15488 (RPL)Vill
P.O. BOX 1504
Building 78-495 CALLE TAMPICO
Address 47-935 Via Firenze LA QUINTA, CALIFORNIA 92253
OwnerCL'ntury. . Homes
Mailing
Address 1535 South OD" St..
City Zip Tel. "
Hari BernardiA, CA '92408 (9419) 331-6007
Contractor
Davison Pools
Address
'&t$edral Cit ,'PCA 92234 Te�24--1232
State Lic. ,( City
& Classif.. 5:7412 Lic. # 1044
Arch., Engr.; -
Designer
Address I Tel. I
City (Zip (State I
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) t. of Division 3 of the Business and Professions Code, and my license is in full force and
r � .
SIGNATURE 0. i-YX./.R"Cx' "'"" -."'�. ,'.d .-.t.-:a+•-C`3.?' ..y:..w^�' DATE
OWNEWBUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law for the following
• 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
requires the applicant for such permit to rile 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 or 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 rive hundred dollars ($500).
❑I, as owner of the property, or my employees with wages as their sole compensation, will
y 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 knprove for the purpose of sale.)
O'1, 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 contractors) Qcensed pursuant to the Contractor's License Law.) .
❑ 1 am exempt under Sec. B. & P.C. for this reason
Date Owner A.,�%ds�X� •• — •. 'rte �:
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
❑ Copy is filed with the city, ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM `
WORKERS' COMPENSATION INSURANCE
(This section need ,not be completed it 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: 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.
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 ($10D,000), IN ADDITION TO THE COST OF COMPENSATION,
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
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 1 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 representativesof this city to enter the ..above-.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, ZIp
BUILDING: TYPE CONST.
Number
No. 15488
OCC: GRP.
Legal Description
Project Description Pool aAd Spa
Sq. Ft.No. No. Dw.
Size Stories -Units
Demolition ❑
New ❑ Add ❑ Alter ❑ . Repair ❑
Estimated Valuation $12,200.00
PERMIT
AMOUNT
Plan Chk: Dep.
Plan Chk. Bal.
93.63
Const.
144,00
Mech.
24.00
Electrical
45.00
Plumbing
2$'„00
S.M.I. ,
Grading
Driveway Enc.
Infrastructure
TOTAL
333.60
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setbacfrom Center Line
Rear Setback from Rear Prop. Line
Side,Streeet Setb ca k f om Center Line
S'IdeSetback
from Property Line
V,
FINAL DATE r�`` ` s9INSPECTORR
/
Issued by
Validated
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
IST FL. SO. FT. @ $
UNITS
SLAB GRADE
2ND FL. SO. FT.
ROUGH PLUMB. BONDING
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT.
DRAINAGE PIPING
WALL SO. FT.
OTHER APP./EOUIP.
DRINKING FOUNTAIN
SO. FT. ®
GAS (FINAL) 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 SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
ROOFING
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
VENTILATION
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 ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ec
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 HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBINI UNDERGROUND
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) 6 /01 METER LOOP
Q J
HEATING (FINAL)
OTHER APP./EOUIP.
REINF. STEEL
GAS (FINAL) TEMP. POLE
GROUT
WATER HEATER SERVICE
FINAL INSP.
'
BOND BEAM
/�
WATER SYSTEM �, 7,
FINAL INSP.
FINAL INSP.
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FRAMING
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL