0060 (AR)PERMIT APPLICATION
City of La Ouinta
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.
LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
and effect.
License Class
Lic. Number
We Contractor
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 heis 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 penally of not more than five hundred dollars ($500.):
1)4 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, Business and Professions Code: The Contractor's License
Law does not apply to an owner of property who builds. or improves thereon, add 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 improvemnt is sold within one year of completion, theowner-builder will have the burden of provingthat
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 swan owner of property who
builQs or improves thereon, and who contracts for such proje\cts with4a ca t'ractor(s) licensed pursuant to the
Contractor's License Law.). /
0 lam exe pt under Sec/-- /J B,& P.C. (Attached Certificate).
(Date /t Owner l
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.
Applicant
APPLICANT NAME (l. F. MI)
d
ADDRESS
51-884 Avenida Megan
CITY/COMMUNITY/STATE/ZIP_ _
SIT [�.A'+
JOB ADDRESS/SPACE
Sam
CITY/COMMUNITY/STATE/ZIP '
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& k1irq Pewit Flee
TRACT NAME y�
OWNER NAME (L. F. MI)
CONTRACTOR-F]RM�N�j MIE,�t,,,.,,
ADDRESS
CITY/COMMUNITY/STATE/ZIP "
PH 564- 4030
14.OU
LICNC M
14.00
ARC/ENG FIRM NAME
ADDRESS WOO
CITY/COMMUNITY/STATE/ZIP Ip
PHONE N LICNC Or
USE OF PERMIT
BL ZON FSB SSB SSBWJIW
ZONE ORD N
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LOT SZ
END SIDE
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CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be completed 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:
0 1 hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be
made in 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 of Industrial Safety Permit No.
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 Addre
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 county to enter upon the above=mentioned property for inspection purposes.
Signature of Applicant or Agent Date
CERTIFICATE OF.COMPL•IA'NCE AND AUTHORIZATION OF ENTRY: I certify I have read this application and statethat
tie informal,-engl den is correct. I agree to comply with all state laws and county ordinances relating to buidling
constructi yAd uthorize a representative of the City of La Ouinta Department of Building and Safetylto enter
uZn pr per I r whi h I have applied for this permit for the purpose of making infpect ns
Signature of Applicant or Agent / Date,
Print Applicant/Agent Name
APPL/PRMT Q 0.0 6 / 1 2!Ab-8
3
Permit for 740 Sq.Pt. of Roam Pddit on with
fireplace and- sspa, Per Plan
6 o Burnish with
�V11��YT��ii
WA' ntiactor's License No. � Vio4: ,s
workman's
�1"}f3at�0lT1 if any portic1 of the Work is
Subcontxactede
Vrt.kuaticia $
2fiJ00sD0
ppm, �t�y���y,�
Jlri.. m �.t� YLI.i.!`+1atic i
30r340.00
Mart Ems}: Free
103.25
& k1irq Pewit Flee
206.50
S.M.I. ..
2.28
A
E1eetric Ge=it
22.00
Plumb Pen -nit
14.OU
A Mech. P+ ,t
14.00
TOTAL
FEE
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VALUATION $32,340.00
Arrow Printing 250/1-83 White: Finance Canary: Assessor Pink: Applicant Tag: Bldg. Dept.
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.
❑
NON
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
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
_1
Cv
log WCJJ
78-105 CALLE ESTADO - LA QUINTA, CALIFORNIA 92253 (619) 564-2246
December 27, 1984
0
Mr. D. S. Krause
P. 0. Box 270
la Quinta, CA 92253
RE: PERMIT NO..0060
51-884 Avenida Obregon
Dear Mr. Krause:
The Community Development Department.has reviewed your request to retain
the existing overhead electrical service when upgrading your service from
100 to 200 amps for the above referenced permit.
It has been determined that your electrical service can remain overhead
provided that all work associated with the permit is completed and finalled
by the City prior to February 22, 1985. The "overhead" determination is
based upon the fact that your permit included fees for a new service and that
the permit was issued prior to the City's adoption of underground requirements.
It is -necessary that the work be ccnpleted by the date specified since the
permit will be expired at that time and any new permit (to replace the existing
.one) would:have to comply with the new underground requirements.
If you have any further questions on this matter, you are welcome to contact
the Community Development'DeparbTent.
very truly yours,
LA QUINTA, CALIFORNIA 92253