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MISC (001168)53424 Avenida Martinez 001168 PERMIT APPLICATION City of La Duintf.- Department of Building and Safety 1 6--!) ✓qc)Y 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 Date 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 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.): w 0 1, 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, and who does such work himself or through his own employees, provided that such improvements are nolintended 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 1, 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. 8 P'C. (Attached Certificate). Date ° Owne WORKERS' COMPENSATION DECLARATION: I hereby affirm that 1 have a certificate of consent to self -insure, or a certificate of Workers' Crrmpensation Insurance , or a certified copy thereof (Sec. 3800, Lab. Q. Policy No. Company 0 Certified copy is hereby furnished. ❑ Certified copy is filed with the City Building Inspection Department or City Department. Date Applicant APPLICANT NAME (L. F. MI) F%wela Johnson ADDRESS + CITY/COMMUNITY/STATE/ZIP la7(>Ltinta. , C 92253 JOB SITE ADDRESS/SPACE sc ' CITY/COMMUNITY/STATE/ZIP sr BOK PAG - PRC C 15.00 TWN RNG SE S TRACT LLOT ^ MOD SB - TRACT NAME NOS OWNER NAME (L. F. MI) 21wlicant+ LY7'j CONTRACTOR -FIRM NAME ADDRESS aL om CITY/COMMUNITY/STATE/ZIP _,b(M PHONEI; LICNC 0 ARC/ENG FIRM NAME ADDRESS CITY/COMMUNITY/STATE/ZIP PHONE M 35.50 - LICNC 0 USE OF PERMIT If .AJ4i 11S.ZK at..JYQ BL ZON FSB SSB SSB RSB OFC ZONE ORD N LOT S2 END SIDE 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 I 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, AA 2, Sec341, Title B, 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. 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 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 COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have read this application and state that the information given is correct. I agree to comply with all state laws and county ordinances relating to buidling cpstruction., and authorize a representative of the City of La Ouinta Department of Building and Safety to enter gon the' openfy I which I ha a applied to thi_s ermit for the purpose of making inspections. Signature of Applicant or Agent Date Print Applicant/Agent Name APPL/PRMT ■ ■ DATE 5 J:emit o install a wood burning stave. ICBG report #3539 - 32" fran mat. on Haack and 18" on side. Plan Check Fee 15.00 const. Fee 20.80 SMI Fee .50 w 1,) fi•t 985. TOTAL FEE 35.50 BLDG. DEPT. VALUATION 1 11200.00 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. ❑ NPON ADDITIONAL INFORMATION SEWAGE SYSTEM SIZE &•LOCATION 11 Exterior Lath 12 Internal Lath 12A Drywall 13 _� Finish Grade INSULATION Thick Value 7A Walls (Batts) 12B Ceiling (Batts) 12C7 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 X- - .iV ;, e.:..ry. ..ws4 . -.r :s - , wJ: _ : r'r. - ,. ,. . ,❑ - 5 R p• l - c 1 RD 41 f4 01 a r(, +5' lA.. °1l.1. . !!.!L•.l.Ll 0 a Q U:,4, ✓ j, L' . • - ► iliW lSR1.y .^S/c.. ■. ' f' 14'•' i )" S'f•. tii Mrd moi-'' •jL•7 3 7.. vi­ ;tel--y yrirf '•fir :r"+h ; f^ .. , I G _ - . E f i r CLEARANCES FROM THE VENT COLLAR TO COMBUSTIBLES it Slto•B IIt Homo ;; w Mobile Horne:., Cleara cco rilth Slagle Walt Plpe Clearances with Double Wall Pip t, F 32 - - _ 4 24 10. 14 y 7 t 93.9% Combustion IEffide ncyri* 84.5% Heat Transfer RaU ng* 79.3% Oveir 1Il IEffff de nc y* Efficiency. As a manufacturer of high quality wood burning appliances, we are as concerned about efficiency as you the consumer. As a result, we have researched, designed, tested and retested to assure you of the most efficient wood heaters on the market today! An amazing 79.3 overall efficiency puts the Fir in a class by itself. Higher efficiency means economy and after all that's what wood heat is all about. Classic Design. Clean, simple lines with a unique pedestal base gives this model its classic good looks. The unrestricted view of a crackling blaze through the large glass door will bring to mind an open campfire under the stars. Versatility. The base of the'Alpine Fir i,3 not only attractive but enables this model to be used in both site -built (free standing residential) homes and manufactured housing (mobile homes). 'Tests on a Grand Fir conducted and certified by Northwest Testing Laboratory (ICBG TL -128) using W.H.A. and Oregon D.E.O. proposed methods. TIftTIJFJ5 Sobtained under test conditions. Actual field performance may vary depending upon installation, fueling, and operation. SAFETY NOTICE: If this appliance is not properly installed, a house fire may result. For your safety, follow the Installation Directions. Contact local building or fire officials about restrictions and installation requirements in your area ETCHED GLASS: (A) Standing Lady . (C) Cabin Scene I (B) Kneeling Lady (D) Yucca Plant l G P B • D Chlmne y Heating "FEATURES: A) Free Floating Bypass Damper in closed position 3 B) Unique "Tunnel -Baffle" for Greatest Efficiency <. C) "Air Wash" draft design to promote clean glass Capacity D) Preheated Air Intake Passage W D H of Bricks E) Wood Handled Draft Control 81ra X,IZ%. - F) Dual Usage pedestal base for outside/inside air intake ~F. G) Double heat shielding for reduced clearances to 18D x 131/2W combustibles H) ASTM approved firebrick lining to increase heat retention Cast door fully gasketed to provide "air -tight" seal ,,r • Heavy Steel Construction _1 • Break Resistant NeoCeram High Heat Glass • PLUS: 5 -YEAR LIMITED WARRANTY ` t fs'f110NS. I •.4 Brass Highlighted Cast Door Etched. Glass Fan ' .. MH Kit for Mobile Home Use f i r CLEARANCES FROM THE VENT COLLAR TO COMBUSTIBLES it Slto•B IIt Homo ;; w Mobile Horne:., Cleara cco rilth Slagle Walt Plpe Clearances with Double Wall Pip t, F 32 - - _ 4 24 10. 14 y 7 t 93.9% Combustion IEffide ncyri* 84.5% Heat Transfer RaU ng* 79.3% Oveir 1Il IEffff de nc y* Efficiency. As a manufacturer of high quality wood burning appliances, we are as concerned about efficiency as you the consumer. As a result, we have researched, designed, tested and retested to assure you of the most efficient wood heaters on the market today! An amazing 79.3 overall efficiency puts the Fir in a class by itself. Higher efficiency means economy and after all that's what wood heat is all about. Classic Design. Clean, simple lines with a unique pedestal base gives this model its classic good looks. The unrestricted view of a crackling blaze through the large glass door will bring to mind an open campfire under the stars. Versatility. The base of the'Alpine Fir i,3 not only attractive but enables this model to be used in both site -built (free standing residential) homes and manufactured housing (mobile homes). 'Tests on a Grand Fir conducted and certified by Northwest Testing Laboratory (ICBG TL -128) using W.H.A. and Oregon D.E.O. proposed methods. TIftTIJFJ5 Sobtained under test conditions. Actual field performance may vary depending upon installation, fueling, and operation. SAFETY NOTICE: If this appliance is not properly installed, a house fire may result. For your safety, follow the Installation Directions. Contact local building or fire officials about restrictions and installation requirements in your area ETCHED GLASS: (A) Standing Lady . (C) Cabin Scene I (B) Kneeling Lady (D) Yucca Plant l G .. CIVERALL bIMENSION8 B • D GENERAL SPECIFICATIONS .. CIVERALL bIMENSION8 boor Opening Hearth Pad Chlmne y Heating Firebox Pedestal Size Number Size' Capacity Size W D H of Bricks -29-,x, 270 81ra X,IZ%. - 33. x 43. '6" j aDprox 1200 18D x 131/2W 18 x 17.318 x 8 15 All Dimensions are in inches. 'Assumes 7' ceiling, adequate Insulation and a good stove location. "Hearth extensions must be of materials specified in Section 3707(1) of the Uniform Building Code. See this Quality Wood YMTH & uoR'iE THE FIFWPI.ACE S110P 1048 T+F.' :;>JAAVE. 32505 SWEET HOME STOVE WORKS, INC. • 1983 (714) 687-6435 Manufactured by Sweet Home Stove Works 307 Clark Mill Road, Sweet Home, Oregon 97386 Printed in U.S.A.