SATT (001270)76990 Calle Mazatlan
001270
LICENSED CONTRACTORS DECLARATI
(commencing with Section 7000) of Divi
and effect.
License Class Lic. Numbe.
Date Contractor. • Lt'
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.):
.0 I, 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 aremot intended 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 k as owner of the property, am exculsively co0tracting 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. B. & 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.). 1 -
Policy No; Company,
.0 Certified copy is hereby furnished. ..
0 Certified copy is filed with the City Building Inspection Department or City 7.Department:
Date Applicant
PERMIT APPLICATION
City of La Duinta
., Department of Building and Safety
This permit becomes void if work not commenced within 180 days from date of issuance: OR, it.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 if
ON: -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
siom3 o1 the Business and Professions Code, and my license is in full force issued,.) shall not employ any person in any manner so as to become subject to the Workers'CompensationLaws of .
California.
APPLICANT NAME (L. F. MI)
ADDRESS P.O. BMC 1000
CITY/COMMUNITY/STATE/ZIP La Quinta, CA • 92253 .
JOB SITE AOORESS/SPACE 76-770 Wle 1' agatlm -
CITY/COMMUNITY/STATE/ZIP La QuirAa, CA 92253
BOK
PAG <
PRC
C
TWN-
AND
SE
S
T1 3765-2
LO
445.50
Elect. Fee
MOD
I S11
7.32
TRACT NAME
tennis Villas
OWNER NAME IL. F. MI)
pp s ,,,,, n .. .. _
applicant
CONTRACTOR -FIRM NAME applic;ant ..
,
ADDRESS above'
CITY/COMMUNITY/STATE/ZIP above'
PHONE • 345-2888
LICNC .
ARC/ENG FIRM NAME
ADDRESS
CITY/COMMUNITY/STATE/ZIP -
PHONE N
LICNC M
TOTAL
FEE
USE OF PERMIT
BL
ZONFSB
SSB
SSB
,RSB
OFC.
ZONE ORD a
LOT SZ
END
SIDE
NOTICE TO APPLICANT: If, after making this Certificate of.Exemption, you should become subject to the Workers'
Compensation provisions of:Ihe Labor Code, you,must forthwith comply with such provisions.or this permit shall ,
be deemed revoked. "
DIVISION OF,INDUSTRIAL SAFETY PERMIT. CERTIFICATION:
0 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, falsework, or
demolition &-dismantling thereof, will be more than thirty-six (36) feet high. (Chap 3.2. Grp 2, Art 2, Sec 341, Title 8,
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. r
Date Applicant
:CONSTRUCTION LENDING -AGENCY: I hereby affirm that there is a cbnstruction lending agency for the performance
of*the work fot 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.
a: —A A • -
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
construction„and authorize a/'representative of the City of La Ouinta Department of Building and Safety to enter
upon` the p opertytf'or whidd ha'vviaapplied for this permit for the purpose of making:inspections.
Signature of Applicant or Agent Date
Print Applicant/Agent Name
APPUPRMT 3-5tL185/vMW
Permit to construct 1632
sq. ft. of • taor-
Pbory condo plus 530 sq.
ft.of porch and
451 sq. ft. of garage as per approved plans.
Medi. Fee
42.00
Pian Check Fee
368.30
Clonst. Fee
445.50
Elect. Fee
70.06
SMI'Fee
7.32
Plumbing Fee
87.00
Few
2,000.00
TOTAL
FEE
.3, 020, Is.
A 0 4 2 6
BLDG. DEPT.
.3 2.0.
VALUATION
Ah
Ah
NO.
OPERATION IWTE
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
a 8
,*1
36
Inlets & Outlets
4
Grout Blocks
37
Combustion Air
5
Bond Beams
38
Compressor
6
Roof Deck
gs
_ /
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
t0A
fireplace T.O.
❑
NON
ADDITIONAL INFORMATION
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath a LM -
12 Internal Lath
12A Drywall % 023 y .Y4
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Batts) /'J S'
12B Ceiling (Batts)
12C Ceiling (Blown)
14 Final
PLUMBING APPROVALS
15 Ground Plumb o7p S
16 Water Piping
17 Rough Plumb
18 Vents
19 Sewage Disposal
20 Sewer , tf-
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 D
29A Grounding Wire
296 Bonding
30 Fixtures
31 Service
32 Final