15271 (RPL)!ding;
P.O. BOX 1504
78-495 CALLE TAMPICO
44-670 N. Harland - ",'LA QUINTA, CALIFORNIA 92253
Alike Cannon
Same
City Zip Tel.
La Su; nta, . CA 32253
Contractor
Aqua Quest Pools
VTass.
BbX 11206'
P61m Desert, Cf 92255 34.E-5070
State LIC.
& Classif. C.-53 -476$47 CitLic.:y # 130
Arcn., tngr:,
Designer
Address
CityZip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division'3 of;the Business and Professions Code,.and.my license is In full force and
effect.
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that am exempt from the Contractor's License Law for the following
reason: (Sec.. 7031.5,13uniness and Professions Code: Any city or county which requires a
permit to construct, alter, bnprove, demolish. or repair any structure,prior to its issuance also
requires the applicant for • such permit to Me" a s1pned' statement that he ,(s licensed pursuant to
the provisions of'the Contractors License Law, Chapter 9 (commencing with Section 7000) of
Division 3: of the fpNness and, Ro/esabns Cada, or that. he is exempt therefrom, and the basis
for the alleged- alfemption. Any violation of Section 7031.5 by 'any applicant fora permit
subjects the applicant to a chd penalty of not more than five hundred dollars. (5500),
❑ I, as ownerof the property, or my employees with wages.as their sole compensation,; will
do the work, and the at is not Intended or offered for sale. (Sec. 7044, Suisness and
Professions Code: The Contractors: License Law does not apply to, an owner of property who
builds or bnproves thereon and who does such work hbnseff or through his own employees,
provided thatsuch trnprovements are not Intended or offered for sale. H, however, the building
or Improvement Is sold within one year of completion,, the owner -builder will have the burden
of proving that he did not build or hlprove for Me 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 bnproves thereon,. and who contracts for
such pro/eCts with a comrector(8) Qoensed pursuant to the Contractor's License Law.) .
❑ 1 am exempt under Sec r1, & P -C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
1 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
❑ Copy Is filed with the city, . ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This sectio ,need not be completed If the pemtlt is for one hundred dollars ($100) valuation
or less.)
1 certify that in ;the performance of thq work for which this permit is Issued, I shall not
employ any ppeerson In any manner so•as to become subject to the Workers' Compensation.
Laws of CalIFe
Date Owner
NOTICE ;TO APPLICANT: M, after making this Cartlff & of. Exemption you should become
subject to the Wbrkers' Cornpenm8on provisions of the Labor Code, you must -forthwith
comply aith such provisions or this permit strap be deemed revoked.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND
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,
DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST; AND:
ATTORNEY'S FEES.
This is at building permit when propedy.fitled out, signed and validated, and is subject,to
expiration, If work thereunder is suspended for 180 days. _.
I certity theft have read this, application and state that the above information is correct.
I agree to comply with all' cityand county ordinances and state laws relating to .building
construction, and hereby authorize representatives -of this city to enter the above.:
mentioned propertyfor Inspection purposes
signature of applicant— Date -
Mailing Address
City, State, Zln
No. 15271
BUILDING: TYPE CONST. - OCC: GRP.-
A.P. Number
,Legal Description
Project Description -Pool and Spa
Sq. Ft. No. - No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑. Repair ❑ Demolition D
Estimated Valuation $11,,5.00.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
99.45
Const.
153.00 .
Mech.
24.00
Electrical
45.00.
Plumbing
. 2? . 00 .
S.M.I.
'
Grading
Side Street Setback; Cente me�
Driveway Enc.
Side Setback from' erty LI
Infrastructure
/12 ECK�R'
Issued by:
y U 7.
Date ••• Permit`s. ti /
vJ
Validated by
�/
TOTAL
348.45
REMARKS
ZONE:
BY:
Minimum Setback
Distances:.
Front Setback from Center, ine
Rear Setback from. R " p.'1=ince
Side Street Setback; Cente me�
Side Setback from' erty LI
FINAL DATE
/12 ECK�R'
Issued by:
y U 7.
Date ••• Permit`s. ti /
vJ
Validated by
�/
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
1ST FL. SO. FT. !g $
UNITS
ROUGH PLUMB. BONDING
2ND FL. SQ. FT.
STORAGE TANK
YARD SPKLR SYSTEM
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO, FT, ®
POWER OUTLET
ROOF DRAINS
CAR P. I SQ. FT.
REINF. STEEL
DRAINAGE PIPING
WALL SO. FT. ®
DRINKING FOUNTAIN.
SQ FT ®
... FINAL INSP.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER, SYSTEM
FINAL INSP.
FINAL INS .
WATER PIPING
NOTE: Not to be used as property tax valuation
LUMBER GR.
FLOOR DRAIN
MECHANICAL FEES
+
I
`/ J
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FIRE ZONE ROOFING
LAUNDRYTRAY
AIR HANDLING UNIT CFM
FIREPLACE
KITCHENSINK
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
MESH
SQ: FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO: FT. RESID ® 1Ya c
SEWAGE DISPOSAL
SO.FT.GAR ® 34c
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 6 AIRCOND. SOLAR
SETBACK
GROUND PLUMBING UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTI ROUGH WIRING
DUCT WORK
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH) METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL) TEMP. POLE
GROUT
WATER HEATER SERVICE
... FINAL INSP.
BOND BEAM
WATER, SYSTEM
FINAL INSP.
FINAL INS .
GRADING,
cu, yd.
plus -x$
_$
LUMBER GR.
FRAMING
ROOFING
+
I
`/ J
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIOWSOUND
FINISH GRADING
FINAL INSPECTION :61 11
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIaNATURESIINITIALS
GARDEN WALL FINAL
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