000984 (RPL)1 .. PERMIT APPLICATION
City of La Duinta
Department of Building and Safety
,• ".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. '
'ADDRESS •'- -'
82-440 Junipero Dr..
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be completed it
LICENSED- CONTRACTORS DECLARATION: I hereby -affirm that 1. 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 inanymanner so asto become subject to the Workers'Compensation Laws of
and effect.
License Class �J' Ljc. Number �" Z f�
California.
Date Applicant
t
Date_ ,`t --' I -! � � � 's^'r, r�1 . �n�7;�-r...
/ 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 ezempt'from the Contractor's License Law for the
'r- Compensation provisions of the Labor Code, you must forthwith comply.with such provisions or this permit shall
y %be
• following reason (Sec. 7031.5, Business and Professions Code; Any city or county which requires a permit to
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 tolfleasignedstatementthat heislicensed pursuant tothe provisions ofthe Contractor'sLicenseLaw
therebycertifythatnoexcav'ationfive(5)ormorefeetindepthintowhichapersonisrequiredtodescend,willbe
❑ -
(Chapter 9 (commencing with section 7000) of Division3 of the Business and Professions Code) or that he. isexempt.
made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or
therefrom and the basis Ier.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: Sec 341, Title 8,
subjects the applicant to a civil penalty of not more than five hundred dollars ($500.):.
C.A.C.)
• ❑ I, as owner of the property, or my employees with wages as theicsole compensation, will do the,work, and.the
O 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 Cade: 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
0 Division.of.Industrial Safety Permit No.
building or improvemnt is sold.within one year of completion. the..owner-builder will have the burden of proving that
Date Applicant
he did not build or improve for the purpose of sale.). y,! ^
tCONSTRUCTION LENDING AGENCY: I hereby affirm thkiftere is a construction lending agency for the performance.
• O I, as owner 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
Lender's Name
builds or improves thereon: and.who contracts for such. projects with a contractor(s) licensed pursuant to the
.
- - - ^
Contractor's License Law.).
Lender's Address
❑ 1 am exempt under Sec. B. & P.C. (Attached Certificate):
I certify that have read this application and state:that the above information is correct. ) agree to comply with all
Date "I 'Owner
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
ZONE ORD I
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 self -insure, 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 OF COMPLIANCE AND AUTHORIZATION OF ENTRY: Lcerlify I have read thisapplicationand state that
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 '..
O Certified 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.
_ , . 4 � V
f. Signature of'Applicani or Agent Date
Print Applicant/Agent Name
APPLICANT NAME (L, F. MI) -
Canyon View Pools
'ADDRESS •'- -'
82-440 Junipero Dr..
CITY/COMMUNITY/STATE/ZIP -- '
Trndio, CA _ 92201
JOB SITE ADDRESS/SPACE
51-120 Avenida. Velasco
CITY/COMMUNITY/STATE/ZIP
. la. Quintao,'CA 92253
BOK
PAG
PRC •'
C
-
TWIN
RNG•
SE
S
TRACT
LOT.
SNI Fee
.60
MOD
SB
TRACT NAME
OWNER NAME (L. F. MI) -
Kevin Sim m
CONTRACTOR -FIRM NAME-
Applicant
ADDRESS
abme -
CITY/COMMUNITY/STATE/ZIP
above
PHONE • - -
LICNC •
-
ARC/ENG FIRM NAME •. '
ADDRESS .
CITY/COMMUNITY/STATF/ZIP '
PHONE •
LICNC 0
USE OF PERMIT ,
Pool and spa
BL
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I ZON
FSB
SSB SSB
RSB
OFC
ZONE ORD I
LOT SZ
END -
SIDE,
APPUPRMTATE
(1A l J9 1A 11 qR4 100-19-04 ..
Permit to opnstnzct
22 x 10 pool and
5' x 616" spa as per approved Plans.
r
Meeh. me
14.50
Plan Check Fee
48.42
Permit Fee
74.50 '
Elect. Fee
10.50
SNI Fee
.60
P1Umbing Fee
8.00
- ESE
C
•.� LR: INTANT
114 W
B11 L
InA
,
MAL
FEE 156.52
VALUATION 1 9,000.00,
BLDG. (DEPT.
NO.
OPERATION DATE INSPECTOR
NO. OPERATION DATE INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVAL'S
1
Set Back
33 Ventilation System
2
Ftgs & Frms
34 Plenums & Ducts
2A
Slab Grade
35 Furnace Compart.
3
Steel
Q
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. ❑
NOADDITIONAL INFORMATION
/ 21- T�4(
SEWAGE SYSTEM SIZE &LOCATION
11 Exterior Lath
12 Internal Lath.ti
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Batts)
126 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