001305 (RPL)PERMIT APPLICATION
Gity of La Ouinta
Department.of Building and Safety .
t
This permit becomes void if work not commenced within 180 days from date of issuance. OR, if work has been suspended or abandoned fora period of 180 days.
'LICENSED CONTRACTORSDECLARATION: I. hereby affirm that.I am licensed under provisions of Chapter 9
(commencing with Section 7000)'ofDivision 3 of the Business and Professions Code, and my license is in full force
and effect.
License ClassLic. Numbeerr//•- ! /a-
Date Contractor•.. �!'(
OWNER -BUILDER DECLARATION: I hereby at ihae l 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 sect ion.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 permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500):
0 I. as owner o1 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, 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
through his own employees, provided that such improvements are not intended or offered for sale. If, however, the .
building or i mprovemnt 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.).
0 I, as owner of the property, am exculsively contracting with licensed contractors to construct 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. 8 P.C. (Attached Certificate).
Date Owner
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.).
Policy No. Company
0 Certified copy is.hereby furnished.,
` 0 Certified copy is filed with the City Building Inspection Department, or _City Department.
Date Applicant
APPLICANT NAME (L. F..IIS ),.r _ �_ Develzpwny.
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ADDRESS P.O. -B= 1371
CITY/COMMUNITY/STATE/ZJP_ QL�ta, CA .2253
JOB SITE ADDRESS/SPACE78-002 ^_"jj_ NOrt '
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'CITY/COMMUNITY/STATE/ZIP
La Quinta, CA 92233
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TRACT NAME DumGardens
OWNER NAME (L. F. MI(
aMlicaft
CONTRACTOR -FIRM NAME
Neptune . Pools
ADDRESS 73-885 Hey Ill
CITY/COMMUNITY/STATE/ZIP - , C ' 92253
PHONE a 340-4900'
LICNC e
ARC/ENG FIRM NAME • +
ADDRESS --
CITY/COMMUNITY/STATE/ZIP
PHONE •
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LICNC
USE OF PERMIT Q/}
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SSB
SSB
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ZONE -ORD 4 .
LOT.SZ •
END
SIDE
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be rbmpleted if
the permit is for one hundred ($100) o, 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 Applicant
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.
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
F) Ihereby certify thatnoexcavationfive (5)ormore feet indepth into which aperson isrequired todescend, will be
made iri connection with work authorized by this permit, and that no building' structure, scaffolding, falsework, or
demolition or dismantling' thereof, will be more than thirty-six (36) feet high. (Chap 3.2, Grp 2, Art 2, Sec 341, Title 8.
C.A.C.)
'0 As owner -builder, I will not employ anyone to do work which would require a permit from the Division of
industrial Safety, as noted above, unless such person has a permit to do such work from that division.
0 Division pf Industrial Safety Permit No.
Date Applicant
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.).
Lender's Name
Lender's Address
I certify.that I have read this application and state thafthe 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 county to enter upon the above-mentioned property for inspection purposes:
Signature of Applicant or Agenf' Date
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF -ENTRY: I certify I have read thisapplication and state that
the information given is correct.Ragree to comply with -all state laws -and county ordinances relating to buidling
construction and authorize aar"epresentative of the City of La Ouinta Department of Building and Safety to enter
upon,thee pr pefty�or which'I ave�pphed'ly this permit for the purpose of making inspections.
(L �' i t 'yb�
Signature of Applicant or Agent Date
Print Applicant/Agent Name
APPL/PRMT n of Po
Permit to oonstnwt one 6 ft round spa
as Per approved plans.
Plan Check 25.02 +s -
Const. Ftp 38.50
SMI Fee .50
TOTAL
FEE
b4 . SIG
A0507 3 27
VALUATION 42;S,Z00. 0
BLDG. DEPT.
Ah
NO.
OPERATION I 199TE
INSPECTOR
NO.
OP TION 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 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
PSL 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