0336 (SATT)-APPLICANT NAME (L• F; MI) . .. • . ,
La Quanta Joint Venture
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z21'PERMIT APPLICATION q
t City of
La 0uinta _ p
• Department of Building and Safety •
.PAG
PRC
This permit becomes void if,work not commenced. within 180 days from date of
issuance; OR, it work- has been suspended or abandoned fer a period of 180 days.
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CERTIFICATE OF EXEMPTION FROM -WORKERS' COMPENSATION INSURANCE: This section need not be completed if
:'LICENSED CONTRACTORS DECLARATION:• I hereby affirm thahl am licensed under provisions' of. Chapter -.9
.the permit is far -ane hundred ($100) o. less. (:certify flat in the performance of the work for which this permit is `s
- (commencing with Section3000) of Division 3 of the Business and Professions Code,'and my license is in full force
issued, l shall not employ any.person.inany manner so'as to become subject to the Workers'Compensation Laws of ..
and effect.
California. -k
License Class Lic. Number
Date Applicant
Date"' '.Contractor "
NOTICE TO APPLICANT_;11,,afler.making this•CertificaL of Exemption, you should become subject to the Workers'• µ:
- OWNER -BUILDER DECLARATION:': i*here'by'affirm that I am exempt from the Contractor's License Law for the • ."
;.. Compensatiomprovisions_of the Labor Cade• you mus; forthwith comply with such provisions or this permit shall
be deemed revoked.
fallowing 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
DIVISION, OF. INDUSTRIAL SAFETY,PERMIT CERTIFICA71014: -
•. such permit to filea,signedstatementthatheislicensedpursuanttotheprovisionsoftheContractor'sLicense.Law '•
01 hereby certify that 66 excavationfive(5)ormorefeetindepthintowhichapersonisrequiiedtodescend,witlbe• ;
• : (Chapter 9(commencing with section 7000) of Divisio'n3 of the Business and Professions Code)or that he is exempt
made in -connection with work authorized by this perm t, and that no building structure, scaffolding: falsework, or
.therefrom and the -basis for. the alleged exemption.-Any.violation of Section 7031.5 by any applicant lora Permit , , .
_ :..demolition or dismantling thereof, will be more than th rty-six (36) feet high. (Chap 3.2, Grp 2, Art 2; Sec 341; Title 8 "
subjects the applicant to a civil penalty;of not more than five hundred. dollars (MO.):
C.A.C.) k°'''`•`< 4
.❑ I, as owner of the property, or.my employees with wages as.their sole compensation. -will do the work, and the
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O As owner -builder, I will "not employ anyone .to do, work which would require a permit from the Division of „
structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License .
builds, improves thereon, does himself or
Industrial Safety, as noted above, unless such persor•has a permit to do such. work from that division. ,
r • `••
Law does not apply to an owner of property who or and who such work
Division of. Industrial Safety Permit No
through his own employees. provided that such improvements are not intended or offered for sale. If, however; the ..- .
SSB
building orimprovemntissold within one year ofcompletion. the owner -builder will have the burden of proving that•..-..
.' Date - Applicant,'
he did not buihl.or improve forthe purpose of sale).
CONSTRUCTION LENDING AGENCY: I hereby affirm cher: there 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 whichthis permit is issued (Sec. 3097 Civ..CJ.
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
O 1 amexempt under Sec. B. & P.C. (Attached Certificate):'
I certify that I have read this application and state thatthe above information is correct. I agree to comply with all „
Date - - " ' - 'Owner ^I ' • '-'` r -
-_ . city and county. ordinances and state laws relating to.tJilding construction, and hereby authorize representatives .' .
'
'of this -county to enter upon the above-mentioned prooerty for inspection purposes.
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 certiffed:copy thereof (Sec: 3800. tab. C.).•.
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Signature of Applicant or Agent Date
Policy No. Company
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION 01 ENTRY: I certify Ihave read this applicationand state that .:
�O'Certified copy is:hereby furnished. . ,. -.. •r.
,the information given is correct. I agree to comply wit"r alhstate laws and county ordinances relating to buidling •:
O Certified co is filed with the Cit Building Inspection'De artment or City, -'_ Department.
Y 9 P. Y
construction, and authorize a'representative ot,the CRY o1.La Ouinta. Department of Building and Safety to enter
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upon the property for which I have applied for this permit for: the purpose of making inspections... = '�
DaeG�pY
/ Applicant.
J, -
Signature of Applicant or Agent Date
r
Print Applicant/Agent Name
-APPLICANT NAME (L• F; MI) . .. • . ,
La Quanta Joint Venture
ADDRESS •• "• '
P. O. Box 780
CITY/COMMUNITY/STATE/ZIP '
La Quinta, CA 92253
JOB SITE ADDRESSISPACE
50-096- Calle Rosarita
CITY/COMMUNITY/STATE/ZIP _ - -
La Quinta, CA 92253
BOK
.PAG
PRC
.C'
Porch
TWN
FIND
• SE'
'S
TRACTLOT
14495'1
143
$ 31.00
Plan Check Fee
MOD
P-3
SB
448,00
ME
TRASanta
SaCme -
OWNER NAME (L, F. MI) ..
CONTRACTOR -FIRM NAME ...
ADDRESS—.il
P. O. Box -780
CITY /COM-_ COMMUNITY/STATE/ZIP
*cif 92_-3. , _
47•^7•
PHONE 0n{di
,
619-564-1315
Property Developirmnt Fee 450,00
LICNC •..
333762
ARC/ENG FIRM NAME
ADDRESS '
CITY/COMMUNITY/STATE/ZIP ..
PHONE N ,
.;, ..- .
LICNCF
$ 1,311.34
USE OF
SingleITFamUy DwelliM
BL
ZON
FSB
SSB
SSB
RSB
OFC
• ZONE ORD. . •.
LOT'SZ e
, r END '
SIDE
APPI/PRM1
DATE 10-19-83 - ,
SM
Permit to Constsvct Model Pt -3-B
Deelling (1st Floor]
1,616 Sq.' Ft. � •':
(2nd'Floor) `
277 Sq. Ft. '
Porch
ll2 Sq. Ft. '
Garage
433 Sq. Ft.
N1ferhanical Fee
$ 31.00
Plan Check Fee
291.20
,Construction Fee
448,00
Electrical Fee
31.25
SM Fee
7,39
PlumbiM Fee
52,50• '
Property Developirmnt Fee 450,00
.;, ..- .
- , TOTAL .
FEE
$ 1,311.34
+T
r y • • VALUATION $1Q5,699 .4Q,'
BLDG DEPT.
NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION 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
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
Fireplace T.O.
❑
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ADDITIONAL INFORMATION
7-/L 8 j/ /d A•rn- eallQd
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)
12C 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 —a- y
25 Final
Tank Pit L. Line
ELECTRIC APPROVALS
REAR OF PROPERTY LINE
PSL P/I
STREET NAME
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
2913- Bonding
30 Fixtures
31 Service
32 Final
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