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13340 (RPL)I •y � � � I • 7�/I P.O. BOX 1504 Building 51--675 Ave. Herrera 78-105 CALLE ESTADO Address LA QUINTA, CALIFORNIA 92253 Owner ane .'MOOR W Mailing Same Address City Zip Tel. La QUinta, CA 922.53. Contractor Western Pools P.O. Box 1447 Clitldio, CA zip 92241 Tel347-5959 State Lic.C53 348768 City 1151 & Classif. Lic. # Arch., Engr., Designer Address Tel. I City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION !.hereby affirm that I amlicensed under provisions of Chapter 9 (commencing with Section �7 000) of Division 3 of ria, u~'Iness aCd4p fessions Code, and my license is in full force and .eftect. SIGNATURE - DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following j, reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a i 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) o/ Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis for the alleged exemption. Any violation o/ Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars ($500). O 1, 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 o/ 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. It, however, the building or improvement is sold within one year o/ completion, the owner -builder will have the burden o/ proving that he did not build or improve for the purpose of sale.) O I, as owner of the property, am exclusively contracting with licensed contractors to con- 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. & P.C. for this reason Date Owner i 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 OtCopy is filed with the city. O Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (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, after 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. - I CONSTRUCTION LENDING AGENCY 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.) Lender's Name Lender's Address 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. I certify that I have read this application and state that the above information is correct. 1 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 -Date- Mailing ateMailing Address City, State, Zip No. BUILDING: TYPE CONST. OCC. GRP.: A.P. Number Legal Description Project Description Pool no heater 13340 FINAL DATE f Issued by: Date_ Validated by: Validation: __­­7Jd Sq. Ft. Size . No. No. Dw. Stories' Units New O Add'o Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $10,500.00 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. 81.. 90 Const. 126. ou Mech. 24.00 Electrical 45.40 Plumbing 27.40 S.M.I. Grading Driveway Enc. Infrastructure TOTAL 303. U REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street SetbaFF'k-fro.,Center Line Side Setback frorhfjj?operty/l i FINAL DATE f Issued by: Date_ Validated by: Validation: __­­7Jd CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FFICS COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING 1ST FL. SO. FT. ® $ UNITS FORMS SEWER OR SEPTIC TANK ROUGH WIRING I DUCT WORK Y ARD SPKLR SYSTEM 2ND FL. SO. FT. Q GAS (ROUGH) METER LOOP i EATING (FINAL) OTHER APPJEGUIP. MOBILEHOME SVC. BAR SINK POR. SO. FT. ® GROUT GAR. SO. FT. ® POWER OUTLET I ROOF DRAINS BOND BEAM WATER SYSTEM FINAL INSP. [ —� —� ( FINAL INSP. DRAINAGE PIPING CAR P. S0. FT. LUMBER GR. FRAMING WALL SO. FT. ��e DRINKING FOUNTAIN SO. FT. URINAL ESTIMATED CONSTRUCTION VALUATION $ I WATER PIPING NOTE: Not to be used as property tax valuation I FLOOR DRAIN MECHANICAL FEES I WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN I WASHER(AUTO)(DISH) APPLIANCE . . ' DRYEA I GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED I LAUNDRY TRAY AIR HANDLING UNIT CFM I KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC I WATER CLOSET COMPRESSOR HP POLE, TEM/PERM I LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT I SHOWER BOILER B.T.U. SO. FT. ® c I BATH TUB SO. FT. ® c I WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c I SEWAGE DISPOSAL SO.FT.GAR ® 3/ac I HOUSE SEWER INSPECTOR'S SIGNATURESIINITIALS GAS PIPING PERMIT FEE PERMIT FEE I PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELIECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBIN —7 UNDERGROUND T '7�(l A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING I HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING I DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP i EATING (FINAL) OTHER APPJEGUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE I ANAL INSP. BOND BEAM WATER SYSTEM FINAL INSP. [ —� —� ( FINAL INSP. TRADING cu. yd. $ I plus x$ i _$ LUMBER GR. FRAMING ROOFING ��e REMARKS: VENTILATION FIRE ZONE ROOFING!/) FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION L '%L7�/(/ CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL n: s/Az- ///- Pool Equip Uc. # p 348768 W- P.O. Box 1047 43 375 Madison St Indio, CA 92201 (619) 347-5959 POOL AREA To BE ENCLOSED By MINIMUM 5 FT. HIGH FENCE. ALL 'GATES TO BE SELF-CLOSING AND SEL F*--LATCH.ING. CITY 0) F) Q1k_flNTA BULDIN"I'_3, C_*SJ1i­ IR k_N 1-10 AND ALL APPLICABLt CC}DE��� DATE Alike S� 00 675' 111-el-rera, OVA t, C14. U5A 7 3 5 -5-39