0784 (SATT)APPLICANT NAME (L• F; MI).
IM Development Dorp.
ADDRESS .. /
P.O. Bos 1000
PERMIT APPLICATION
City
of La Quinta
Department of
.
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' - -
•
s
• 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 hundred ($100) o, less. I certify.that in performance of the work for which this permit is .
(commencing with Section 70001 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'CompensationLaws of
and effect.
California.
' License Class Lic. Number
Date Applicant _
Date •• Contractor
NOTICE TO APPLICANT: If;,afler making this•Certificate of Exemption, you should become subject to the Workers' . .
OWNER -BUILDER DECLARATION: I hereby aflirm 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. PERMIT, CERTIFICATION:. .
such permit to file a signed statement that h6s licensed pursuant to the prqvisions of the Contractor's License Law*_
01 hereby certify th'at no'exca�valion live (5) or more feet in depth into which 4pers�bn is required to descend, will be
(Chapter 9(commencing with section 7000) of Division 3 of the Business and,Protessions Code) orthat he is.exempt -.
therefrom and the basis for the alleged exemption. Any of Section 7031.5 by any applicant fora
made in connection with work authorized by this permit, and that no building structure; scaffolding, falsework, or
violation permit _
� demolition or dismantling thereof; wilt be more than. thirty-six (36) feet high. (Chap 3.2. Grp 2, Art 2; Sec341, Title 8. .
subjects the applicant to a civil penalty of not more than five hundred dollars ($500.):
C A.C) •• s1(1<., •--
0 I. as owner of the property, or my employees with wages as their sole compensation; will do the work, and the.
0 As owner -builder, I will not employ anyone to do work which would regliire'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•
, .... •,
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 improvenlpj,is sold within one year of completion, the owner -builder will havetheburden ofprovingthat
Date Applicant
he did not build or improve for the purpose of sale.).
CONSTRUCTION LENDING AGENCY: I hereby affiim that there is a construction lending agency for ttie'performance .
0 1, as owner of the property, am exculsively contracting with licensed contractors to constructthe project (Sec. _
-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 s Name'
' builds or improves thereon, and who contracts for such projects with a contractors) licensedi pursuant to the
1,586.54 '
Contractor's License Law.). a
Lender's Address
0 I am:exempt under -Sec. 'B. 8 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 ,
Dale' ' 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 have a certificate of consent to self -insure, or a
. .. .
certificate of Workers' Compensation Insurance , or a certified copy thereof (Sec. 38OOAab. C.): - "
-
Signature of Applicant or Agent Date
Policy No. Company
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION!OF ENTRY: ('certify l have read this application and state that '
0 Certified copy. is hereby furnished: ..
the information given is correct. I agree to comply,wilh altstate laws and county ordinances relating to buidling
` D.Certified co Is tiled with the Cit Building Inspection Department or Department... !
PY Y 9 D D y D
I
'
construction land authorize a'representative of>the City of La Quinta Department of Building and Safety to enter
. s 1...
upon� the dperty for which I have applies for this for the purpose"of making inspections.
• .. ' ••1-,
Date Applicant
jp permit
{�
r
> Signature of Applicant or`Agent �y Date T.
Print Applicant/Agent Name
APPLICANT NAME (L• F; MI).
IM Development Dorp.
ADDRESS .. /
P.O. Bos 1000
CITY/COMMUNITY/STATE/ZIP
La Quinta,. Ca 92253
JOB SITE ADDRESS/SPACE -
78-142 Calle Norte
CITY/COMMUNITY/STATE/ZIP -
La Quinta, CA 92253
BOK
PAG
PRC .
C
TWN
RNG
SE
S
TRACT
18767
LOT^
330,20
ConstruUtion Fee'
T MOD
SB
_
Unit' 5
TRACT NAME
Duna La Quinta Phase Ii
OWNER NAME (L• F, MI) +.
UL Devleopmant Corp. •
CONTRACTOR -FIRM NAME
Same
ADDRESS .,
P.O.' Bax 1000
CITY/COMMUNITY/STATE/ZIP -
La Ouinta: CA 92253
PHONE a
345-2888
^
LICNC a
413636
Prop, Development Fee
ARC/ENG FIRM NAME - -
ADDRESS -
CITY/COMMUNITY/STATE/ZIP
PHONE N
LICNC N
....
USE OF PERMIT.
Comb.- Elect.. Plumb.. Bldst.
BL
ZON FS8 SSB,
a
SSB RSB
5 M7
OFD' ^•
ZONE ORD t
LOT SZ
END
SIDE.,.
APPL/PRMTDATE
8 6-25-84
Q0
-Permit to+bui'ld, 3523
Sq, Ft,
of
Coudomiaium.
Meech, Fee
19,00
Plan Check Fee
330,20
ConstruUtion Fee'
508,00
Elect. Fee , �.
47.27
SMI Fee `
-9.07
Plumb. Fee
73.00
Prop, Development Fee
600.00
J
5 M7
.f i. .-.
TOTAL•'-•
FEE
1,586.54 '
BLDG. DEPT.
VALUATION 129,628,00 •,
NO.
OPERATION GATE
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 fnlets'& Outlets
4
Grout Blocks
37 Combustion Air
5
Bond Beams
38, Compressor
6
Roof Deck
o2 %
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.
❑
NON ADDITIONAL INFORMATION
IIIJJJ / �J`
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 GG ��
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
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 Uf G ie
29B Bonding
30 Fixtures
31 Service
32 Final