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9577 (RPL)4 P.O. BOX 1504 No. 9577 Building 78-105 44-185 Goldenrod Circle LA OUINTAC Address CALIFORNIA 92253 Owner Mailing Gary Thompson BUILDING: TYPE CONST. OCC: GRP. Address same I A.P. Number City Zip Tel. La Quints 92253 1 Legal Description Contractor Project Description Majestic dater Trends POOL AND SPA Address 1390 E. Sixth St 08-10 CityTel.: Zip Beaumont 32223 341-6950 State Lic. City & Classif. C53 $60471 Lic. # 1435 Sq. Ft. No. No. Dw. Arch., Engr., Size Stories Units Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State Lic. # _ LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am,licensed under provisions of Chapter 9 (commencing with Section Togo)of`Division 3ofof� the'Business and Professions Code, and my license is in full force and . fiefpc,I %_ SIGNATURE -- DATE J OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following Estimated ValuationOs ��Q fl� reason: (Sec. 7031.5,Business and Professions Code: Any city or County which requires a permit to construct, after, improve, demolish, or repair any structure, prior to its issuance also, AMOUNT requires the applicant for such permit to rile a signed statement that he is licensed pursuant to PERMIT the provisions o/ the Contractor's License Law, Chapter 9 (commencing with Section 7000) o/ Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the, basis for the alleged exemption. Any violation. of Section 7031.5 by 'any applicant fora permit Plan Chk. Dep: 122.85 subjects the applicant to a civil penalty o/ not more than five hundred dollars .(s500) Plan Chk. Bal. 12 2 . rJ ❑ I, as owner of the property, or my employees with wages as their sole compensation, will t do the work, and the structure is not Intended or offered for sale. (Sec. 7044, Buisness and Const. 1$ 9.00 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 o/ sale.) - ❑ I, 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, andwhocontracts for S.M.1. 1.00 such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading ❑ I am exempt under Sec. B. 8 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.) Policy No. Company es03$,r� `t {i li`�- 1:w'� 14 ❑ Copy Is filed with the city.. 0 Certified copy Is hereby furnished. TOTALi}�.`�3,r. CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE ,. (This section need not be completed i/ 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 not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California..` �7 ar r Date LI/11' ems/ Owner -'�� NOTICE TO APPLICANT: , ;alter making this Certificate of Exemption you shou/d • become ZONE: BY: subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Minimum Setback Distances: comply with such provisions or this permit shall be deemed 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 Code.) 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 if 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. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS SLAB GRADE 2ND FL SQ. FT. BONDING YARD SPKLR SYSTEM POR. SQ. FT. ® MOBILEHOME SVC. BAR SINK GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS CAR P. SQ. FT. GAS (ROUGH)'"/ 4,4P ( DRAINAGE PIPING WALL SQ. FT. OTHER APPJEQUIP. DRINKING FOUNTAIN, SQ FT ® TEMP. POLE URINAL ESTIMATED CONSTRUCTION VALUATION $ GROUT WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SYSTEM WATER SOFTENER VENT SYSTEM FAN EVAP.COOL ' HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP. 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 SPARK ARRESTOR SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1% c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ic 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 PLUMBING (t 4,� UNDERGROUND St�� KC 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)'"/ 4,4P ( METER LOOP HEATING (FINAL) OTHER APPJEQUIP. 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 � ,/ 1 / �l�lSiJrtVr 1 X. G A /� / (y V ` ` G� ` �C l �Q�t Q�� ''"`4 j0/Z(lk( LO 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