SATT (001271)76992 Calle Mazatlan
001271
APPLICANT NAME [L: F. MI)
Lancbmrk Lhnd
ADDRESS
P.O. Sox "idOb
PERMIT APPLICATION
City of.La Quinta
Department Building Safety
CITY/COMMUNITY/STATE/ZIP•
la nuinha, CA 92253
of and
This permit becomes void if work not commenced within 180 days from date of issuance, OR, if.workhas been suspended or abandoned fora period of 180 days.i
PRC
CERTIFICATE OF -EXEMPTION FROMWORKERS'COMPE4S ATIOWINSURANCE: This section need not be completed if'
LICENSED CONTRACTORS 'DECLARATION: I hereby affirm that I ann'licensed under piovisions of Chapter 9
the permit is for one hundred ($100) o..Iess:l 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,,Ishall not employ any. person in any manner so as to become subject to the Workers' Compensation Laws of
and effect.
California.
License Class Lic. Ndmberl—
Date —Applicant
Date. Contractor
NOTICE TO APPLICANT: If, after. making this Certiticale,of Exeiyiption,.you should become'subject.to the Workers',.-,'. - -
OWNER -BUILDER DECLARATION: I her'eby"affirm't'6-I`am ex'empt from the Contractor's License'Law for.the
Compensation provisions of the Labor Code, you must forthwith comply with such provisionsorthis permit shall
following !easqq'(Sec. 7031.5, Business and Professions Code: -Any city or county Which riequires.a permit to
be deemed ie vok,0 I
construct, alter, impr6ve,'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
it n I be--.•
t no excavation five (5)or more feet in depth into which a person is required I ,
o sce dwi I
.(Chapter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code) or that he is exempt
made in connection with work authorized by thispermit. and that no building structure, scaffolding, falsework', or
therefrom and the basis,for-the alleged exemption. Any. violation of Section .7031.5 by any applicaht for a permit
five
-demolition or dismanllindthere0 will be more than thirty-six (36) feet high. (Chap 3.2, Grp Z Art 2;Sec 341. Title 8.
subjects the applicantio,a civil penalty of not more than hundred dollars (S500.):
-A
0 1, as owner o ' I the property, or my employees.with wages as their sole compensation, will do the work, -and the -
0 Aiownerwtibildir, I will not employ anyone to doworkwhich would require a permit from the Division of
.structure is not intended or. offered for sale (Sec. 7044, Business and.Prolessions Code:.The Contractor's License
1ndustrial Safety, as noted above, unless such person has a,perinit 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 oroffered for sale. It, however, the o
0 'Division of Industrial. Safety. Permit No.,
• building or improvernitt is sold within one year of completion, the owner-builderwill have the burden of proving that
Date --1 Applicant• -
he did not build or improve for the purpose of sale.). ;,"N
CONSTRUCTION LENDING AGENCY: I hereby affirr,that there is a construction lending agency for the performance
0 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
6 1 am exempt under Sec. - B..B P.C. (Attached Certificate)..
A certify that I have read this application and statethatthe above information is correct. I agree toicomply with all
Date Ow " ner
city and county ordinances and state laws relating to building construction, and hereby authorize representatives.'
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I hatie-a certificate of consent to self -insure, ora.
of this county to enter upon the above;mentioned property'for inspection purposes.
Y
.:.cerlifical.e.of Workers' Compensation'Insurance .-or'a certified 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 stateithat
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 Buildi . ng: . Inspection De . partment or City Department.
construction and au hor*7:e,a 'representative of the City of LaOuinta Department of Building and Safely.to enter
upon the 10 to ich I have applied tor thiis pe rrRi t for the purpose of making inspections.
Oat Applicant
Sigriffure-of-Applicant or Agent Date
Print Applicant/Agent Name
APPLICANT NAME [L: F. MI)
Lancbmrk Lhnd
ADDRESS
P.O. Sox "idOb
CITY/COMMUNITY/STATE/ZIP
la Quintiit.` CIC -9.2.253
0
JOB SITE ADDRESSISPACE .-76 492'. -C ; f4Azatlari
CITY/COMMUNITY/STATE/ZIP•
la nuinha, CA 92253
BOK
• PAG
PRC
C'.
.
TWN
PING.
SE
S
TRACT 18 765-
LOT
4 4 -
Elect. Fee
70.06
M D 3
C
SIB
Plurrbing Fee
TRACT NAME
ItmAs Villas
OWNER NAME (L. F. MI)
Armt
CONTRACTOR -FIRM NAME
appli=t
ADDRESSJ.
above;'
_SI_7?COMMUNITY/STATE/ZIP
PHONE 345-2888 1
LICNC 0
ARC/ENG FIRM NAME
ADDRESS
CITY/COMMUNITY/STATE/ZIP
PHONE#
LICNC 0
3,020,.18 -
USE OF PERMIT
BL'
ZON'
FSB',
SSB
SSB--
RSB
OFC,-,
ZONE ORD 0-•
-'..LOT SZ"
SIDE.
'APPUPRMT
DAT
,Penmit to construct
1632 sq. ft.. of-Ingo-Eftry
coficb plus 530 sq. - ft. of porch and -451 sq,
ft. of garage as per r approved plans.
mach. Fee
42.00'
.Plan 0-mc3c Fee,
368.30 -
Oomt. Fee
445.50
Elect. Fee
70.06
smi- Film
7.32
Plurrbing Fee
870'00-
Infrastnmature' Fee
2,000.00,
TOTAL
F!
3,020,.18 -
-A 0 4 2 3 _20 ft 1 0 1,11
VALUATION [fu `- 64 47 9081
BLDG. DEPT._.-. -
I♦
Ah
NO.
OPERATION MTE
INSPECTOR
NO.
OPE TION DATE INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs & Frms
34
Plenums & Ducts
2A
Slab Grade
rK/
35
Furnace Compart.
3
Steel
36
Inlets & Outlets
4
Grout Blocks
.
37•
Combustion Air
5
Bond Beams
38
Compressor
6
Roof Deck
/D
,/[t'
39
Appl. Clearance
7
Framing
'7 S
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.
❑
OP'N
NO.
ADDITIONAL INFORMATION
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Batts) D 7
12B Ceiling (Batts)
12C Ceiling (Blown)
14 Final
PLUMBING APPROVALS
15 Ground Plumb
16 Water Piping
17 Rough Plumb 0 S
18 Vents
19 Sewage Disposal
20 Sewer 1,7
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
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final