SFD (001004)76923 Calle Mazatlan
001004
APPLICANT NAME:(L.- F. MI)
Art&m Corr),
ADDRESS . . I . - . . - '• : ,
PERMIT
APPLICAilON,
City of
Department of
La Ouinta
Building and Safety
. 76-923 CAlle Mazatlan
CITY/COMMUNITY/STATE/ZIP
-This permit becomes void it work not comm,enced.within 180 days.Irom date,of issuance: OR, if work has been suspended or abandoned for a,period-of 180 days.-
BOK
-CERTIFICATE OF EXEMPTION FROM WORKERSTOMPENSATION INSURANCE: This section need not be completed it.,
LICENSED CONTRACTORS. DECLARATION: I hereby. affirm that 1 am licensed under provisions of Chapter 9
the permit is for one hundred -($100) o,.Iess. I certify that in the performance of the work for which this permit is
(commencing with Section 7000) of Division3of the Business and Professions'Code and my license is in full force .
issued: I shall not employ any person inany mannerso asto become subject to the Workers'Compensation Laws of
and effect.
California.
License Class
Date Applicant
Date.- V"LU62J Contractor-
NOTICE TO APPLICANT: If, after making this Certificate'ot Exemption, you should become subject to the Workers "'
• OWNER -BUILDER DECLARATION: I hereby affirm that I am exempt fronitilte Contractor's License Law for -the
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 - *
Ittideeffied revoked.'
. Z. 1.
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 provisions of the Contractor's License Law-
O'Ihe 11 be' -A'
reby certify that no excavation five (5) or moVefeet in depth into which a person is required to descend;wi
• (Chapter 9(c6mmencing.with section 7100) of Division 3 of the Business arid Professions Code) or that heisexempt
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 violatibitof,Stiction 7031.5 by any applicant for i permit
demolition or dismantling thereof, will be more than thirty-six (36)'fe6thigh. (Chap 3.2. Grp 2, Art 2, Sec 341, Title 8,-
subjects the applicant to a civil penalty of not more than five,600red dollars ($500.):
C.A.C.)
0 1, as owner of the property: or my employees with wages as their sole compensation, will do the work, and the
-`0 As ownerAuilder,-1 will not employ anyone. tb do work: which would require a permit from the Division
structure is not intended or.offered for sale (Sec. 7044, Business arid Professions Code: The Contractor's License
-industrial Safety, as noted above. unless such person has a permit-to'do such work from that division. 14
Law does not apply to an owner of property who builds, or improves thereon, and who does such work.himself.or
. . . : . .: 1, .. . I . . . . 4
through his own employees, provided that such improvements are not intended or offered for salea,lf:howev6, the.
..0 Division of Industrial.Safely.Pe6l No.
building or-improvemnt is sold within one year of completion,the owner-builderwill have the burden of proving that
'Date Applicant
..he did not build oI improve for. the purpose of sale.).
' .. .. . . ". ; , . I I
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance
0 1, as owner of the propjertyam 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 wilh a contractor(s) licensed pursuant to the
single ftnily dw6Uim
.Contractor's License Law.).
Lender's Address ti
0.1 am exempt under Sec. B. & P.C. (Attached f3ertificate).
„I certify, I have read this "pli
I application and state that the above information is correct.,) agree to comply with all
Date" Owner
city and county ordinances and state laws relating to building construction; and hereby authorize representatives'
Sse
of this county to enter upon the above:mentioned properly for inspection -purposes.
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell Insure, ora
certificate of Workers' Compensation'Insurance ., or a cerlified,copy thereof (Sec.,3800. Lab. C.).
Signature of Applicant or Agent' Date
Policy No. Company.
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have read this application and state that
.0 -Certified copy. is hereby furnished.
the information given is-cofr—ect. Vagree to comply with all state laws and county ordinances relating to buidling , 'J
0 Certified copy is filed with the City Building Inspection Department or City Department.
construction, and authorize:a repres6lative of the City of La Ouinta Department of Building and Safety to enter
upon lhe prq erty,.I'or'–Whlch-,I.haveapplibd for this.permit for the purpose of making inspections.
Date Applicant,
"000.0 "i I *
•
Signature ofAliplicant or Agent Date
Print Applicant/Agent Name
APPLICANT NAME:(L.- F. MI)
Art&m Corr),
ADDRESS . . I . - . . - '• : ,
P.O. Box 780
CITY/COMMUNITY/STATE/ZIP
La Quinta, CA 92253
JOB SITE ADORESS/SPACE
. 76-923 CAlle Mazatlan
CITY/COMMUNITY/STATE/ZIP
I Qu=ta,CA 92253
BOK
PAG
PRC
C1
TWN
R NG
SE,
S.
TRACT
LOT
Tim J
7.39
MOD
SEI
Prop. Devel . Fee
14496=3
32
G-31
I n
CITY OF LA
BUIL D r NTA`
)ING R1
FIR TMIZNX
TRACT NAME
.qmta Rosa C&re
OWNER NAME (L. F. MI)
Arden
CONTRACTOR -FIRM NAME
Anden
ADDRESS
above
CITY/COMMUNITY/STATE/ZIP
abignm
PHONE 6 -'I '
.'I LICNCA
sf;A-lw 1-
333762
ARC/ENG FIRM NAME
nav;m
ADDRESS
1531 Chapala Street
CITY/COMMUNITY/STATE/ZIP
Santa Barbara, CA 93101
PHONE 0 LICNC
USE OF PERMIT
single ftnily dw6Uim
OL
ZON
FSB
SSB
Sse
AS13
ZONE ORD,#
LOT S1
END
SIDE,.
APPUPRMT 1 DATE
nn4
Pe mit to =Lstowt 2,326 sq. ft. 'of
single y dwelling with attached
garage•
Mich. Fee
.,-26.60
Plan Check Fee
291.20
Const. Fee
448.00
Elect, Fee
36.90
Tim J
7.39
Plut"cr Fee
11,00
Prop. Devel . Fee
I V E)
-QCT 2 3 QP
I n
CITY OF LA
BUIL D r NTA`
)ING R1
FIR TMIZNX
TOTAL
FEE FL332.49 J
U
W SFl tv"A 7 1 11.
7-
4 .70 p K.
J, .+s L. 6, 14'. .. k - F , 41* 4.
"1'. 444 36,;
'V VALUATION Is- 105 86 .66 1:
7
- IV
4 1 ELM- DEM, fl`' 1
Alk
A
NO.
OPERATION IMTE 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
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.
❑
NO.
ADDITIONAL INFORMATION
SEWAGE SYSTEM SIZE & LOCATION
/
11 Exterior Lath 7 g yC-1
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 Pi
STREET NAME
26 Power Pole
27 Conduit
2$ Service Entrance'
29 -,.Airing
29A.'GFounciing V1 i e.
296
30 Fixtures.:.
31 • Service
32 Final