BLCK (14597) + RPL (14449)78765 Lowe Dr
14597
14449
Building
Address 78-755 Lowe Far.
Owner Louis J. Olson
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
mainn
Address 79-351 Horizon Palms Circle
City Zip Tel.
La Quanta, CA 32253 360-764
Arlington Masonry Inc.
1y"2 El R;vino Road
Riverside, CA zip 92509
State Lic.
& Classif. 497743 C-29
Arch., Engr.,
Designer
Address
T I
IM)275-933!
275-933!
City '
Lic. # 3481
City (Zip I State I
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
,7 t.of Division 3 of the Business and Professions Code, and my license is in full force and
effec
SLGNATURE DATE
OWNER -BUILDER 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 or county which requires a
permit to construct, atter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to rite 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 thathe 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 provirog.that he did not build or improve for the purpose of sale.)
! 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 a,r/m exempt under Sec. l B. & P.C. forthisreason
Date/ _ ' J►Owner
I' 1
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -Insure, or a certificate of
Worker's.99Mpensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Company
Pol'cy :
Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATIONINSURANCE
(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 the work for which this permit is issued, 1 shall not
employ anyPerson in any manner so as to become subject to the Workers' Compensation
Laws of California
Date Owner
NOTICE TO APPLICANT. If, 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 ($100,000), 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.
1 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. 14597
LDING: TYPE CONST. OCC. GRP. -
.P. Number
i
egal Descriptior,
4ff'
n
roject De. 'pt' ir% _ " —
Sq. Ft.
Size
New ❑ Add ❑
of 61 high garden wall
No. No. Dw.
Stories Units
Alter ❑ Repair ❑ Demolition ❑
(Estimated Valuation 06,000.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
81.00
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
n
TOTAL
1 "
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 Property Line
FINAL DATE
Issued by:_
Validated by:
Validation:_
INSPECTOR
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
1ST FL. SO. FT. ® $
2ND FL. SO. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. SO. FT.
WALL SO. FT. ®
SO. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
SLAB GRADE
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
SEWER OR SEPTIC TANK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
ROCK STORAGE
LAUNDRY TRAY
AIR HANDLING UNIT CFM
GAS (ROUGH)
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
WATER HEATER
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1 V. c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/4C
HOUSE SEWER
GRADING
cu. yd.
$ plus x$
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
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)
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
®
C74—
C./
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION (
CERT. OCC.ir
FENCE FINAL
INSPECTOR'S SIGNATURESIINTTIALS
GARDEN WALL FINAL
BuiIdi,yg 78—',--765 Lwe Dr.
Address
•,44 Y
P.O. BOX 1504 No. 14449
78-495 CALLE TAMPICO '
LA QUINTA, CALIFORNIA. 92253
".. Louis. John Olson
Mailin
Address 79-351 Horizon Pals, Circle
City Zip Tel. '
La Quinta, . CA 922x3 36{ -if 4
Contractor - -
Ov nerljauilder' Subli. t attached,
Address
BUILDING:- TYPE CONST.' OCC: GRP.
A.P. Number
Legal Description
Project Description ' " •Poo and Spa
City
Zip
Tel.:
State Lic.
& Classif.
City
Lic. #
Sq. Ft.
Size
No. No. Dw.
Stories Units
• Arch.; Engr.;. ....
' Designer
New ❑ Add ❑
Alter ❑ Repair ❑- Demolition',[]
Address _
Tel.
City
Zip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and,
effect
-
. SIGNATURE DATE
OWNER -BUILDER DECLARATION
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 alsoAMOUNT
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 penally 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 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 ownerof the property, am exclusively contracting with licensed contractors to corn
atr ct 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.) ..
O I am exempt under Sec B. 8 P.C: for this reason
Estimated ValuationI
48 000.00
_ •`•PERMIT -
-
_. ..
Plan Chk. Dep.
..
-
Plan Chk. Bal.
64.35
Const.•
9900.
Mech.
.
_ M
Electrical -
- • -
Plumbing
•
S.M.L. • ..
-
Grading
-
Driveway Enc.
/
D'ate1 'Jj Owner :'— +
Infrastructure
WORKERS' COMPENSATION DECLARATION
I heieby affirm that I have a certificate of consent to self -insure, or a certificate of -
Worker's Compensation Insurance, or a certified copy thereof. (Seca 3800, Labor Code.) -
Policy No. company
O Copy is filed with the city, O Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE-'
(This section need not be completed g the permit is for one hundred dollars (8100) 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 becom subject to the Workers' Compensation
LAWS"O CalilOfAlaf C' -• i r -
' tt y y owner' 7,•".x'
-
;,, .t A,
3
TOTAL
'4 •
REMARKS
-
NOTICE TO APPLICANT:p„Iff'aRer making this Certificate of Exemption you should become
subject to the Workers' CompenCaatlon 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, ($100,000), 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 if work thereunder is suspended for 180 days.
I car ify.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
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Pro Line
Side Street Setback frog ter 'ne
Side.Setback from Prop e Line
l
FINAL DATE INS CT
Issued by: Date-.--- 1. pie i q
Validated by: i 1A \ 7,9 / /
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
1ST FL. SO. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SO. FT. ®
CAR P. SO. FT.
WALL SO. FT. ®
SQ. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM '
BAR SINK )
t
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
BONDING w
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEQUIP.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
n
, 36
SQ.FT.GAR Q 3/ac
HOUSE SEWER
VENTILATION
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
s 1!
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING w
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC AN
ROUGH WIRIN
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.
$ plus x$
_$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
n
, 36
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
CERT. OCC.
FINAL INSPECTION JINSPECTOR'S
FENCE FINAL
SIGNATURES/INITIALS
GARDEN WALL FINAL
CITY OF LA Q'CJ I NTA
Contractor Address;/' -3 f( er La tl , /,
Owner 7hj Job Address2g Zac. e 012, " °
d '
This form shall be posted on the job with the Building Inspection Card at all times in a
conspicuous place. It is the responsibility of the General Contractor or the Owner/Builder
to monitor the sub -contractors that are on this list are the same persons performing the
work. Any changes of this list must be approved by the City of La Quinta Department of
Building and Safety prior to work being performed by a changed sub -contractor. Failure to
comply will result in a stoppage of work and/or the voidance of building permit.
A
TRADE
SUB -CONTRACTOR NAME
CONTRACTOR'S
LICENSE NO.
WORKMAN COMP.
NO. ON FILE
CITY BUSINESS
LICENSE NO.
GRADE/
EXCAVATE
At F
PIPELINES
pig
CEMENT/
FOUNDATIONS
fiZ ( UNITe
(, I
/,r G `?j""/"
CEMENT/WALKS
& DRIVES
i
01")/U
ASPHALT
Q( ✓%v L
FRAMING
QWN 0,%L
STEEL/
STRUCTURAL
6 /V ej'L
MASONRY
P"
PLUMBING
OWN C)/L
LATHING
" -/..L'TIES
DRYWALL
0WNe/L
PLASTERING
I
ZA if 5thce1A1 S
%SyZl°
HVAC
ELECTRICAL
dW/v e2
ROOFING
149S03.2-
9S03.zSHEET
SHEETMETAL
esu
FLOORS
it p /V &L
GLASS/
GLAZING
INSULATION
vvC r2 1vs vLit iary
3g I a3 ,q
SEWAGE DISP
PAINTING/
DECORATING
QW/Ve/Z
TILE
0j,✓%U e/ -
CABINETS/
INSTALLATION
01-J UQ/L
ORNAMENTAL
METAL
FENCES/
BLOCK WALLS
Al 4-
LAN LANDSCAPING
j(,/N2✓4--
OTHERS