SATT (001255)76994 Calle Mazatlan
001255
APPLICANT NAME (L. F. MO • _ , '• . . . - -
ADDRESS' P.O. BIC& 1000
PERMIT
APPLICATION .•
1 • City of
La Og a
Department of
•
a
Building and Safety ,.•,'
This permit becomes void it work not commenced. within- 180 days from date of issuance, OR, if work has been.suspended or abandoned fora period of 180 days.
- — •. - ^ _
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This sectionneed'not be completed if ti;
,LICENSED~CONTRACTORS DECLARATION: I'hereby affirm that I am licensed under'. provisions of Chapter 9.
;the permit is for one hundred ($100) o. Iess.1 certify that in the performance oLlhe 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; I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of .1
and effect.
..
California.
"-' '-Applicant '
License Class Lic..Nu b
Date • ' 'Contractor . " - • Q.
Date
NOTICE TO APPLICANT: If, after. making this Certificate of Exemption, you should become subject to the Workers'
OWNER -BUILDER DECLARATION: I hereby affirm that I am exempt fromwthe Contractor's License Law for the '
Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall
..
to reason (Sec.'7031.5. Business and Professions Code:.Any city or county which requires a permit to
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:
sych pe'rmit to file asigned statement that he is licensed pursuant to the provisions of the Contractor's License Law.e0•I
hereby certify that noexcavation five (5)or refeetiii depth intowhichaperson isrequired todescend. will be '
(Chapter9(commencing with section 7000) o1 Division 3 of the Business and Professions Code) or that he is exempt .
made in connection with work authorized bythi permit; and thatno building structure, scaffolding, falsework,or
',.therefrom and -the basis for the alleged exemption:.Any violation of Section 7031.5 by any applicant for a permiC• . '
-demolition or dismantling thereof, will -be more han'thirty-six (36) feet high. (Chap 3.2,.Grp 2 Art 2, Sec341;Title8,. 7
subjects the applicant to a civil penalty of not more thanAive hundred dollars ($500:):
C.A.C.) "
O.1. as owner of the property, or my employees.with wages asfheir sole compensation, will do the'work, and the '.
" - O`As'owner•builGer, twill not employ any .to do work wliicfi'would require.a permiffrom the Division of
• structure is not intended or offered for.sale (Sec. 7044. -Business and Professions. Code: The Contractor's License....- .
Industrial Safety, as noted 'above..unless ch person has a permit 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 improvementsare not intended or offered for sale. ll, however, the i
O Division -of IndustrioI Safefy Permit o.
'building or,improvemntissold within one year ofcompletion, the owner -builder willhavetheburdenolprovingthat ..•
•' Date Applicant
he did 'not build or improve.for the purpose of sale.), ;.
CONSTRUCTION LENDING'AGENCY: I hereby aj)firmy.`' -.'.'' 'ere is a construction lending agency for the performance
• O 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 (Se .Lr3097; Civ. C.). "
7044, Business and Professions Code: ,The Contractor's License Law does not apply. to an owner of property who
'
•Lender's Name. •
builos or improves thereon:and who contracts for such projects with a eontractor(s) licensed pursuant to the •
a'
Contractor's License Law.). __
Lender's Address
a 1 am exempt -under Sec. : 13.1 P.C. (Attached Certificate). . ,
I certify'that,l have read this application and state that the above,information is correct. I agree to'comply with all .4,
' Date Owner
city and county ordinances and state laws relatinglto 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; ora'•
certificate of Workers' Compensation Insurance , or a.certified copy thereof (Sec. 3800. Lab. C.): • .....
Signature of Applicant or Agent • " 4 Date
Policy No. Company
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have read this application and state that
O Certified.copy is hereby furnished. • : "Y N.
the information given.is correct. I agree'to comply with all state laws and county ordinances relating to buidling-
O Certified copy is filed with the City Building InspecGan Department or.Cit y Department. ...
• construction, and author ze a representative of the'City of La Ouinta Department of Building and Safety to enter -
upon the ydpe f 'forr W 'ch II have applied for this permit for the purpose of making inspections:
Date Applicant
Signature of Applicant or Agent *' Date
APPLICANT NAME (L. F. MO • _ , '• . . . - -
ADDRESS' P.O. BIC& 1000
CITY/COMMUNITY/STATE/ZIP T aQuirit.. , CA • 92253
JOB SITE ADDRESS/SPACE"' 76-994 Calle Mazatlan .
CITY/COMMUNITY/STATE/ZIP T,a•.Z•yu{'nta,,/' 7t
.' 92253
BOK'-
PAG
PRC
C.
•• TWN•
N*ch. Fee
RNG .
SE
S
e"s`iT65-2
LOT
45
.. ,,
3
SB_
" Plimbing Fee ,
TRACT NAME - _ '
OWNER NAME (L• F. MI) appli caint • '
CONTRACTOR -FIRM NAME ' • above
. C7LJVV i
ADDRESS
ADDRESS ay;m
CITY/COMMUNITY/STATE/ZIP
PHONE • 345-2888-
LICNC .
.. '
ARC/ENG FIRM NAME
ADDRESS `
CITY/COMMUNITY/STATE/ZIP " •^' - - -
PHONE 1
-
LICNC •
3 '].10.52
USE OF PERMIT Condo. •.
BL
ZON,
.FSB
"SSB.
SSB
'RSB
•
OFC: -
ZONE ORD M . i"3f?..
_
LOT SZ.' ;
•
END
SIDE
Print Applicant/Agent Name
APPL/PRMT , >' •> I"]j "'
D TE X85 , ' _
' Piemit to construct 1931 sq. ft. of , 56 -story
.condo plus 166 sq. ft.
of poach and .4bl
sq.' ft -of- image as per approved '.plans... '
N*ch. Fee
42.00: ,
.Plan (heck Fee
-399.19
Const. Fee,
480-.50-
80-.50-'Elect.
'Elect.Fee
77.53
SM Fee
ri
8.30
" Plimbing Fee ,
103,99 '
Inffastructure Fee
20000.00
TOTAL ` 7--
FEE
3 '].10.52
t "A 0. 4.09,_
BLDG. DEPT.
3... 2 .0 •
3-1
VALUATION 118;389100
r-1
Ah
NO.
OPERATION 7XT E
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!j
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
? ((j
(
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 �% -77d-
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 (Q
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
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32. Final
.