0833 (SATT)APPLICANT yNAME (L; FF Mi) ent /yam ` • '
]P*U*
MUNITY�'T,TE ZIP
CIrLT^/COM.�• u6i • 92253 .
W
'�'
PERMIT APPLICATION •. - -
~ City of La Ouinta
Department of Building and Safety
- This permit becomes void if work not comnenced within 180 days from date of issuance. 0R if work has been suspen,� n or for a period of 180 days. e
-,
• tx+ CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not completed if -
LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 ...
the permit is fo'r one hundred ($100) o, less. I certify that in,the performanceof. 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, I shall not.employ any person in any manner so as to become subject tothe Workers'Compensation Laws of '
and effect.
California. • -
License Class Lic. Number
Date Applicant
Date — " Contractor _ -, •
. NOTICE TO APPLICANT; It, after making this Certificate of Exemption, you should become subject.to the Workers'
OWNER -BUILDER DECLARATION: I hereby affirm dial I am exempt from the Contractor's License Law. for the
Compensation.provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall '
following 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: •, f ,
such permit to file a signed statement thatheislicensed pursuant tothe provisions ofthe Contractor's License Law .;.
•+ olherebycertify thatnoexcavation five (5)ormore feet indeptfiintowhichaperson isrequiredtodescend. will be
(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 this permit, and that no boilding structure, scaffolding,"falsework, or
therefrom and -the basis for the -alleged exemption. Any violation of Section 7031.5 by any applicant -fora permit
demolition or dismantling thereof, will be -more than thirty -'six (36) feet high: (Chap 3.2, Grp 2, Art 2, Sec341, Titfe8,
subjects the applicant to a civil penalty of not more than five hundred dollars ($500): y+?-ngc
C.A.C.)
• ITI. as owner of the properly. or my employees with wages as their sole compensation, will do the work, and the
p 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
Industrial Safety, as noted above, unless such 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
USE OF PERMIT
Canb: - Elect. Plumb. Eui.ld.
through'his own employees, provided that such improvements are not intended or offered for sale. If, however, the
•0 Division of Industrial Safety Permit No. .
building or improverrint is sold within one year of completion. the owner-builderwill have the burden of proving that
Date Applicant
he did not build or improve for the purpI ! ..sale.)'. ,-
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a.construction lending agency for the performance
O I, as owner of the property, am exculsively contracting with licensed contractors to construct the project (Seca
of the work for which this permit is issued (Sec. 3097; Civ. Q. "
' 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
❑ 1 am exempt: under Sea B. & P.C. (Attached Certificate):
I certify that I have read Misapplication and state that the above information is'correct. I agree to comply with all
• Date 'Owner
city and county ordinances and state laws relating to building construction, and herebrauthorize 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,:or a'
• -. - -
certificate 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 l have read thisapplicationand slatethat
❑ .Certified copy is hereby furnished. ,
:�.+. ':•. 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 Inspection Department or City. Department.
construction, and authorize a:'representative,ol;the City of La Ouinta Department of Building and Safety to enter
%
Date Applicant -
dpon•the property for which I have applied for'this permit for the purpose of making inspections:
r CJ
,fir errs �--1� 1 1 / r� a��.w----- / --1 r. - .�S'', 1
/ Signature of Applicant or Agent Date''
a
Print Applicant/Agent Name /
APPLICANT yNAME (L; FF Mi) ent /yam ` • '
]P*U*
MUNITY�'T,TE ZIP
CIrLT^/COM.�• u6i • 92253 .
W
JOBDDRR�ESS/SPACE
BBSITEE ADDRESS/SPACE
78-163 Calle Nolte.
CITY/COMMUNITY/STATE/ZIP -. n .. ' -
La Quinta, CA 92253
BOK
PAG
PRC I
C
Plan O rf!k Fee
TWN
RNG''
SE
S'
TRACT
18767.
LOT
8.37
-
MOD
SB
Unit` 54
TRACT NAME
L6ttJY L.0 Phase II '
GI�.L
yLa p�tw /f
OWNER
t 0 :i•'P.. .
iik�
dVel
CONTRACTOR -FIRM NAME
ADDRESS .. .. •.
P.O. Erns 1000
CITY/COMMUNITY/STATE/ZIP
rr/COMuu�N.lnTrt/sa, E/CAla 92253
PHONE .LICNC•
345-28888`
413636
ARC/ENG FIRM NAME '
ADDRESS ..
CITY/COMMUNITY/STATE/ZIP
PHONE . _
-
LICNC A •
'
USE OF PERMIT
Canb: - Elect. Plumb. Eui.ld.
BL
ZON
-`FSB`
SSB
•SSB
RSB
.OFC
. • ZONE ORD a
', LOT SZ
END
-APPUPRMT - DATE
6-2.5-84
comb..
Permit to build 2684 Sq, Ft. of
Condominium
Mich.'
.00
37
Plan O rf!k Fee
313.95
Construction -."Fee
483.00
Elect. Fee
40.73.
Smi Fee
8.37
Pli mb 'Fee +'
65.50
Prop. 6eve ypment Bee
450.00
Lail
p A n r=k
K..° TOTAL
f 1 FEE
I , 398.55
I ` VALUATION 119,414.40'
t BLDG. DEPT.
NO.-
OPERATION
INSPECTOR,
NO.
10PTJATION DATE INSPECTOR
MECHANICAL APPROVALS
BUILDING APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs & Frms
IC11-2 71k� X
34
Plenums & Ducts'
2A
Slab Grade
35
Furnace Compart.
3
Steel 4ZAc 10VA64.4
g to g
36
Inlets & Outlets
4
Grout Blocks
37
Combustion Air
5
Bond Beams
38
Compressor
6
Roof Deck
39
Appl. Clearance
7
Framing eo M
40
Fire Damper
8
Vents
41
Smoke Detection Device
9
Garage iiro.J4lell
f
42
Commercial Hood -
10
Fireplace P. L. ❑
43
Final
10A
Fireplace T.O. 'ED
OPO.'N ADDITIONAL INFORMATION
N
OU
-0 4? S
I sw
�� /�O/�J�
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick IV"aluel
7A Walls (Batts) 2 4glQ4 r- A"'
12B Ceiling (Batts)
12C Ceiling (Blown)
14 Final
PLUMBING APPROV41-S.
15 Ground Plumb
16 Water Piping
17 -Rough Plumb
18 Vents
19 Sewage Disposal
20 Sewer jcz�
21 Water Heater Or
22 Water Softener
23 Water Service
.24 Gas Test
25 Final
Tank Pit
L. Line
ELECTRIC APPROVALS
REAR OF PROPERTY
P/L
STREET NAME
LINE
P
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
298 Bonding
30 Fixtures
31 Service
32 Final
1
78-105 CALLE ESTADO — LA QUINTA, CALIFORNIA 92253 - (619) 564-2246
:F iliti
FAX (619) 564-5617
August 21, 1991
Barclays of North Carolina
P. O. Box 33243
Charlotte, NC 28233-3243
Attention: Rebecca Wright
RE: Loan #637043
Tanya Burak
Dear Ms. Wright:
The structure located at 78-163 Calle Norte is located in an
"X" flood zone (areas determined to be outside 500 year
flood plain) per the revised F.I.R.M. (panel 060709 0005 B,
effective August 19, 1991) for La Quinta. The property was
previously designated as zone A3 (areas of 100-year.=if-lood;
base flood elevations and flood hazard factors determined.)
If you have any questions, feel free to contact me.
Sincerely,
BUILD G AND :EAFETY
ti - zn Hartu_ng
---Director of Building and Safety
TH/lc
cc: Tanya Burak
MAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253