0815 (SATT)~ r
ADDRESS ' - '
P.O. BOX 1000
c Z PERMIT APPLICATION
JOB SITE ADDRESS/SPACE _
786127 Cable Norte '
City of La Duinta .
C Department of Building and Safety
�L
PAG'
PAG
^ 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
CERTIFICAT&OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be completed if
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
.ICENSEO
commencing with Section 7000) of Division 3 o1 the Business and ProfessionsCode, and my license is in lull force '
issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Lawsof
Ind effect.
California.
,icense Class Lic. Number
Date Applicant
late - + Contractor; -
NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to the Workers',—
OWNER DECLARATION:I hereby.affirmlIh';h 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 . u
-BUILDER
following reason (Sec. 7031.5: Business and Professions Coder Any city,or-county which requires a permit to
construct, alter; improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for
be deemed. revoked.
DIVISION OF INDUSTRIAL , SAFETY PERMIT CERTIFICATION: -
suchpermittofileasignedstatementthatheis,licensedpursuant to the provisions aLtheContractor's License Law
'O (hereby_cerlifytha(noexcavationlive(5)ormore feet indepihinto which aperson isrequired todescend, will be
(Chapter 9':Icommencing with section 7000) of Division 3 of the Business and Professions Code) or that heisoxempt'
made in'conneclion with work authorized by this permit, and that no building structure, scaffolding, falsework, or
'8,. "
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-tfian thirty-six (36) feet high. (Chap 3.2, Grp 2, Art 2, Sec341, Title
subjects the applicant to a civil penalty of not more than five hundred dollars (S500.):
C.A.C.)
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-builber, ( 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
0 Division ol,Industrial Safety Permit No.
through.his own employees, provided that such improvements are not intended or offered for sale. ll, however, the'
n
building or improvenint is sold within, 3ne year of completion. the owner-builder.will have the burden of proying that .-
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
0 I, as owner of the property, am exculsively contracting with licensed contractors to construct the 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 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
0. Lam 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
bate`Owner' 'a ` r t
city and county ordinances and state laws relating to building construction, and hereby authorize representatives•
y
"conse`nt
of this county to enter upon the above=menlioned property for inspection purposes.
WORKERS' COMPENSATION DECLARATION: I herebyaffirm that I have a certificate of to Self -insure, or a
certificate of Workers' Compensation Insurances or'a certified copy thereof(Sec. 3800. Lab: C.):T
Signature of Applicant or Agent Date
Policy No. Company, _
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have.read this application and slatethat
0 Certified -copy is hereby furnished, - •< -
' the information given is correct. I agree to comply with -all stale laws and county ordinances relating to buidling :•
O Certified copy is filed with the City Building Inspection Department or City Department.
Date Applicants.
onstruction Viand authorize a.'representativ;ot the City of La Ouinta Department of Building and Safety to enter
cupon the property,for•wlich 1 -have as plied for thh s permiVfor the purpose of making•inspection .
r Signature of Applicant or Agent Date
APPLICANT NAME (L• F. MI)
IML Dove nt • Corp.
ADDRESS ' - '
P.O. BOX 1000
CITY/COMMUNITY/STATVZIP - "• -
�a Quinta, CA 92253
JOB SITE ADDRESS/SPACE _
786127 Cable Norte '
CITViz iquintaE/ZIPC '92253
(AC
BOK
PAG'
PAG
PRC
Mech-Fee' ;:
' 28,00
Plan Check Fee
RNG
Construction Fee
438.00
TRACT -
18767
LOT.
•
7.11
MOD .
SB
Unit 36
TRACT NAME
RAmia LaQuint"a Pbase II
OWNER
ll'JfJ�66,w1dipment C=P. • . • -
CONTRACTOR -FIRM NAM£
Same
ADDRESS
P.O, Box 1000
CITY/COMMUNITY/STATE.IZIP
La Quanta, CA 92253
PHONE . • 7LICNC
-345 2888
9
413636
ARC/ENG FIRM NAME
ADDRESS
CITY/COMMUNITY/STATE/ZIP '
PHONE M -
LICNC'
USE OF PERMIT
Cant. Elect. Pltu b. B".
BL
ZON
FSB
SSB'
•' SSB'
'RSB
-
OFC
'
ZONE ORDN ."
LOT, SZ
END
"SIDE
Print Applicant/Agent Name
APPL/PRMTZ ■ DATE
♦!p(A S1 6-25-84
com,
Permit to build 2349 Sq. Ft.
of Condominium
Mech-Fee' ;:
' 28,00
Plan Check Fee
284.70'
Construction Fee
438.00
Elect. Fee t
36.54
S14I Fee
7.11
Plumb Fee.
55.500
Prop. Dev, Fee
450,00
A If fi F414.1
TFEE. .�
1,299.85
BLDG. DEPT:' ,
VALUATION 101,037.40'
Ah
AM
NO.
OPERATION ATE INSPECTOR
NO.
O ATION DATE INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs & Frms
9
34
Plenums & Ducts
2A
Slab Grade
35
Furnace Compart.
3
teel
36
Inlets & Outlets
4
Grout Blocks
37
Combustion Air
5
Bond Beams
38
Compressor
6
Roof Deck
14
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.
❑ .
NO
ADDITIONAL INFORMATION
57
/ ,rte
7 J�
s l 07 L4I � S
SEWAGE SYSTEM SIZE& LOCATION
11 Exterior Lath a Y
12 Internal Lath
12A Drywall S
13 Finish Grade
INSULATION Thick al
Value
7A Walls (Batts)
12B 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 d
21 Water Heater
22 Water Softener .
23 Water Service
24 Gas Test 3
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