13042 (RPL)QUM&
P.O. BOX 1504
78-105 CALLE ESTADO
Address "17-551 Calle Potrero LA QUINTA, CALIFORNIA 92253
DoDco Construction
Mailing
Address F.O. BOX 1015
City Zip Tel.
La Quinta, CA 92253 564-6478
Contractor
American pool Construction
Address
68--575 Sar. Felipe Road
City Zip Tela
Cathedral, Citi t 92234 322--6669
State Lic. City
& Classif. C-53 518742 Lic. # 1104
Arch., Engr.,
Designer Flying B'utlrtlss
y � g
Address i/ //./ 7.—
City
/ Zip j j 1State
I hereby affirm that I am
J00) of Division 3 of the I
s pf Chapter 9 (con)mencing with Section
, Code, and my tic rise is in full fort .and,
t�� 7 /_. 7 —q_. o
1 herebfirm that I am exempt from the Con
y aftractor'Lic rise Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any Yy or county which requires 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 ($500).
O I, as owner of the property, or my employees with wages as their sole compensation, will
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Professions Code: The Contractor's License Law does not apply to an owner of property who
builds or improves thereon and who does such work himself or through his own employees,
provided that such improvements are not intended or offered for sale. If, however, the building
or improvement is sold within one year or completion, the owner -builder will have the burden
of proving that he did not build or improve for the purpose of sale.)
O 1, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property who builds or improves thereon, and who contracts for
such projects with a contractors) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent fto self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thefeof.!(Sec. 3800, Labor Code.J
Policy No.
Company
❑ _Copy is filed with the city. C) Certified copy:is ereby`jurnished.
i� �� jj rj
CERTIFICATE OF EXEMP�TION'FROM
WORKERS' COM PENSATION;INSU RANCE
(This section need not be completed if the permit' `
s for one one dollars ($fOO) valuation
or less.) C , �( t
I certify that in the performance of the work for which this per it is is ued, I shall not
employ any person in any
je s
manner so as to becomubject to he Workers'OCompensation
Da eLaws of California. Owner F j f � 1 I
NOTICE TO APPLICANT: If;, alter making this Certificate of Exemption' you should become
subject to the Workers' Compensation provisions of the Labor Code, you Jmust forthwith
comply with such provisions or this -permit shall be deemed revoked. {f
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 sof this city to enter the above-
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
No. 13442
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 ❑
Estimated Valuation $14,000.00
PERMIT
AMOUNT
Plan Chk. Dep.
Distances:
Plan Chk. Bal.
99.45
Const.
153.00
Mech.
24.00
Electrical
45.00
Plumbing
27.00
s.M.l.
1.40
Grading
Validated by:
Driveway Enc.
Infrastructure
TOTAL
349.85
REMARKS
1 /�
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 Property Line
FINAL DATE
INSPECTOR
Issued by:
Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUM
1ST FL. SQ. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB. BONDING
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
FORMS
SEWER OR SEPTIC TANK ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
FOR. SQ. FT. ®
GAS (ROUGH)rj-(7, 4,A METER LOOP
//
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL) TEMP. POLE
DRAINAGE PIPING
CARP. SQ. FT. ®
GROUT
WALL SQ. FT.
FINAL INSP.
DRINKING FOUNTAIN
SQ. FT. ®
URINAL
ESTIMATED CONSTRICTION VALUATION $
_$
WATER PIPING
NOTE: Not to be used as property tax valuation
ROOFING
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAI• EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
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
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
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 PLUMBINGIt-(017,t�/3UNDERGROUND l�.,C/
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)rj-(7, 4,A METER LOOP
//
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL) TEMP. POLE
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP. '7!e
FINAL INSP./d�,`� O�
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FRAMING
ROOFING
�., a JI _ r��, `3 �.
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