RPL (001370)PERMIT APPLICATION µ'• 5 p? y U, 4 C&AA A
\ \
r; City of La Duinta •, '_ r
.. Department of Building and Safety
JOB SITE ADDRESS/SPACE
52-400 Avenida Navarro
CITY/COMMUNITY/STATE/ZIP
La Quinta, M 92253
This permit becomes void if work not commenced within 180 days from date of
issuance, OR, if work has been suspended or abandoned for. a period of 180 days.
r
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be completed if,
LICENSED CONTRACTORS DECLARATION: I hereby affirm that.l am licensed under provisions of, Chapter. 9 •; .,i :.
'.: :,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 inany manner so as to become subject to the Workers' Compensation Laws of
and effect.
California.
License Class Lic. Nu tier. r f- 6 -' "
Date.^ Applicant
Date Contractor -% c 1. L,i', -G1 - ••
:• .NOTICE TO APPLICANT: II„after making this.Certificate of Exemptipn,.you should become subject to the Workers: r. F
OWNER -BUILDER DECLARATION: I hereby affirm that I'am exempt Irom the Contractor's License Law for the
Compensation provisions of.the Labor Codii, you.must forthwith comply with such provisions or this permit shall •
following reason'(Sec. 7031.5. Business and Professions Code: Any city or county which requires a,permit 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.f ile a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law ;:
0 I hereby certify that excavation five (5) or mole teetin 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.
made in connection with work authorized by this permit, and that no building structure: scaffolding, falsework, or ,
therefrom and the basis for the,alle,ged•exemption. Any violation of Section 7031.5 by any applicant for a permit
It
demolition or dismantling thereof; will be more than thirty-six (36) feet high. (Chap 3.2, Grp 2, Art 2; Sec341, riUeB. • ••'
subjects the to a civil penalty'of not more than five hundred dollars ($500.):
C.A.C.)' ;
0.1. as owner of the property. or my employees with.wages as their sole compensation, will do the 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 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. ,
' 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.:%:, : `
O Division of Industrial Safety Permit No. fi
building orimprovemntissoldwithinone year ofcompletion, the owner -builder will have the burden of proving that:
:Date ' Applicant
'
he did not build or improve for the purpose of sale;) - "•
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance
0 I, as owner of the property, am exculsively contracting with licensed contractors to construct -the project (Sec.
ofthe work for which this permit is issued (Sec. 3097, Civ. C.): t.
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 contractors) licensed,pursuant.to the: ` •
,
Contractor's License Law.). .:
Lender's Address
` 0 1 am. exempt under Sec.' • B. 8 P.C. (Attached Certificate).
I cenify.that I have read this application and state that the above information is correct. I agree to comply with all .
Date Owner'' ”*r '
city 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. r
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate ofconsent to self -insure; or a
certificateof Workers' Compensation Insurance; or a certified copy thereof•{Sec. 3800. Lab. C.).: k -
's I i6nature of Applicant or Agent Date
Policy No. Company
'CERTIFICATE OF.COMPLIANCE AND AUTHORIZATION OF, ENTRY: I certify I have read' thisapplicationand statethat
0 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 Ceitified copy is filed with the City Building Inspection Department or City Department.
construction, and authorize a' representative of the City of La Ouinta Department of Building and Safety to enter _
•
upon the property for which I have applied for this permit for the purpose of making inspections.
Date Applicant
Signature of Applicanto�('Progent L4, Date
Print Applicant/Agent Name
APPLICANT NAME (L, F.
9W= Pools
,.
MI) - APPL/PRMT DATE
ADDRESS
- 67-652 R� Road
CITY/COMMUNITY/STATE/ZIP
Palm , CA 92263
JOB SITE ADDRESS/SPACE
52-400 Avenida Navarro
CITY/COMMUNITY/STATE/ZIP
La Quinta, M 92253
SOK •
PAG
PRC
C
17.50
TWN
RNG.
SE,
S
TRACT
- LOT
. SMI Fee
.88 .
MOD
SB
TRACT NAME
OWNER NAME (L. F. MI)
BobB�� • • - • , ,
Davis
CONTRACTOWFIRM NAME
ADDRESS
above
CITY/COMMUNITY/STATE/ZIP
ahlie .
PHONE a
320-6996
LICNC 0
.,
ARC/ENG FIRM NAME `
ADDRESS -
CITY/COMMUNITY/STATE/ZIP
PHONE 01
-
LICNC.11
210.90
USE OF PERMIT -
Pool and sm
8L
ZON
'FSB.
SSB
-SSB
RSB
OFC
' ZONE ORD N'
.,LOT SZ
END ..
SIDE.
, ���.� ry��
R'l■
i
Pemut to build one 21 x 15 pool and
spa as per approved plans.
tech. Fee
17.50
Plan ick Fee
. ' 64.02 r
Oosnt. Fee
.98.50
Elect. Fee
12.00
. SMI Fee
.88 .
....Plumbing
18.00
..., t.
TOTAL'
FEE
210.90
A09`80 5, 9
BLDG.DEPT.
L9 C
VALUATION' 13,000.00
NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION 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.
❑
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 f if
25 Final
Tank Pit L. Line
ELECTRIC APPROVALS
REAR OF PROPERTY LINE
p/L P/I
STREET NAME
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding S .�
30 Fixtures
31 Service
32 Final
N
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4
IAI
0
C4, A
Nit
A
7-1 POOL SIZE X DEPTH TO
LITE NO
SPA W/ JETS DIV ALL
SHAPE
5-6(7211 POOL RETURN LINES
ACCESS F T SKIM -LENGTH MAX FT
r" MOTOR. 'PUMP A, P i FILTER
FILL LINE FT-. ANTI -SYPHON
ELECT ON
ELECTRICAL --,Z12 FT BONGING
70 'CT "p-1 TRAP TILE TRIM
Fo'r Office Use Only
yin
COPING -621ax SWEEP r
PE (METER SO CT FENCE
ENTIRE POOL RECIRCU-
LATING SYSTEM TO BE
LOT
OF COPPER 00 P.V.C.
ELECTRICAL GROUNDING
TRACT
INSPECTION NECESSARY
BEFORE STEEL'& PLUMBING
SALESMAN S 727
INSPECTION CAN BE CALLED
j
.lar
t—
1 7
.
OOL AREA SCALE:
1/8"
N
A.
w%
4
IAI
0
C4, A
Nit
A
7-1 POOL SIZE X DEPTH TO
LITE NO
SPA W/ JETS DIV ALL
SHAPE
5-6(7211 POOL RETURN LINES
ACCESS F T SKIM -LENGTH MAX FT
r" MOTOR. 'PUMP A, P i FILTER
FILL LINE FT-. ANTI -SYPHON
ELECT ON
ELECTRICAL --,Z12 FT BONGING
70 'CT "p-1 TRAP TILE TRIM
Fo'r Office Use Only
yin
COPING -621ax SWEEP r
PE (METER SO CT FENCE
DRAFTSMAN
DATE
TILE L 69 LIGHT
BOARD CLR PAkK_',..
SEAT TREES
SLIDE SHLLW END
HEATER DEEP END: 010
MAINT ;Z
DECKS KIT_
MASTIC
FOOTINGS IVO -- ROPE RIN9;1�
GRADING 0 F I-
93WAN POOLS owner 4.,QA Z22JLJIS
67652 RAMON ROAD Job -Address 5.;L --V,.06 AIX71
CATHEDRAL CITY, CA 92234 cityZ.A
(619) 320-6996
STATE LICENSE 421014 Job Phone us. Phone
'm
ENTIRE POOL RECIRCU-
LATING SYSTEM TO BE
LOT
OF COPPER 00 P.V.C.
ELECTRICAL GROUNDING
TRACT
INSPECTION NECESSARY
BEFORE STEEL'& PLUMBING
SALESMAN S 727
INSPECTION CAN BE CALLED
DRAFTSMAN
DATE
TILE L 69 LIGHT
BOARD CLR PAkK_',..
SEAT TREES
SLIDE SHLLW END
HEATER DEEP END: 010
MAINT ;Z
DECKS KIT_
MASTIC
FOOTINGS IVO -- ROPE RIN9;1�
GRADING 0 F I-
93WAN POOLS owner 4.,QA Z22JLJIS
67652 RAMON ROAD Job -Address 5.;L --V,.06 AIX71
CATHEDRAL CITY, CA 92234 cityZ.A
(619) 320-6996
STATE LICENSE 421014 Job Phone us. Phone
'm