RPL (001213)77243 Calle Mazatlan
001213
APPLICANT NAME (L. F. MI) Hamilton I s .. .
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_
ADDRESS P .OB ..
a . ' e
ox ••1593
PERMIT
APPLICATION _
• + , City of La Ouinta
Department of Building and Safety
PAG°''
01
PRC'
.This permit becomes void if work not commenced within 180 days from date of issuance,'OR: if -work has been suspend or abandoned for a period of 180 days: ♦ -. :' 4
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section needriot tie completed If
LICENSED CONTRACTORS DECLARATION: I hereby affirm that I' am licensed *under 'provisions, of Chapter 9'• '
' ' the permit is for one hundred ($100) o; less. I certify that in the performance of the work for -which this permihis •:
(commencing with Section 7000) of Division 3 of the Business and Professions -Code; and my license is in full force`, •
issued, I shall riot employ any person in any.manner so as to become subject to the Workers' Compensation Laws of
and effect. //1^ (California.
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License Class - Lic Number f — %-+4—
Date Applicant'
x, ✓j. r^i ;
.Date' ' ' Contractor.: - 4 `
- NOTICE TOAPPLICANT: If, after making this Certificate of Exemption, you should become subject to the Workers' - `w
•OWNER -BUILDER DECLARATION: I hereby affirm that I arii'exempLfrom the Contractor's License Law for the
:. Compensation provisions of.the.Labor Code, you must forthwith comply with such provisions or this permit shall
following reason (Sec. 7031.5.'Business and Professions. Code: Any cilybr county .which 'requires a pernlil to
be deemed revoked...
construct; alter, improve. demolish, or repair any structure, prior to its issuance; also requires the applicant for
DIVISION OF INDUSTRIAL SAFETY PERMIT -CERTIFICATION:
• -such permit to file a signed statement that he is licensed,pursuant to the provisions of the Contractor's License Law, ,;:
0 1 hereby certify that no excapation five (5) or more feet in depth into which a person is required to descend, will be
-(Chapter 9(commencing with section 7000) of. Division 3 of the Business. and Professions Code)or that he is exempt.
"c made in connection with work authorized by this permit, and that no building structure, scaffolding; falsework; or • • +
therefrom and the basis.for the alleged exemption. -Any violation of Section 7031.5 by any applicant for a permit•' •
.: • ' demolition or dismantling thereof, will be more than thirty-six.(36)•teet high. (Chap 3.2, Grp 2, Art 2, Sec 341: Titlell "
subjects
the applicant to a civil penalty of not moedhan five hundred dollars ($500.):
C.A.C.)
.a 0 I, as owner of.the-property, or my employees with wages as their sole compensation, will dothe.work, -and the
•• 0 As owner•builder,'I will not employ'anyone to do work'which would require a permit -from the Division of
structure is noFintended or offered •forsale (Sec. 7044, Business and Professions Code: The Contractor's License
_ Industrial Safety,'as`noted above, unless such person has apermit to do such work from that division:
claw does not apply to an owner of property who builds, or improves thereon; and who does such work himself or
<e
'• 'through his own employees, provided that such improvements are not intended or offered for sale. If, however, the
• O Division of InQustrial Safety. Permit No.,
building or improvemnt is sold within one year of, completion, the owner -builder wil I have the burden of proving that ,.
'Date 'Applicant:
1: ,Od not build or improve for the purpose of sale.): .. ,
CONSTRUCTION LENDING AGENCY: I hereby affirm.that there is a construcbenlending'agency for the performance
•. 0 I; as owner of the property, am exculsively contracting with licensed contractors to construct the project (Sec:
.• .,"of the work for. which this permit is issued (Sec. 3097; Civ. C.).-
7044', Business and Professions Code: The Contractor's License Law does not apply to'an owner of property who' '
• Lender's Name
builds or improves thereon, and who contracts'for such projects with a.contractor(s) licensed pursuant -to the
• "•; LOT SZ
Contractor's License Law.).- _
Lender's Address 2
• . 0 1 am exempt under. Sec: - -.'B. 8 P.C. (Attached Certificate)..
I certify that I have read this application and state that the,above information is correct: I agree to comply with all
" Owner
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
.Date
of this county to enter upon the above-mentioned'property for inspection purposes.
WORKERS' COMPENSATION DECLARATION: -1 hereby affirm that I have a certificate of consent to self -insure' -or a"...
" certificate'of Workers' Compensation Insurance • or a certified copy thereof (Sec. 3800. Lab. C.).
Signature of Applicant or Agent ` Date '
PoliRy No. Company,
-CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have read this application and statethaI
- ..0 Certified copy is hereby.furnished: 3a -.
the informatiooZgiven is correct. l agree to comply with all state laws and county ordinances relating to buidIing
'•x-'17 Certitied'copy is filed with the City Building Inspection Department or City, Department. `
construction; and authorize,a'representative of the City of La Ouinta.Department ofBuilding and Safety to enter'
' a-•
upon the property iorywhich.l have appliedjfoytSis•per mit for the purpose of making inspection's. ,
Date Applicant
( \ < < Gr•C f.d' '' / // j...
Signature of Applicant or Agent' Date a,
APPLICANT NAME (L. F. MI) Hamilton I s .. .
r
_
ADDRESS P .OB ..
a . ' e
ox ••1593
CITY/COMMUNITY/STATE/ZIP' Palm Desert,A
CA 92253
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:JOB SITE ADORESS/SPACE7;%W iv-
A_9 _ <' - i y N
CITY/COMMUNITY/STATE/ZIP •," La'' Quinta", CA 9225,.3 '
BOK• J
PAG°''
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T1,,T496,i—
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9.1.
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MOD
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TRACT NAME - 1 Santa Rosa Cove
OWNER NAME (L. F. MI) 7,- .. .. ,
CONTRACTOR -FIRM NAME Applicant
ADDRESS.'
. above • .
CITY/COMMUNITY/STATE/ZIP above '
PHONE• ..'.346=48b'1
I "N"YO445
ARC/ENG FIRM NAME •-, , . -
ADDRESS
CITY/COMMUNITY/STATE/ZIP - -
PHONE N
LICNC 0
'
USE OF PERMIT Spa
BL
ZON
'FSB
SS8 ••
SSB:.
RSB
OFC`
. ZONE ORD. M •
• "•; LOT SZ
-
Vit' )-TOTAL
FEE •
':END<'-
,, SIDE
Print Applicant/Agent Name
APPUPRMT ..
DATE- j` a PAUL .
_a
Permit
to install
a-6'" x 81 spa
as per
approved plans..
Plan Check Fee
z. . u'L ,
Cori'st.
Fee.
Sts. U
Elect:
Fee
- SMI Fee
4 ..
Vit' )-TOTAL
FEE •
6 j ., p 2 ^+
BLDG. DEPT. y
VALUATION r 2,90.0.0
"•
- f y
? rr7 V., ..+
T
NO.
OPERATION TE
INSPECTOR
NO.
•OPt ;',TION I DATE INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Back
33
Ventilation System
2
Ftgs & Frms
34
Plenums & Ducts
2A
Slab Grade
35
Furnace Compart.
3
Steel
36
Inlets & Outlets
4
Grout Blocks
37
Combustion Air
5
Bond Beams
38
Compressor
6
Roof Deck
39
Appl. Clearance
7
Framing
40
Fire Damper
8
Vents
41
Smoke Detection Device
9
Garage Fire Wall
42
Commercial Hood
10
Fireplace P.L.
❑
43
Final
10A
Fireplace T.O.
❑
NON
ADDITIONAL INFORMATION
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Batts)
12B Ceiling (Batts)
12C Ceiling (Blown)
14 Final "
PLUMBING APPROVALS
15 Ground Plumb
16 Water Piping
17 Rough Plumb
18 Vents
19 Sewage Disposal.
20 Sewer
21 Water Heater
22 Water Softener
23 Water Service
24 Gas Test
25 Final
Tank Pit L. Line
ELECTRIC APPROVALS
REAR OF PROPERTY LINE
p/L PyI
STREET NAME
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures µ
31 Service
32 Final