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0827 (SATT)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 for a period of 180 days. • ' CERTIFICATE OF EXEMPTION FROM WORKERS: COMPENSATION INSURANCE: This section need not be completed if LICENSED CONTRACTORS DECLARATION: I' hereby affirm that I am licensed Under provisions of Chapter 9 the permit is for one hundied.($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 Cade, and my license is in full force issued: I shall not employany person inanymannerso as to become subject to the Workers'Compensation Laws of - and elfect. - California. - License Class Lic. Number . Date Applicant ' Dale •- Contractor NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should,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 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 PERNII7,CERTIFICATION: such permit to file a signed statement thathe is licensed pursuant to the provisions of the Contractor's License Law ❑ 1herebycertifythatnoexcavationfive(5)ormorefeetindepthintowhichapersonisrequiredtodescend.willbe (Chapter-9(commencingwith section 7000) of.Division 3 of the Business and Professions Code)or that he is exempt made in connection with workauthorized 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 • •.. demolition or dismantling thereof, will be more than thirty-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 ($500.): C.A.C.) ` •' w^'� ❑ I. 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 ariy-one 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 A such work from that division. Law does not apply to anownerof property -who builds, or improves thereon, and who does such work -himself or .. . . ,• - r through his own employees, provided that such improvements are not intended or offered for sale-Ifthowever, the O Division of. Industrial Safety Permit No.. building or improverrint is sold within one year of completion. the owner-build.Qf will have the burden of proving that. DateApplicant he did not build orimprove for the purpose of sale.)., - ti"' • : q __ CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance ❑ I, as.owner of the property, am-exeulsive contracting with licensed contractors to construct the project (Sec: of the work forwhich this permit is issued (Sec: 3097, Civ. C.). • • - • • - 7044. Business and Professions Code: The Contrac enseLaw does not apply to an owner of'property who 'Lender's Name builds or improves thereon, and who contracls.for such pro).with a contractor(s) licensed pursuant to the OFC Contractor's License Law.), _ _ Lender's Address •' O 1 am exempt under Sec. B: & P.C. (Attached Certificate). I certify that I have read this application and state that the above information is correct. I agree to comply with all r .Date ^' Owner e,city and county ordinances and state laws relating to 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, 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 Misapplication and statethai 0 -Certified copy is hereby.furnished: ` the information given is coirect. I agree to comply with all state laws and county ordinances relating to buidling' ❑ Certilied co Is filed with the Cit Buildin Inspection Department or Cit Department. PY City.Building P. Y P construction, and authorize a'representative of the City of La Ouinta Department of Building and Safety to enter. r i _ Date Applicant:... upon the property for which I have applied for this permibfor the purpose of a ing inspeclions�^ n "" 1' �J iI Signature of Applicant or Agent e Date' V Print Applicant/Agent Name r APPLICANT NAME (l, F. MI� � r il'LJ �Y "!'I'LL^"•/ - ADDRESS '• P.O. Boat 1000 CITY/COMMUNITY/STATE/ZIP Ia Quanta, CA .92253 ' JOB SITE ADDRESS/SPACE 78-1151 Calle Norte CITY/COMMUNITY/STATE/ZIP • - - La Quinta, CA 92253 BOK PAG PRC C TWN FIND SE S TRACT 18767 LOTMOD 284.70. ,'ConattHction Fee SB - Unit 48 TRACT NAME UltnL: La Quinta Phase ii NAME(Li,MI) p • •. .. OWNER NAME 1J ii•CYCl CONTRACTOR -FIRM NAME ADDRESS - - P.O. BOX 1000 CITY/COMMUNITY/STATE/ZIP ' • .. La Quanta, CA 92253 Plumb. Fee PHONE .' 345-2888'• 55.50 LICNC M 413586 - ARC/ENG FIRM NAME - - ADDRESS CITY/COMMUNITY/STATE/ZIP• c. -• r PHONE 1 . LICNC N USE ' ,,,.O�FF,,77PERMIT ��,{. `•4., b. Elect. P1wnb • Build, BL ZON FSB SSB SSB 'RSB OFC ' ZONE ORD . • ' s 'LOT SZ i „299-88; END' • SIDE',— APPUPRMTDATE ,, 6-25-84 COMB.' Permit to build 2349 Sq. Ft. of. Condominium Hoch. Fee 28:00 Plan Check Fee 284.70. ,'ConattHction Fee 438.00 'Elect. Fee "..` 36.54 SMI Fee, 7.11 Plumb. Fee 55.50 Prop; Dev. Fee 450.00 s . `TOTAL FEE i „299-88; VALUATION 101.037.40 -BLDG: DEPT. a r' i1 NO. OPERATION ATE INSPECTOR NO. OP ATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back 33 Ventilation System 2 Ftgs & Frms 34 Plenums &Ducts 2A Slab GradeA c 35 Furnace Compart. 3l Steel O 36 Inlets & Outlets 4 Grout Blocks 37 Combustion Air 5 Bond Beams 38 Compressor 6 Roof Deck S �, 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. ❑ UPON ADDITIONAL INFORMATION ��`'��/`/ � � 0 �� / �• 31 SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Lath g 12 .Internal Lath 12A Drywall 13 Finish Grade INSULATION Thick al Value 7A Walls (Batts) 126 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 /,V//-1 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 PiI STREET NAME 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service 32 Final