13648 (POOL)• 1IIIIIIIIIIIIIII11111IIII 39
Building
Address
54-205 Ave. Alvarado
sefiQubt
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Owner
Kennedy
Mailing -
Address Same
City . •
La-:Quinta, CA
Z
P
92253
Tel.
C�ontlbactotr Pools
Address
P.O. s Box 11206
No. 13648
BUILDING: TYPE CONST. OCC: GRP.-
A.P. Number ?
Legal Description
Project pescription Pool
CPaim desert, Zi
92253
Tela
345-5070
State Lia C-53 476807
& Classif:..
City
Lic. # 130
Arch., Engr.,
Designer
Sq. Ft.
Size
No.
Stories
No. Dw.
Units
New ❑ Add ❑
Alter ❑ Repair 0
Demolition 0
Address
Tel.
City
Zip
State
Lic. #
hereby �/ LICENSED CONTRACTOR'S DECLARATION
on
7000)01 Div sion/0 of pthatIam licensed the Bus net`s and'Prunder dressions Cof ode, andrmy license (commencing
of}11th once and
effect. 1-t 6-•-l7
SIGNATURE DATE
OWNER•BUILDER DECLARATION
1 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 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 live 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.)
❑ 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 Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No Company
0 Copy 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 (5100) valuation
or less.)
I certify that in the performance of thy 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: l(, 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 .of this city to enter the above-
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
Estimated Valuation
$10,500.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
81.90
Const.
126.00
Mech.
24.00
Electrical
45.00
Plumbing
27.00
S. M.I
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
31)3.90
ZONE' BY:
Minimum Setback. Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback fr, m Property Line
FINAL DATE SPECTO�R�\
Date' Permit Ifll
Issued by'
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO.
ELECTRICAL FEES
NO.
PLUMBING FEES
1ST FL.
SQ. FT.
SQ. FT.
g0, FT.
SO. FT.
SQ. FT.
SQ. FT.
SQ. FT.
VALUATION
®
$
ROUGH PLUMB.
UNITS
HEATING (ROUGH)
STORAGE TANK
FORMS
r' r
2ND FL.
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
YARD SPKLR SYSTEM
-
HEATING (FINAL)
POR
®
REINF. STEEL
GAS (FINAL)
MOBILEHOME SVC.
BAR SINK
GROUT
GAR.
®
FINAL INSP.
POWER OUTLET
BOND BEAM
•
WATER SYSTEM
ROOF DRAINS
GRADING
cu yd
CAR P.
LUMBER GR.
FINAL INSP.7 l?J-,s/�
$
plus
FRAMING
DRAINAGE PIPING
i,
Ci
WALL
®
Pjc t T," 6-(7 -l%"
[,,`,,�/i�/
vI `eCtlP 6
REMARKS:
DRINKING FOUNTAIN
®
FIREPLACE
URINAL
SPARK ARRESTOR
ESTIMATED CONSTRUCTION
$
GAR. FIREWALL
LATHING
WATER PIPING
NOTE: Not to be used as property tax valuation
MESH
INSULATION/SOUND
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
��/�
J�_..$,./
VENT SYSTEM FAN EVAP.COOL HOOD
CERT. OCC.
SIGN
FENCE FINAL
WASHER(AUTO)(DISH)
INSPECTOR'S SIGNATURES/INITIALS
APPLIANCE DRYER
GARDEN WALL FINAL
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/nc
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE
PL.CK.FEE
CONST. FEE
ELECT. FEE
SMI FEE
PLUMB. FEE
STRUCTURE
PLUMBING
ELECTRICAL
HEATING & AIR COND.
SOLAR
SETBACK
GROUND PLUMBING r7//
7!
(a UNDERGROUND6_2, ..cry
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu yd
x$ -$
LUMBER GR.
FINAL INSP.7 l?J-,s/�
$
plus
FRAMING
_T
FINAL INSP. 2� _Tv
7
i,
Ci
ROOFING
Pjc t T," 6-(7 -l%"
[,,`,,�/i�/
vI `eCtlP 6
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION `2
��/�
J�_..$,./
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL