Loading...
0140 (RPL)APPLICANT NAME (L, F. MI) LT , - 1 • PERMIT APPLICATION City of La Ouinta - Department of Building and Safety This permit becomes void if work not commenced within,180 days from ilate of issuance, OR, if work has been suspended or abandoned for a period of 180 days.- , CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section neednot be completed if LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 the permit is for one hundred (5100) It, 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 mannerso as to become subject to the Workers' Compensation Laws of ' and effect: California.' _ License Class Lic. Number Date Applicant Date Contractor NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to the Workers' OWNER -BUILDER DECLARATION: I hereby 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 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 file a signed statement that he is licensed pursuant to the provisions ofthe Contractor's License Law 0 hereby certify that no excavation live (5) or more feet in depth into whic'h a person is required to descend, I 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 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) feet high. (Chap 3.2, Grp 2, Art 2, Sec341, Title B.. subjects the applicant to a civil penalty of not more than five hundred dollars (S500.): , C.A.C.) 0 I, 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 Law does not apply to an owner of property who builds, or improves thereon, and who does such work himself or Industrial Safety, as noted above, unless such person has a permit to do such work from that division. through his own employees, provided that such improvements are not intended or offered for sale. If: however, the 0 Division of Industrial Safety Permit No. . building orimprovemniissold within one 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.). - ' r.� • , fi • — 0 I, as owner of the property, am exculsively contracting with licensed contractors to construct the project (Sec+ CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance 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 OFC' builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Lender's Name Contractor's License Law.). Lender's Address 0 1 am exempt under Sec. B. 8 P.C. (Attached Certificate). I certify that 1 have read this application and state that the above information is correct. I agree to comply with all Date Owner city and county ordinances and state laws relating to building construction, and hereby authorize representatives WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure, ora of this county to enter upon the above-mentioned property for,inspection purposes. . " certificate of Workers' Compensation Insurance , or a certified copy thereof (Sec. 3800. Lab. C.). 1 .. Policy No. Company Signature of Applicant or Agent �" Date i O.Oertified copy is hereby furnished. CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have read this application and state that - r Gp 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 City Building Inspectio Department or City Department. + S � 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 for the inspections. ,a� Applicant , r. „r^ te � -� �''---� Da / permit purpose of making . APPLICANT NAME (L, F. MI) LT ADDRESS + CITY/COMMUNITY/STATE/ZIP ` JOB SITE �A.�D/DRREESS/SPPjACE ,v� T�•1� CITY/COMMUNITY/ST/ATJ 21P ,X/STA C .iT� BOK PAG PRC C TWN RNG SE S TRACT LOT TFEEL MOD SB TRACT NAME OWNER NAME (L F MI) B CONTRACTOR, -FIRM NA7 �p ADDRESS ...i;!5 /� —./y A5�i f....!'eT1ti.�l�%% O, CITY/COMMUNITY/STpTEIZIPe PHONE ARC/ENG FIRM NAME ADDRESS -. CITY/COMMUNITY/STATE/ZIP PHONE, a ' " LICNC a USE OF PERMIT - BL ZON FSB SSB SSB RSB OFC' ZONE ORD M - LOT SZ END -SIDE Signature of Applicant or Agent - Print Applicant/Agent Name Date APPL/PRMT �+DAT/E $ Ij r� `��✓.�•"/� y y/ /�' y� w yam. --j.. ��"".� �r / �t t .0..9 �dlr�s/ QG n� qonow 4,e4VI ��✓%i a ' f r �.y It ECEIVED • .r I to TFEEL Arrow Printing 250/1-83 White: Finance Canary: Assessor Pink: Applicant Tag: Bldg. Dept. VALUATION 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. ❑ NPON ADDITIONAL INFORMATION I t / �� ��� /V G SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Lath 12 Internal Lath✓I 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/I STREET NAME 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service 32 Final 0 24XSG PRINTED ON NO. 10001-1-8 CLEARPRINT FADE-OUT 4� R POOL AND SPA �(--LIGHT SWITCH r) 0 n POOL -t, SPA EQUIPMENT EQUIPMENT SPECS. I 1 2,NP PREMIEP BRASS PUMP (POOL) 1 34 HP PREMIER BPASS PUIVP (SPA) 1 2 HP PPEA41EP Bt;ASSPUMP (8,DA) I 1,HP BUPIAL BLOWEP 7 1 48 SQ FT NAUTILUS FfL /EP (SS. DE) I 3G SQ FT NAUTILUS FILTER (SS. D.EJ 1 2. L-IACNWASH, V4LVE (BPA -3S) 1 112 BACKWASH VALVE (BP, ASS) 2 qOOOOO BTU LAAPS HEAT ERS 2 LEN-WPDON',Alp- SW17-CHES I SOL AP COVEP (POOL) I SOLAR COVEP PEEL SYSTEM (POOL ONLY) SOLAR COVEP (SPA) 2 Lf TRS? SKIM COVEP THEPMOMETER 1 100 W AMERICAN SPA LIGHT WITH COLOR PACK 1 400 W AMERICAN POOL LIGHT WITH COLOR PACK 2 AUTOFILL.DEVICES POOL SPECS SIZ E 29'X 22" CUSTOM S H, A Pr_ APER 592 SO F1 PER FT 102 LIN FT DEPTH 3/(3//T(.) 8' I LIGHT 2 RETURNS I SWEEP STUB I SKIM. (114EP I AUTOFILL 1...8 DRYWELL SPA', SPECS SIZE l0, x 91 SHAPE CUSTOM -A REA PER FT 28 LIN FT DEP TH 4 0" - BENCH DEPTH 25" I LIGHT I PET URN I S KIMMER JETS 2 AI P S V11 TCHES CUSTOM POOL AND SPA FOR MP AND MPS EJ 0 CONNELL AT 78047 SAN TfMOTEO LA QUINTA CA JOB PHONE 5G4-2101 CHARLES CLARKE SN�.IMMING POOL flimbing & Construction License f330970 36770 Cathedral Conyoo Dn _7 Ga+hodral Crty, CA 9223r, 324.6434 APPROVED ;,1- 4 ri y ItA QL11Nf,,"U1LDl G OEPT.