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13694 (RPL)Building T4t,yl P.O. BOX 1504 78-105 CALLE ESTADO 78-745 W. Harland LA QUINTA, CALIFORNIA 92253 Address Same City Zip Tel. La Quanta, CA • 92253 6 F Pools oho Bays 11206 PkIm Desert, q417 92255 1 345-5034 State Ljc. & Classif. C53 476807 CitLic. y # 130 ress CityI Zip I State I Lic. # LICENSED CONTRACTQR'S DECLARATJON I hereb!M11__e am licensed unggppr vQons of Chaptgd,r (commencing with Section 7000) ofthe Business anti:Prol6ssions Code, ar) J my license is in full force and effect. SIGNATURE y��t/ DATE OWNER -BUILDER DECLARATION I hereby affirm that 1 am exempt from the. Contractor's License Law for the following reason; (Seca 7031:5,8usiness 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 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 fora permit. subjects, the applicant to a civil penalty of not more than five hundred dollars ($500). ❑ 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 of 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. If, 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 improve for the purpose of sale.) ❑ 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.) ❑ I am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION' DECLARATION I hereby affirm that I have a certificate of consent to self -insure; or a certificate of Worker's Co ensation Insurance; or a certified copy thereof. (Sec. 3800, Labor Code.) Policy Company opy is filed with the city. 0 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 ($400) valuation or less:) I certify that In the performance of the work for which this permit is issued, I shall not employ any person ln.any manner sous to become subject to.the Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT: It, 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. 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 If work thereunder is suspended for 180 days. I certify that I have read this application and -state that the.above information Is.correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives iof this city to enter the above-. mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip 6J No. 13694 BUILDING: TYPE CONST. OCC. GRP. A.P. Number Legal Description Project Description Pool and Spa Sq. Ft. Size No. No. DIN. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $13,000.00 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. 93.60 Const. 144.00 'Mech. 24.00 Electrical 45.00 Plumbing 27.00 S.M.I. Grading Driveway Enc. Infrastructure TOTAL 333.60 REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from�P eraty Line FINAL DATE Issued by;_ Validated by: Validation:_ Al CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ UNITS COLL.,AREA r ROUGH PLUMB. YARD SPKLR SYSTEM 2ND FL. SO. FT. HEATING (ROUGH) STORAGE TANK FORMS MOBILEHOME SVC. BAR SINK POR. SO. FT. ® DUCT WORK ROCK STORAGE GAR. SO. FT. ® POWER OUTLET ROOF DRAINS 1 METER LOOP HEATING (FINAL) DRAINAGE PIPING CAR P. I SO. FT. ® GAS (FINAL), WALL SO. FT. ®. DRINKING FOUNTAIN. GROUT WATER HEATER URINAL SO FT ® FINAL INSP. ESTIMATED CONSTRUCTION VALUATION $ WATER SYSTEM WATER PIPING NOTE: Not to be used as property tax valuatlon GRADING cu. yd. $ plus x$ FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER y�f, GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED REMARKS: LAUNDRY TRAY 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 ® 1+/4 c SEWAGE DISPOSAL SO.FT.GAR.® 3Ac HOUSE SEWER MESH 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 A HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBIN UNDERGROUND A.C. UNIT COLL.,AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TAN .ROUGH WIRING. 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 INSP. ROOFING/ y�f, G•� I REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR OAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOWS SIGNATURESIINITIALS GARDEN WALL FINAL Pool Sizp 130 Surface tl Spa Size Total Perimeter EXCAVATION Concrete Removal sq Trash Loads Stump Removal STEEL 3/ " Deck Ties Yes No PLUMBING Gas Line_ y0 Number of Returns Number of Jets Anti Syphon Valve3 Fill Line Footage ft Stub fo Auto Cleaner Yes No Type �3 U( Other a PL DESIGNED FOR MR/MRS ADDRESS g- _qLo SNCL �CE. gY pC`n� aq�-A BNiGH FE gE SELF-CLOSING ALL GATES TO ANS SELF ETCHING' . F L U IATA PARTM BUILDING & SAFETY -- C.Okt71TION . SUC,JECT TC` Ii�T�LI r TlGi`I ISS SER GUNITE. Seats or Ledges Deep.End Walk Out Yes No Raised Bold Beam sq ft TILE Type Bridle Work Other DECKS Finish 1y 4 T L_ Total sq ft N D o Drains Mastic Steps ()DES � POOL EQUIP ��j ..L i 1'�L•ILl r� .L Filter �-� � _.. _ •_- Yea - ._ _-_. _�; ump = .r�' �T`"' Auto Cleaner Heater, / DL ZE7 Jet Pump SECTION THROUGH POOL Maintenance it Diving Board Slide 3� y Additional Itemes 1/80 = 1 Foot