0787 (SATT)PERMIT APPLICATION
City of La Ouinta
Department of Building and Safety
ADDRESS - .• •. .'.• - ,
P.O. Box .1000
CITY/COMMUNITY/STATE/ZIP ' ' -
La Quitna, CA 92253
�•. This permit becomes void if work not commenced within 180 days from date of issuance.
OR, it work has been'suspended or abandoned for a period of 180 days."
• tt• r -
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be completed if t '
•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 the performance of 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, Ishall 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 ContractorNOTICE
TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to the Workers' '
' OWNER -BUILDER DECLARATION: 'I he affirm tf at 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 he is licensed pursuant totheprovisions ofthe Contractor's License Law
❑Iherebycertify'thatnoexcavation7ive(5)orniorefeetindeothinto which apersonisrequiredtodescend. will be
(Chapter.9jcommencing with section 7000) o1 Division 3,of the Business and Professions Code) or that he is exempt
made id connection'with work authorized by this permit, and that no buildingstructure, scaffolding, falsework, or
therefrom and the basis for the alleged.exemption. Any violation of Section 7031.5 by any applicant for a permit
demolitionbr dismantling thereof,'viill be more than thirty-six (36) feet high. (Cfiap 3.2, Grp 2, Art 2. Sec34t. Title B.'
subjects the applicant to a civil penalty of not more than five hundred dollars ($500.): sr .-.
" C.A.C.)
O I.:as owner of the property, or myemployees with wages as their sole compensation, will do the work, and the
❑ As owner -builder, I will not employ anyone to do work .which would'requiie 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
, .- 1•.. :- - -
through hisbwn employees, provided that such improvements are not intended or offered for sale. If, however., the
-O Division.of Industrial Safety Permit No.
building or improvernnt is sold within one year of completion, the owner --builder will have the burden of proving that
Date Applicant-
pplicanthe
hedid not build or improve for the purpose of sale.). . -
1.. - - '
- "t.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance
0 I, as owner of the property, am excufsively contracting with licensed contractors to construct the project (Sec:
of the work for which this permit is issued (Sec. 3097, Civ. G.).
7044. Business and Professions Code: The Contractor's License Law does not apply to an owner of property who '
''.builps
Lender's Name
or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the
Contractor's License Law.).
Lender's Address
s
0 1 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. ) agree to comply with ally ,
' Date Owner "
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 (Seca 3800. Lab. C.). '
Signature of Applicant or Agent * Date "
Policy.No. _ Company -CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: Icertify Ihave read this application andstalethat
O Certified copy is hereby furnished. _ n. • • • . 'A:
,•
- 'the.information givenis correct. I agree:tii 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. , '.
Z:f consiruc/ n, and authorize a Yep�eseritative of the City of La Ouinta Department of Building and Safety to enter �-
'the
Date Applicant
upon property+for which I+�iav applied for this permit for the purpose of making inspection'\'
r�f/� V� e4:1 e(" - -
r Signature of Applicant or Agent Date
r
J
Print Applicant/Agent Name
APPLI ANT NAME (L. F. MI(
Y.1�11G Development Corp.
ADDRESS - .• •. .'.• - ,
P.O. Box .1000
CITY/COMMUNITY/STATE/ZIP ' ' -
La Quitna, CA 92253
JOB SITE AD RESS/SPACE - -
/ti -136 Calle Norte
CITY/COMMUNITY/STATE/ZIP -
La Quitta, CA 92253
BOK
PAG
PRC i
C
19.00'
TWN.
.RNO
SE
S
TRACT y
LOT
$M- Fee -
'-9.56
MOD
SB
Unit18767 8
V
TRACT NAME -
Duna Ta Quinta Phase,II .
OWNER NAME (L, F MI( -
1AL Development Corp.
CONTRACTOR -FIRM NAME • -
Same
ADDRESS '
P.O. Box 1000
CITY/COMMUNITY/STATE/ZIP
La Quinta,.CA 92253
PHONE . • '
345-2888
LICNC e ' '
4136363
ARC/ENG FIRM NAME
ADDRESS '
CITY/COMMUNITY/STATE/ZIP - •• - '
PHONE. -
LICNC .
USE OF PERMIT
Comb.-ElectrreM. Plumbing, Building
BL
ZON
FSB
SSB
SSB
RSB
OFC
- ZONE ORO.
LOT SZ
.if
END.
SIDE
APPL/PRMT8.' OATS -
6-25-84
COMM.
Permit to build 3657 Sq. Ft.
of Condominium .
Mech Fee -
19.00'
Plan Check Fee
341.58
Consturction Fee
525:50
Electrical Fee
-49.02
$M- Fee -
'-9.56
Plumbing Fee '
73,00
Prop,JDevelopment Fee
600.00
R H@.
LJ
• r . TOTAL-
' FEE
61
VALUATION 136,386.90
BLDG. DEPT.
ft
r
NO.
OPERATION TATE INSPECTOR
NO. OP ATION DATE INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33 Ventilation System
2
Ftgs & Frms
34 Plenums & Ducts
2A
Slab Grade4
35 Furnace Compart.
3
Steel
36 Inlets & Outlets
4
Grout Blocks
37 Combustion Air
5,
Bond Beams
38 Compressor
6
Roof Deck
9
39 Appl. Clearance
7
Framing
3
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
t 7�
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lathe/i/,C/�W����J
12A Drywall
13 Finish Grade
INSULATION Thick
Value
7A Walls (Batts)
12B Ceiling (Batts)
12C Ceiling (Blown)
14 Final
PLUMBING APPROVALS
15 Ground Plumb
16 Water Piping
i
'17 Rough Plumb
18 Vents ,
19 Sewage Disposal
20 Sewer ,
21 Water Heater
22 Water Softener
23 Water Service
24 Gas Test /a
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 ,e
296 Bonding
30 Fixtures
31 Service
32 Final