RPL (001208)77303 Calle Mazatlan
001208
4
11% r' PERMIT APPLICATION: 4'
City at
Department of Building and Safety
This permit becomes void if work not commenced within 180,days from date of issuance.,ORif work has been -suspended or abandoned for a period of 180 days. -
CERTIFICATE OF EXEMPTION FROM WORKERS! COMPENSATION INSURANCE: This section need not.be completed if J,,A
*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 permit is
(commencing with.Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force .issued, I shall not employ any person in any mannerso as to become subject to the Workers' Compensation Laws of.
and effect. California.
License.Class Lic. NiImbi , Date Applicant
Date Contractor
NOTICE TO APPLICANT: If, afteir, making this Certificate of Exemption, you should become -subject to.the'Workers'
OWNER:B6lLDER b&LARATI6N1:':.I-hereby affirm that I am exempt from the Contractor's License Livi fo'r'the,.. Compensation provisions of the Labor Code, you must forthwith. comply with such provisions or this permit shall
be deemed revoked.
following reason (Sec. 7031.5. Business and Professions Code: Any city, or county.which requires a -permit to -
-construct; alter, improv6-clemoliiih, or repair any structure, prior to its issuance, also requires the applicant for DIVISION OF, INDUSTRIAL SAFETY PERMIT CERTIFICATION:.
..,such permit lo.file a signed statement that he is licensed puirsuant to the provisions of the,Conlractor s License Law
0 1 hereby certify thit no excavation five (5) or more feet in depth into which a p6son is required to descend, will be
(Chapter 9(comrnencing with section 7000) of Division 3 of the Business and Professions.Code) or that he is exempt• 0
made inconnecti n 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 thefeof, will be more than thirty-six (36) teet.high: (Chap 3.2, Grp',2. Art 2; Sec341, Till 8,
subjects, ttiiipplicant to a civil penalty of not more than five hundred dollars ($500.): C.A.C.)'
0 4, as owner.of the property, or my employees With wages as their sole compensation, will do the work, and the r. 0 -As owner-builder,'l will notemploy anyone to -do'work which would require a permit.frorn'the Division. of-., 4
structure -is not intended or offered for sale (Sec. 7044. Business and Professions Code: The Contractor's License Industrial Safety, as noted above: unless such person has a permit to do such work from that division.. 4
Law does not apply to an owner of property who 6uilds.Ior ' improves thereon, and who does such work himself or I 't . . I.,
through his own employees, provided that such improvements are not intended or offered for sale. If, however; the 1, .0 Division. of Industrial Safety. PermiNo. I
building or improverrint is sold within one year of co * mpletion, the owner-builderwil - [have the burden of proving that Date -.Applicant.
he did not build.or improve !or the purpose of sale.).;
1, • 0 CONSTRUCTION LENDING AGENCYf.,I herebyalfirm that there is aconstructioi lending agency for the peirformance -
as owner :Z*
r 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 -
builos or improves thereon, and who contracts for such projects with.a contractor(s) licensed pursuant to the . lender's N; -mi
Contractor's License Law.). Lender's Address
0 1 am exempt under.Sec. B. & P.C. (Attached Certificate). 'I certify that I havereadthis application and state that the above.information is correct:) agree to comply with all
Date Ownercity.and.county ordinances and state laws relating to building.construction.-and hereby authorize representatives
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 sell-insuri, 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 6. COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have read this application and state that
Certified copy is hereby furnished." the information given is correct. I agree,to comply with all state laws and county ordinances relating to buidling
0 Certified copy is filed -with the Cit Building Inspection Department or City Department. constructi6-6,.and authorize a 'representative of the City of La Quinta Department of Building and Safety to enter
u pon '11his permif'fbr the purpose of making inspections.
tfe.,propefty.fer, winch I have aqlied'.fV
Date Applicant. /7),,
Signature of Applicant or Agent Date
Print Applicant/Agent Name
APPLICANT NAME (L, F, MI) Hamiltorrls, 4
ADDRESS P.O. 86x-1593
CITY/COMMUNITY/STATE/ZIP Palm Desert CA 9226-0
JOB SITE ADDRESSYSPACE
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CITY/COMMUNITY/STATE/ZIP La QuintA, CA 92253
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38.50
. TRACWUMESanta . Rosa Cove--
OWNER NAME (L. F. MI)
CONTRACTOR -FIRM NAME Applicant
ADDRESS above
CITY/COMMUNITY/STATE/ZIP abolis
PHONE 03,46
'.50.
LICr
2 0445.1
ARC/ENG FIRM NAME
ADDRESS
CITY/COMMUNITY/STATE/ZIP
PHONE 0
LICNC.#
USE OF PERMIT SPA
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SSB
RSB.
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END.-
- SIDE.'
APPUPRMT
2.O TE -85 POOL -
?
..Permit
to install -a-61.x
81
..spa as
per ,approved
plans.
-
Plan Check' Fee
- •-25.02
Const.
Fee. =
38.50
.Elect.
Fee':
5.00.
SMI Fee
'.50.
TOTAL
FEE ,
9 02.
7 -6 -
VALUATIONI 21900.00.]
BLDG. DEPT.
Alk
r -
NO.
OPERATION I DVF
INSPECTOR
NO.
OPE ,.. ON 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
8
Vents
41
Smoke Detection Device
9
Garage Fire Wall
42
Commercial Hood
10
Fireplace P. L.
❑
43
Final
10A
Fireplace T.O.
❑
NPON
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 AP O ALS
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 PiI
STREET NAME
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final