15873 (RPL)P.O. BOX 1504
Building 47-970 'iia. Nice 78-495 CALLE TAMPICO
Address LA QUINTA, CALIFORNIA 92253
Cohen 's
Mailing
Address Same as above
City La Quanta Zip 32253
Contractor
Dodson Pools
Address
73-031 Country Club Or #4
CityPalm Desert Zip 32211 Tel.: 346-40332
x
State Lic. City
& Classif.. x74.127 Lic. #- 1044
Arch., Engr.,
Designer
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed•under provisions of Chapter 9 (commencing with Section
7000) of ;Division 3r�of the Business and Profdssions Code, and my lice a is in I I foroce�land—
effect. r ..:1_JW ail .1S'�. .. , tib- s� ^" ale
4 SIGNATURE DATE 'r
No. 3587.3
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number
Legal Description '
Project Description 'Pool and Spa
Sq. Ft. '' No. No. Dw.
Size Stories Units
It
Repair ❑ -Demolition ❑
OWNER -BUILDER DECLARATION Estimated Valuation 1 E oo AAy►�
I hereby affirm that I am exempt from the Contractor's License Law for the following $14 f A v ®• 0'.
reason: (Sec. 7031.5,Sustness 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 file 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
for the alleged exemption. Any violation of section 7031.5 by 'any applicant for a permit Plan Chk. Dep. - 994�
subjects the applicant to a civil penalty of not more than five hundred dollars ($500). Plan Chk. Bal. J�
[II,.as owner of the property, or my employees with wages as their sole compensation, will t 5 ''
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. 1 6 V .
Professions Code: The Contractor's. License Law does not apply to, an owner of property who • a. 1.7�qV 00/q
builds or improves thereon and who does such work himself or through his own employees, Mech. R r
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 �S a ��
of proving that he did not bulid or improve for the purpose of sale.) ,A
❑'I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing .0 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 contractors) pcensed pursuant to the Contractor's License Law.)
❑ I am exempt under Sec B. 8 P.C. for this reason
,�f 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. Oompany
6opy Is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL 1 $363.30
CERTIFICATE OF EXEMPTION FROM REMARKS
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 thg work for which. this permit is issued, I shall notT.
.__employ'any, prson in any manner so as to become subject to the Workers' Compensation
Laws of Cal ifeornia l tgy'
Date Owner'
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become . ZONE: BY:
subject to the Workers' Compensation provisions of- the Labor Cede, you must forthwith Minimum Setback Distances:
comply with such provisions or this permit shall be deemed revoked. _
Front Setback from Center Line
Rear Setbaekj 1 ' ��r Prop. Line
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND - Side Street' a ack from Center Line
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO -ONE
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, Side Se ac •from Prgpe Line
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND - - -0 V
ATTORNEY'S FEES. - )
This is a building permit when properly filled out, signed and validated, and is subject to: FINAL DATE Ax -
expiration_" �P�SPECTOR
it work thereunder is suspended for 180 days. Z'
I certify that I have read this application and state that the above information, is correct: •' Issued by: � D$t"e � P, �� rm)t,,
I agree to comply with all city and county ordinances and state laws relating to building. J
construction, and hereby authorize representatives of .this city to enter .the above-: 1.r
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 M
1ST FL. SO. FT. ® $
UNITS
A.C. UNIT
2ND FL. SO. FT.
SLAB GRADE
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT.
SEWER OR SEPTIC TANK
DRAINAGE PIPING
WALL SO. FT.
DUCT WORK
DRINKING FOUNTAIN
SO. FT. ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
METER LOOP
WATER PIPING
NOTE: Not to be used as property tax valuation
REINF. STEEL
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
WATER HEATER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FINAL INSP.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
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 ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
FIRE ZONE ROOFING '
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 PLUMBING// / 7
UNDERGROUND l/ l/9f�
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) /�9�'
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
/
REMARKS:
VENTILATION
FIRE ZONE ROOFING '
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTIONl f%
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
Steve Dodson Construction Inc. 73011 _Country'Club Dr. #F4 Palm Desert Ca. 92260
Phone. (619) 346-4032 FAX. (619).341-0895