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12114 (RPL)Ce P.O. BOX 1504 ' Building„ 78-105 CALLE ESTADO Address 47,Y" 445 Via Cordova LA QUINTA, CALIFORNIA 92253 Owner gig. Bedew Mailing'.," Address@ City Zip La CA 92253 Contr ctor ' Tel. 564-°5447 Cal1f6i a� '- Pools ' S ' Spas Address 41 9fl©acwak, Sa3 a X24 City Zip' Tel.: a]. •.. e�+ zt 92260. 340-9000 State rulic? 185.102 355 S Designer �r D6jjg Ferrell.. Address ; ti Tel.. Itt City ;,�*� Zip State. .. LIC. # ' Yz' LICENSED CONTRACTOR'S DECLARATION .I hereby 8ffirm tljat I am licensed under provisions of Chapter 9 (commencing with Section 7000) of D141sio of the Business and Professions Code, and my license is in full force and effect. , `SIGNATUREt' '•f DATE OWNEWBUILDER DECLARATION I hereby affirm that I^am exempt from the Contractor's License Law for the following reason: (Sec% 7031.5,Business and Professions Code:. Any city orlcounty which requ4es a ?"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) 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 subjects the applicant to a civil penalty of not more than five.hundred dollars ($500). ❑ I, 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.).. , ❑ 1 am exempt under Sec. • B. & P.C. for this reason Date Owner n• WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of ;y Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Poli No: CN' Company Copy is fit with the city. ❑ 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 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: Date--- I -�_Owner NOTICE TO APPLICANT: If, eller making this Certificate of Exemption you should be• o.me 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 -of .this city to enter- the•above-. mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip No. BUILDING: TYPE CONST. OCC: -GRP. - A.P. Number Legal Description ' Project Description Pool and Spa ! t Sq. Ft. No. No. Dw";'r—`,L Size Stories Units N New O Add O .. Alter O . Repair O •Demolition'❑ M 2 � i Estimated Valuation 4 2, 500.00 PERMIT AMOUNT Plan Chk. hep." Plan Chk. Bal. , - 33• i((3 Const. yy Mech..:Df3. Electrical 45.00 Plumbing 27.00 .S.M.I. 1.30 4 Grading Driveway Enc. - Infrastructure " r . TOTAL REMARKS I • �•R`:x''((Ai51 r,,•�(�+; ��y•,�,gtr�"/".�s� �jy.{� - 3/- 47 "ly i,�y .•a F ' •'G�'. .��.i6,�i ��� +i•r"•"V.IY'R �.F .'•'.t,NV, %,..,C.Y� Yl�r�i ZONE: BY: i Minimum Setback Distances: w Front Setback from Center Line rr Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: i CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FECES 1ST FL. SO. FT. ® $ UNITS SLAB GRADE F " BONDING YARD SPKLR SYSTEM 2ND FL. SQ. FT. FORMS SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® GAS (ROUGH) METER LOOP GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS GAS (FINAL) TEMP. POLE DRAINAGE PIPING CARP. SQ. FT. GROUT WATER HEATER WALL SQ. FT. FINAL INSP. DRINKING FOUNTAIN. SQ. FT. ® WATER SYSTEM URINAL ESTIMATED CONSTRUCTION VALUATION $ _$ WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP..Gi3 FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER VENTILATION GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY 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 SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER FINISH GRADING 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 PLUMBINGS( YI UNDERGROUNDS/s�3 t'P% 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) METER LOOP HEATING (FINAL) OTHER APP.IEQUIP. 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..Gi3 FRAMING __ ��JJ FINAL INSP. ^7/ ROOFING ? y 5(1� TY 5-10 3 C /J n (F %➢cid ��-�,Ss ��� REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL