11601 (RPL)ilk
�.
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P.O. BOX 1504
Building78-105 CALLE ESTADO
Address 49'-751 San Vicente LA QUINTA, CALIFORNIA 92253
Owner
Tonv Lizza
Mailing
Address P.O. Box 861
City I Zip ITel.
Contractor
Robert .Ainsworth Pool. const.
Address
City Zip Tel.'
Palm Desert 92260
State Lic. / City
& Classif. / Lic. #
C53 598681 t ;�.
Arch., Engr.,
Designer TonV Lizza
Address Tel.
Same as glove
City Zip State
Lic. #
'LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000).of Division 3 of ,the Business go frpfessions Code, and my license is in full force and
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior to its Issuance also -
requires the applicant for such permit to file a signed statement that he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that.he is exempt therefrom, and the -basis
for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will
do the work, and the structure Is not intended or offered for sale. (Sec. 7044, Buisness 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 through his own employees,
provided that such improvements are not intended or offered for sale. If, however, the building
or improvement Is sold within one year of completion, the owner -builder will have the burden
of proving that he did not build or improve for the purpose of sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (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 contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
0 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No.J Company I
❑Copy is filed with the city. ❑ Certified copy is hereby furnished. t
TOTAL
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
No. 11601
JILDING: TYPE CONST. OCC: GRP.
P. Number
;gal Description
oject Description Spa
Sq. Ft.
Size
New ❑
No.
Stories
No. Dw.
Units
Add ❑ Alter ❑ Repair ❑ 'Demolition ❑
IEstimated Valuation $11,600.00
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech..
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
(This section need not be completed If the permit is for one hundred dollars (5100) valuation
or less.)
I certify that in the performance of the work for which this permit is Issued, I shall not
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California.
Date � Owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
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, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this city to enter the above-.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
REMARKS
AMOUNT
87.75
135.UU
24. OU
45.UU
27.00
1.t0
1
I�. ifti14�1Y i`r•'lI.�3°t'i�l]^i) �•_. v, t41 •� ��,�
ZONE:
BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE
INSPECTOR
Issued by:
Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE I NO. I ELECTRICAL FEES I NO. I . PLUMBING FEES
IST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SQ, FT, ®
CAR P. SQ. FT.
WALL SO. FT. ®
SQ FT ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
sI
YARD SPKLR SYSTEM
BAR SINK _—
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN.
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
SLAB GRADE
FLOOR DRAIN
MECHANICAL FEES
STORAGE TANK
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH),( C METER LOOP
7
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
REINF. STEEL
LAUNDRY TRAY
AIR HANDLING UNIT CFM
I
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE,TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER, B.T.U.
SQ. FT. ® c
BATH TUB
REMARKS:
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
FIREPLACE
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBLTOTAL
FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING UNDERGROUNDk/;
7 A.C. UNIT
COLL, AREA
SLAB GRADE
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK ROUGH WIRING.
DUCT WORK
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH),( C METER LOOP
7
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL) TEMP. POLE
GROUT
WATER. HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP.
FINAL INSP.
GRADING
cu. yd.
$ —Plus—X$—=$
LUMBER GR.
FRAMING
ROOFING
�f
1 1 I�U ,Vl j
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
---------------------------- 14, -----------------------------------------------
lu 017
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I Jo
NTA
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Ate C IE K,
fO !-NSTA'L_411'�DUN AS PER
ANE. "%-U. APPUCAUE
By
ED By
POOL. ARE -ENCE.
ml ING
m mum 5. OsMG
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L
spo ALL GATES LAT .
TO
C'
-HING
AND SELF -�TCH ING �
s. -
'of
Earth Systems Consultants Buena Engineers Division
11%+ Southern California 79-811B Country Club Drive
Bermuda Dunes, CA 92201
(619)345-1588
(619) 328-9131
FAX (619) 345-7315
November 30, 1992 B7 -4043-P9
.92-11 -765
Tony Lizza
P., 0... Box 861
y
La. Quinta, California" 9.2253
Project: 48-751 San Vicente
La Quinta, California
Subject: RASTA Grout and. Rebar Inspection
A representative of Earth Systems Consultants performed special
inspection on the following portions of work, on the above referenced
project which required continuous inspection, and which Earth Systems
Consultants was employed to inspect:
Conducted Rebar and grout placement inspection in RASTA wall panels.
.Also sampled 3000 psi grout for compression testing.
Based. on my personnal observations it is my opinion that the work
inspected was performed in accordance with the approved plans,
specifications,. and the applicable workmanship provisions of the Uniform
Building Code.
If there are` any questions please contact this office..
Respectfully submitted,
EARTH SYSTEMS CONSULTANTS
oel L. Nadler
Orange County Reinforced Concrete 367
RLR/rlr
RLR/TR3
Copies: 4 -Tony Lizza
1 -PS File 1 -VTA
.78-495 CALLE TAMPICO — LA QUINTA, CALIFORNIA 92253 - (760) 777-7000
FAX (760) 777-7101
TDD (760) 777-1227
December 23,1997
Tony Lizza
48-751 San Vicente
La Quinta, CA., 92253
RE: Spa Permit #11601
Dear Mr. Lizza
The .purpose of this letter is to inform you that your Spa Permit #11601, for the project at
48-751 San Vicente, has expired. In accordance with 1994 UBC section 106.4.4, no further
work may be performed until a new permit has been issued.
Please contact Daniel P. Crawford Jr., Building Inspector I, at (760) 777-7012 to obtain any
information you need regarding a new permit and/or any required inspections. Should you
choose not to complete the project, we would then have to pursue any or all of the following
actions:
1) Abatement of the project through the City Attorney's Office and Code Compliance Division.
2) Notice of non* conforming structure placed upon property profile.
3) Action filed with Contractor State License Board.' Optional if Owner/Builder.
Please contact us at your earliest convenience prior to 10 working days to resolve this issue, and
for any questions you may have.
Sincerely,
Mark Harold
Building & Safety Manager
Daniel P. Crawford Jr.
Building Inspector I
cc: file
dpc
MAILING ADDRESS - P.O. BOX 1504 -.LA OUINTA, CALIFORNIA 92253'