001193 (CP)•APPLICANT NAME (L• F; MI) G.L.Q. Pao1 Construct, 4 . M
ADDRESS 68-465 ' Pextez Fri.
' PERMIT APPLICATION . r -
- r -City 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. •. ..
•" ' -
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be'compleled it.
- LICENSED CONTRACTORS •DECLARATION:`I hereby affirm that I am' licensed under provisions'. of Chapter 9 I
the. permit is for one hundred ($100) o.•less. Lcertify 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 shaII not employ any person in any manner so as to become subject to the Work ers'Compensat ion Laws of
and effect. -
California. _
'
License Class Lic..Numbe���! i'�
' '° ..
- Date' Contractor. -X +-- •-
Date' Applicant ,
NOTICE TO APPLICANT: if, after making this Certificate of Exemption, you should become subject to the Workers'
3 - -•`n ' -
OWNER -BUILDER DECLARATION: I hereby affirm that'I am exempt from the Contractors License Law;for Ne `
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 PERMITCERTIFICATION::-
.. suctfpermittofileasignedstatementthatheislicensedpursuanttotheprovisionsoftheContractor'sLicenseLaw'
O lherebycertifythai,noexcavationfive (5)ormore feetindepth into Which aperson isrequired todescend, willbe•
-' (Chapter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code) or that he is exempt,
- ']made jn'connectiomwiih 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 dismalitl_ing thereof, will be more than thirty-six t36) feethigh. (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.): ox:K:^++ .
: C.A.C.), - - • _
0 Vas owner of the property: or my employees with wages as their sole compensation, will,do the work, and the •
O As owner -builder, I will not'employ anyone to do work which would requite a permit from the Division of
structure is. not intended or offered'for-sale (Sec. 7044. Business and. Professions Code: The Contractors License . '•
' Industrial Safety, as noted aboie,-unless such person has a permit to do such work from that division. - '
' Law does not apply an owner of property who builds, orimproves thereon, and who does such work.himseltor -
USE OF PERMIT Pool and spa'
' through his own employees: provided that such improvements are not intended or'offered for sale. It. however. -the
,q,0 Division of Industrial Safety.P.ermit No:
• building or improvemntis 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,).
' ., L -
CONSTRUCTION LENDING AGENCY. I hei"Gy affirm that there is a construction lending agency for the performance
0 1: 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
ZONE ORD.,
'Contractor's License Law.). .... ._ „_
Lender's Address
O' 1 am exempt under Sec.- •: a.B. & P.C. (Attached Certificate).. , ,
I certify.that I have read this application and state that the above information is correct. I agree to comply with all
Date ' w. Owner ••
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. --
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure, ora '
certificate of Workef6' Compensation Insurance, or a certified.copy thereof (Sec. 3800. Lab. C.). ":
•'• _ Signature o1 Applicant or Agent Date
Policy No. Company. .
CERTIFICATE OF COMPLIANCE ANDAUTHORIZATION OF ENTRY: fcertity I have read this application and state that '
F❑ Certified copy is hereby- furnished: - ; : •.. ''c .I
• tithe 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'D.eartment 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] have applied for this permit for the purpose of making inspections.
Date _Applicant
" y)Signature of ApelIicant,orA%intDate
Print Applicant/Agent Name -
•APPLICANT NAME (L• F; MI) G.L.Q. Pao1 Construct, 4 . M
ADDRESS 68-465 ' Pextez Fri.
CITY/COMMUNITY/STATE/ZIPCathedralCiT,y 6wC1 i, ^T ' 92234 *'
JOB SITE AODRESS/SPACE 48-300 Vista a .Nopa •t
CITY/COMMUNITY/STATE/ZIPT ^ ta' CA 92253 '
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TRACT NAME Uquna: De Ta Paz. '
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OWNER NAME (L. F. MMI)MSB. J bnso
CONTRACTOR -FIRM NAME a':•jt - '
ADDRESS above
CITY/COMMUNITY/STATE//ZIP `.
PHONE 11 1 328-268.1-`
2826 8.1•.
,
LICNC II .
'.
ARC/ENG FIRM NAME
ADDRESS'
CITY/COMMUNITY/STATE/ZIP - - •^ - - ti.
PHONE M -
LICNC N
USE OF PERMIT Pool and spa'
at:, -
ZONFSB
SSB
SSB
RSB
ZONE ORD.,
.LOT S2
_
END '
.:SIDE
APPL/PRMT ." 1q
• L1DAQT!0-5 AXILIflni.
Pemit to, construct a bb • x 52 pram= - -
Poo1 at the CJ.w nouse M 3 is' r una
spas aid a 15:' x 15 ° fountain- as per µ `
app p
Pool and spas mast have --solar oars at
time of final. -They mist be fenced with -
-a 49 fence around pool and spa. - Cannot be
' constructed'in the set back area.
Mach. Fee 27.00'
,.Plan Chick Fee 261.12
Const. Fee 313.00
Elect. Fee 17.00.
" Fee S.40. ;
PlUMbing Fee 28.00 '
TOTAL ': •
• FEE
650.52
. r. • "- _ ' VALUATION Sy U.UU
BLDG. DEPT.
Ah. ,
Ah
NO.
OPERATION TE
INSPECTOR
NO. OP ATION 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 —
2-T—
�j-
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.
❑
OP'NO.
ADDITIONAL INFORMATION
\ 3.► b,� C\
`F
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)
127 Ceiling (Blown)
14 Final
PLUMBING APPROVALS
15 Ground Plumb 3' C -1'S`
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 CS,
29B Bonding
30 Fixtures
31 Service
32 Final