARKS:
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.
SO. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1% c
SEWAGE DISPOSAL
SO.FT.GAR a 3/ac
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 PLUMBIN
UNDERGROUN
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB. al
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SE ANK
ROUGH WIRIN
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 INPP. re
ROOFING
U
/
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL