SFD (000900)76957 Calle Mazatlan
000900
APPLICANT NAME (L. F. MI)
Arden Corporatim
PERMIT APPLICATION
City of L;
Department of Building and Safety.
JOB SITE ADDRESS/SPACE
i,; .Cil o (C_,-3 ON I
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 clays.
La QuirAa. CA 92253
CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATION.INSURANCE: This section need not be completed if -:,I t
LICENSEO'CONTRACTORS. DECLARATION: I hereby. affirm.thatI 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 0ivision'3of 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. ..I . . . . I . , A
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' 6
that I am exempt from if Contractor's'Li L 'i" th 'Y
OWNER -BUILDER DECLARATION: hereby affirm I cense aw or e,
Compensation provisions of the Labor Code,youmust 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 tot
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: -Gia
su ch pe(mit I o ti le a s i g ned sta I em ent in at h e i s lice nsed pu rs9a ntto.the prov is ion s of.th e Contractor's Licen s e Law •
'0 , I h ereby ce rti I y that n o exca vat i on fi ve (5) or mo re fee I i n d epth i n to wh i ch a perso n i s req u i red I o descend, w it I -be
• (Chapter 9 (commencing with section 7000) of Division 3 of the Business s and Picif ess i o ns " Code) or that he is exempt
made i n _6 6n tic I i on with work authorizid'Uy this permit, and that 6o* bui Idi ng structure, scaffolding, fal sework, or .4R
therefrom and the basis for the alleged. exemption. Any violation of Section 7031.5 by any applicant f6r a permit'
demolition or dismantling theriofwill bemorethin thirty-six (36) feet high. (Chap 3.2, Grp Z Art 2, Sec341, Title8,
• subjects the applicant to a civil penalty of not more than five hundred dollars ($500.):
CONTRACTOR-FIRMaboNAME
m
• 0 1, as. owner of the property, or my employees with wages. as their sole compensation, will do the work, and the. -
0,As'owner-builder, I will not effiploy.anyone-Wcict work which would require a permit from the Division of
structure is not intended or ofiered.for sale (Sec. 7044, Business and Professions Code: The Contractors License
Industrial Safety, as noted above, unless sucWperson has a permit to do such work from that division. ;_iv.
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 not intended or offered for sale. If, however, the
. r
0 Division of Industrial Safety Permit No
building or improverrint is sold within one year of completion, the owner-builder.wi.11 have the burden of proving that
Date Applicant•
he did not build or improve for the purpose
CONSTRUCTION LENDING AGENCY: I here6y affirm that there is a construction lending agency for the performance
C1 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; Div. 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
PHONE a
• Contractor's License Law.).
Lender's Address
0 1 am exempt under See. B. & P.C. (Attached Certificate):
I certify that I have,read this, application and state that the above information is correct. I agree to comply with all .
Date Owner
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, ore
certificate of Workers' Compensatiow Insurance , or a certified copy thereof (Sec. . 3800. Lab. C.).:
Signature of Applicaint or Agent Dite
Policy No. Company
• CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRi., I certify I have read this application and state that -
0 Certified copy is hereby furnished.
-the information given is correct. I agree to comply with all state laws and county ordinances relating to buidling
0 Certified copy is filed with the City Building Ini—peRt-o-n-D I _or City -
epiirt - Department..
-77
.... ..• construction, and authorize a 'representative of the City of La Quinta Department of Building and Safety to enter
Date Applicant- -r
u
upon the property for which I have applied for. this permit for thi'liurlpose of making inspections -
—
LOT SZ,
Signature of Applicant or Agent Date
END
Print Applicant/Agent Name
APPLICANT NAME (L. F. MI)
Arden Corporatim
A T.DRESS
O. B= 780
CITY/COMMUNITY/STAE/TZIP
!A Q==a, CA 92253
JOB SITE ADDRESS/SPACE
i,; .Cil o (C_,-3 ON I
CITY/COMMUNITY/STATE/ZIP
La QuirAa. CA 92253
SOK
PAD : PRC C
Garage
433 'sq. "ft.
.S
finical Fee
31.00.
Plan Ck. EVe
291026.,
TR49AC,T
L46-3'1
'448.ob
I
31,25
MOD
S13
Plumbing Fe6
TRACT NAME
Fee
OAi-R i;;Mi (L. F. MI)
CONTRACTOR-FIRMaboNAME
m
ADDRESS
CITY/COMMUNITY/S.TATE/ZIP,
C
PHONE It
LIcNc
564-1315
333762
-
--------
AF(a/ENG FIRM NAME
ADDRESS
CITY/COMMUNITY/STATE/ZIP
PHONE a
LICNC P
USE OF PERMIT
family &weUing
BL
ZON
FSB
SSB
SSB
RSB
4. ZONE ORD a
LOT SZ,
END
Fitt'
44
A. -
-BLDG. DEPT."!
V,
-I
, ,%i , Ili- V
VALUATION
105;699. K01]
DATE
8-16-84
P=dt to cqjst zct
Model P -3B
Dw-Ujiw (lse floor)
1,616 scr ft
(2nd floor)
277 sq." fto'.
FUrdn
sq.t- fc.
Garage
433 'sq. "ft.
finical Fee
31.00.
Plan Ck. EVe
291026.,
Const, , I Fe . e
'448.ob
Elect.
31,25
SMI Fee
7139
Plumbing Fe6
52,50.
Fee
450.
UG_
984 -
Of
`TOTAL"
FEE . 34
44
A. -
-BLDG. DEPT."!
V,
-I
, ,%i , Ili- V
VALUATION
105;699. K01]
Ah
Ah
NO.
OPERATION L TE
INSPECTOR
NO.
OP WATION DATE INSPECTOR
BUILDING APPROVAL'S
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
f=ireplace T.O.
❑
NON
ADDITIONAL INFORMATION .
t
SEWAGE SYSTEM SIZE .& LOCATION
11 Exterior Lath
12 Internal Lath 177
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 3
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