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RPL (001211)77273 Calle Mazatlan 001211 PERMIT APPLICATION City La Ouinta " a ' ` Fx s ? sem' r' _ *. '1 ' i. 4 W ,• .; • Department of of • • . Building and Safety ; PAG'I00 'suspended • 4-' This permit becomes,void.if work not commenced within180days from:date of issuance, OR, if work has been or abandoned for a period -of 180 days., • ' ' - :> CERTIFICATE OF EXEMPTION FROM WORKERS' -COMPENSATION INSURANCE:. This section heed not be completed if' "I LICENSED CONTRACTORSDECLARATION: 1 hereby'.affirm that I am licensed under.. provisions of - Chapter 9- '... the permit is for one hundred ($100) o. less. I.certity that in the performance of thework for which this permit is -- (commencing with Section 7000) of Division 3 of the Business and Professions Code; and my license is in full force "' .f issued, I shall not.employ any person in any manner so as to become subject to the Workers' Compensation Laws of = and effect. /p „` California. + License Class Lic'Numbe / •r - - n Date r - Date Contractor ' ` _ . NOTICE TO APPLICANT: It attecmaking this.Certificateot Exemption, you should become subject to the Workers ' OWNER -BUILDER DECLARATION: 'Lhereby affirm' that I am exempt from the Contractor's License Law for the. Compensation provisions of the Labor, Code, you must forthwith comply with such provisions.or this permit shall r ` `be following reason (Sec. 7031.5, Business and Professions Code: Any city'or county which requires a permit to 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.:•,• •rOIhereby certify that noexcavationfive (5)ormore feet indepthintowhichaperson isrequired todescend, will be' , •.,(Chapter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code) or that.heis'exempt ," : 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 dismantling thereof, will be more than thirty-six (36) feet high. (Chap 3.2, Grp 2, Art 2; Sec341, TitI4 subjects the applicant to a civil penalty of not more than five hundred dollars ($500.): _or C.A.C.) "'•"x - -' p- I. as -owner of.the property, or my employees with wages as their sole compensation; will do the work, and the ' . ❑ As owner -builder, I will not employ anyone to do work which'would require a permit from the Division of ;•,. , structure isnot intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License does builds, improves does himself - Industrial Safety, as noted above, unless such person has a permit to do such work from that division. Law not apply to an owner of property who or thereon, and who such work or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the p Division -of Industrial Safety Permit No. i 1' ' building or improvemntis.soldwithin one.yearofcompletion,theowner-builder will have the burden of proving that Date Applicant z he did not build or improve for the. purpose of sale.). ., . ' r M CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the'performance. ••11 • 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.):." '- . • - , . +,. -'rT' 7044, Business and Professions Code: The.Contractor's License Law does not apply to an owner of property who end'N Lersame -builds or improves thereon, and who contracts for such'projects with a contractors) licensed pursuant to the. Contractor's License Law.). Lender's Address .. ❑ 1 am exempt under Sec. ' B. 8 P.C. (Attached Certificate). -.' I certify that 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: I 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 Policy No. Company - + . '-CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF,:ENTRYi I certify I have read this application and state that' 2 O Certified copy is hereby. furnished.' .. -'the information given is correct l.agree to comply with all state laws and county ordinances relating to buidling • ❑ Certified copy is filed with theCity Building Inspection Department or'City' Department.-'. : . • construction; and authorize aorepresentative of th_e City of La Ouinta Department of Building and Safety to enter , -Date Applicant upon Vie;roperGty whichrt e apD d onth per It for the purpose of making inspections. Signature of Applicant or Agent Date APPLICANT NAME (L• F,• MI) .' Hamilton's ADDRESS P.©. tok 1593 ' CITY/COMMUNITY/STATE/ZIP palm' Devert, CA 92260 ( C7 (9•17,3 • Q S.' 1,.. `•,..' r^ JOB SITE ADDRESS/SPACE '(• j \ CITY/COMMUNITY/STATE/ZIP La CA '92253 BOK Q/ PAG'I00 Pvpl% C TWIN. RNG SE', S. TRf4T4.9 6a- ? LOT 19 QSe Const. MOD 1. Elect: TRACT NAME Santa Rosa Cove OWNER NAME (L. F. MI) - 7." . .. . . CONTRACTOR -FIRM NAME' Applicant . ADDRESS - above' CITY/COMMUNITY/STATE/ZIP above' ' •' PHONE 346" 4804,1 3,165445^ - ARC/ENG FIRM NAME , ADDRESS - CITY/COMMUNITY/STATE/ZIP PHONE 0 - '. LICNC . USE OF PERMIT Spa ,• BL ZON FSB • SSB SSB RSB - OFC 'ZONE ORD .II LOT SZ • TOTAL' FEE • END -, .•-BIDE Print Applicant/Agent Name ' APPUPRMT l A JAT J- 8 5 POOL Permit to install a 6 • .x.8'1-.* spa as per approved,plans. Plan -Check Fee, ' -25.02:- Const. Fee, :3 .50 Elect: Fee ''.Uv SMI Fee .50 TOTAL' FEE • 6 9 '0 2 `'. VALUATION 2,900.00 BLDG.OEPT. I.- J Ah A& NO. OPERATION TE INSPECTOR NO. OP ATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 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- amper8 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 P/1 STREET NAME 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service 32 Final