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
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'•fir :r"+h ; f^ .. ,
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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.