0831 (SATT)APPLICANT iew i F- __ MI) ____t Corp.1
100 j00�� C
JP.O.
' _ . .
Bmcmc 1000
PERMIT
APPLICATION'
City of
• Department of
La Duinta
Building and Safety •
This permit becomes void if work not commenced within 180 days from date of issuance:.OR, if work has been suspended or abandoned fora period of 180 days.
PRC
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section'need not be completed if .
LICENSED CONTRACTORS DECLARATION: 1 hereby affirm that 1•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
(commencing with Section 7000) of Division 3of the Business and Professions Code, and my license is in•full force.
issued, I'shall not employ any person inanymannerso asto become subject tothe Workers'CompensationLaws of
and effect.
'.
California. -
License Class Lic. Number i
Date Applicant
C=; Oate - Contractor. _
NOTICE TO APPLICANT: If, after making this Certificate of Exemption, yousho.uld become subject to the Workers%.
` OWNER=BUILDER DECLARATION: 1 hereby affirm that I am exempt from the Contractor's License Law for the:
Compensation provisions. ol 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: .
such permit to file a signed statement that he islicensed pursuantto the provisions of the Contractor's License Law .:
0 I'hire . by certify that no excavition fiv - e.(5) or�mor . e feet in depth into which a person is required to descend, will be
• (Chapter 9(commencing with section 7001) of Division.3 of the Business and.ProtessionsCode)or that he is exempt
made in connection with work authorized by this permit, 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 for a permit, -
1.371siubjects
demolition or dismantling thereof, will be more than thirty-six (36) feet high`''(Chap 3.2. Grp 2. Art 2, Sec 341, Title 8,
the applicant to a civil penalty of not more than five hundred dollars ($500.):
CAC)
O 1, as owner of the property, or my employees.with wages as9heicsole compensation; will do the work; and the . • ..
O'As 6wner•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
Or
❑Division Industrial, Safety Permit
through his own employees, provided that such improvements are not intended or offered for sale. It, however, the
at
building or improyemnt is sold within'one year of completion. the own.eL-builder will havethe burden of provingthat
Date' Applicant
he did not build or improve for the purpose of.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 (Sect
- 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
• O 1 am exempt under Sec. B..B P.C. (Attached Certificate).
- >, I certify that (.have read this application 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 hereby authorize representatives
- P
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•irisure, or a
' certificate of Workers' Compensation Insurance; or 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 statethat
O Certified copy is herebyfurnished. -
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 of the City of La•Ouinta Department of Building and Safety to enter .
Date Applicant
upon the property foyr'wi ich I have4pplied flir•this permit for the purpose of making inspections.
.r1� 4t l i -� /i"' f/ A
/ Signature of Applicant or Agent Date
APPLICANT iew i F- __ MI) ____t Corp.1
100 j00�� C
JP.O.
' _ . .
Bmcmc 1000
Clrr/cOMM�u-a, NInTvt/sFJZICA 92293 • . . , .
JOB SITE ADDRESS/SPACE .. -
'/8---159 Uaile Notte -
`lLa°Qudata; /ZCA 92253
BOK
PAG -
PRC
C.
-
TWN'
FIND -.
SE -
. S
TRACT 18761
� LOT
313.95 '
�
MOD
39
Unit 52
a
TRACT ,,NAME
y� y..�
La �il l a Phww ii .
OyLNum
O=P -
CONTRACTOR -FIRM
ADDRESS
P.O. Falx . 1000 - ..
CITY/COMMUNITY/STATE/ZIP ' ' . , : ' ' '
La Quinta. CA 92253
PHONE . '
'345-2888
L.ICNC
413633
'
ARC/ENG FIRM NAME • '
ADDRESS
CITY/COMMUNITY/STATE/ZIP
PHONE 0;
LICNC N
.• -
L EwaL-R.-T •��. A Plumb. Budde
BL
ZON
.FSB
SSB'
SSB
RSB
'OFC -
ZONE ORD N.
LOT SZ
ENDJ..
• . SIDE
Print Applicant/Agent Name
APPL/RRMT • '! ■ �
DATE
-25_O
6-25_8
•CODs{!.' •
Permit to build 2684
Sq. Ft. of
Condominuim '
recti. ' Fee -
37.00
Plan Check Fee
313.95 '
Constructdon Fee
483..00
B1.eq. Fee
40.73
SMI Fee.
8:37
PLumb. Fee
65.50
.Prop Dev. Fee
450.00
1,398'55
gJ 2
VALUATION
BLDG.
�t9f414.4�% +
BLDG. DEPT.
Ah
r -I
NO.
OPERATION
ITATE
INSPECTOR
NO.
OP ATION 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 1"'W14641.$
8
36
Inlets & Outlets
4
Grout Blocks
37
Combustion Air
5
Bond Beams
38
Compressor
6
Roof Deck
/oZ
39
Appl. Clearance
7
Framing
jot
�'�
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
C)s
�j 6214—S
/
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick Value "al
7A Walls (Batts)
128 Ceiling (Batts)
12C Ceiling (Blown)
14 Final
PLUMBING APPROVALS
15 Ground Plumb 7
16 Water Piping
17 Rough Plumb
18 Vents
19 Sewage Disposal
20 Sewer �Q 4—'P vy10
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
298 Bonding
30 Fixtures
31 Service
32 Final