SFD (001345)54335 Avenida Martinez
001345
Policy No. Company
O Certified copy is hereby furnished.
O Certified copy is filed with the City Building Inspection' Department or City Department
Date Applicant
APPLICANT NAME (L, F, MI) Const.
ADDRESS
P.O. Box 2288
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.
r
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be completed it
LICENSED CONTRACTORS, DECLARATION: I hereby affirm that I 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 in any manner so as to become subject to the Workers`Compensation Laws of
and effect.
California.
License Class Lic.-Number
Date Applicant.
Date •- Contractor • % ' /-=
NOTICE TO APPLICANT: If, after.making this,Certificate of Exemption, you should.become subject to the Workers'
OWNER -BUILDER DECLARATION: I hereby affirm the I am exempt from the Contractor's License.Law for the
Compensation provisions of the Labor Code, you must forthwith comply with such provisions octhis permit shall
'
following reason (Sec. 7031.5. Business and Professions Cade: 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 PERMIT,CERTIFICATION:
such permit to file a signed statement that he is licensed pursuant to the,provisionsofthe Contractor's License Law
01 hereby certify that no 6cavation five (5) or more feet in delith in -to which a person is required to descend. will be
(Chapter 9 (commencing with section 7000) of Division 3 o1 the Business and Professions Code)or that he is exempt
made in'connection with 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 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.)
O I, as owner o1 the property, or my employees with wages as their sole compensation, will do the work, and the.
O As owner -builder. 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 Code. The Contractor's License
-I
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
BL
through his own employees. provided that such improvements are not intended or offered for sale. If, however, the
Q,Division of Industrial Safety Permit. No.
building or improvemni is sold within one year of completion. the owner -builder will havetheburden ofproving that
Date Applicant
• he did not build or improve for the purpose of sale.).
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance -
O 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
Contractor's License Law.).
Lender's Address
O 1 am exempt under Sec. B. 8 P.C..(Attached Certificate).
I certify that I have read this application and slate that the above information is correct. I agree to comply with all
Date Owner°I
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; or a'
certificate of Workers' Compensation Insurance or a certified copy thereof (Sec^3800 Lab C )
Policy No. Company
O Certified copy is hereby furnished.
O Certified copy is filed with the City Building Inspection' Department or City Department
Date Applicant
APPLICANT NAME (L, F, MI) Const.
ADDRESS
P.O. Box 2288
CITY/COMMUNITY/STATE/ZIP Indio, CA 92201
JOB SITE ADDRESS/SPACE 54-335 Avenida Martinez
CITY/COMMUNITY/STATE/ZIP .La 1Cu•ta/ .CA 92253 -
BOK
PAG
X53
PRC'
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Dont- Fee 388.00
TWN
PING
SE
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TRACT
LOT
4
MOD
SB
-
TRACT NAME
OWNER NAME fL. F, MI) l t -
CONTRACTOR -FIRM NAME
Applicant
ADDRESS•
.above
CITY/COMMUNITY/STATE/ZIP '
above
PHONE . I
I
I LICNC •
- -
ARC/ENG FIRM NAME'
ADDRESS
CITY/COMMUNITY/STATE/ZIP '
PHONE a -
' LICNC M
USE OF PERMIT -
Single family dwella nlg
BL
ZON
FSB SSB
SSB
RSB
I OFC
ZONE ORD 0 ',
LOT SZ
END. SIDE
Signature of Applicant or Agent Date
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF'ENTRY: (,certify I have read this application and state that*
the information given is correct. I agree to comply with.alPstate'lawsand county ordinances relating to buidling
construction, and authorize a'representative of the Citrj,L'a Ouinta Department of Building and Safety to enter
upo he- propeFjyfor•which-1 Have applied for tKis permltfort a purpose of making inspections.
Signature of Applicant or Agent Date
Print Applicant/Agent Name
APPL/PRMT 4'-21285 S.F.D.
Permit to construct 1592 sq. ft. of
s.f.d. & 91 sq. ft. of porch and
430 sq. -ft. of garage as per approved
Plans.
Mach. Fee 22.00
Plan Check Fee 306.33
Dont- Fee 388.00
Elect. Fee 43.13
SMI Fee 6.65
Plumbing Fees 50.50
2,000.00
TOTAL
FEE
A 0 7 8 3
BLDG. DEPT.
4- 23 28
VALUATION
84 417.00
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
s
, /
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)
12C7 Ceiling (Blown)
14 1 Final /f
PLUMBING AP RCVALS
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)
STREET NAME
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final
x%PIED
r. .o
y BERMUDA DUNES r
RANCHO MIRAGE
t" INDIAN WELLS H
0 PALM DESERT a
J' LA OUINTA
''gyp INDIO 1�
Desert Sands Unihed School District
82-879 HIGHWAY 111 O INDIO, CALIFORNIA 92201-5678 0 (619) 347-8631
April 23, 1985
City of La Quinta
Department of Community Development
78-105 Calle Estado
La Qui*nta, CA 92253
Re: 54-335 Avendia Martinez
Gentlemen:
The developer of the above referenced . lot
has mitigated its impacts on our overcrowded schools by payment
of the amount of $628 per unit to be applied to the cost of
district educational facilities made necessary by such new
development.
Sincerely,
oo
John D. Brooks
Assistant Superintendent
Business Services
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