SATT (001264)76972 Calle Mazatlan
001264
PERMIT APPLICATION
City of La Ouinta
• Department of Building and Safety
This permit.becomes•void if work not commenced within 180 days fromidate of issuance. OR; if work has been suspended or abandoned for a period of 180 days.
LICENSED -CONTRACTORS DECLARATION: 1 hereby affirm that I am licensed under provisions of Chapter 9
(commencing with Section 7000) of Division Sof the Business and Professions Code, and my License is in full force
and effect.
License Class Lic. NumberAt
y
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 permitJo
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 ofthe Contractor's License Law
(Chapter 9 (commencing with section 7000) of Division 3 of the Business and I?rofessions 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.): r . .
O t. 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 not intended or offered,for sale. If, however, the
building or improvemnt 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 purpost of sale.).
0 I, as owner of the property, am exculsively contracting with licensed contractors to construct the project (Sec.
7044. Business and Professions Code: The Contractors 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. B. 8 P.C. (Attached Certificate).
Date) Owner
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
0 Certified copy is hereby furnished.
O Certified copy is filed with the City Building Inspection Department or City Department., k
Date Applicant
'
APPLICANT NAME (L. F. MI) •p •TMyark Land
ADDRESS P.O. Bax 1000
CITY/COMMUNITY/STATE/ZiT 0ii nta, CA. 92253
JOB SITE ADDRESS/SPACE 76-972 Calle Ma?.at-Um
CITY/COMMUNITY/STATE/ZI% QW ria/ CA 92253
BOK
PAG
.PRC
C
TWN
RNG
SE,
S
11r,Y65-2
LOT 34
Coast. Fee
1.
O3 D
so
SNI Fee
TRACT NAME Tennis V f ill as
Villas
OWNER NAME (L. F. MI) Applicant.
.CONTRACTOR -FIRM NAME
`a1 lit -
ADDRESS om ..
CITY/COMMUNITY/STATE/ZIP`b
PHONE
LICNC /
ARC/ENG FIRM NAME '
ADDRESS
CITY/COMMUNITY/STATE/ZIP -
PHONE A
LICNC 0
1 3,020.18 -
USE OF PERMIT ClotJLJ
BL
ZON
FSB
SSB
SSB
RSB
OFC
ZONE ORD . . ,
, LOT SZ
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:
O 1 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,talsework, or
demolition of dismantling thereof, will be more than thirty-six (36) feet high. (Chap 3.2r Grp 2, Art 2. Sec 341, Title 8.
C.A.C.)
0 As owner -builder, I will not employ anyone to do work which woulb 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 ot,lnduslrial Safety Permit No.
DateApplicant
CONSTRUCTION LENDING AGENCY: 1 hereby affirm that there is a construction lending agency for the performance. 3'
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. l 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 l 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
construction and authorize a' representative of the City of La Ouinta Department of Building and Safety to enter
upon the, w ,Idyl have applied for this permit for the purpose of making inspections.
% ' [ire!
Signature of Applicant or Agent Date
Print Applicant/Agent Name
APPL/PRMT Unj : 4
3-e"35
Permit to construct
1632 sq. ft. of two--
story condo plus M 530 sq. ft. of porch
and 451 sq. ft. of garage as per approved
plans. -
meth. Fee
42.00
•Plan Check Fee .
368.30
Coast. Fee
445.50
Elect. Flee
. 70.06
SNI Fee
7.32
LlYii rt a
872.06
Infrastructue Fee
21000.00
TOTAL-:
FEE
1 3,020.18 -
A 0 4 2 0
BLDG. DEPT.
3 20
VALUATION 1 4 a nil
14731.00 -
Ah
Ah
NO.
OPERATION TE
INSPECTOR
NO.
OP TION 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
j
39
Appl. Clearance
7
Framing
gs
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 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 T ,
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final