0811 (SATT)PERMIT APPLICATION
- . City of La Quinta
•
Department of Building and Safety
,I
This permit becomes void it work not commenced within 180 days from date of issuance, OR, if work has been suspended or abandoned for a period of 180 days.
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LICENSED CONTRACTORS DECLARATION: I hereby allium that I am licensed under provisions of Chapter 9'
(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
and effect.
License Class Lic. Number
Date Contractor
OWNER -BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractor's License Law for the
following reason (Sec. 7031.5. Business and Professions Code: 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
such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law
(Chapter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code) or that he is exempt
therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars (5500.):
0 I, as owner of the properly, or my employees with wages as their sole compensation, will clothe work, and the
structure is not intended or offered for sale (Sec. 7044, Business and Professions Coder The Contractor's License
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
building or improvemnt is sold within one year of completion, the owner -builder will have the burden of proving that' .
he did.not build or improve for the purpose of sale.).
0 I, as owner of the property, am exculsively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who
builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the
Contractor's License Law.).
0 1 am exempt under Sec. B. & P.C. (Attached Certificate).
Date Owner
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 certitied.copy thereof (Sec. 3800. Lab. C.).
Policy No. Company
0 Certified copy is.hereby furnished. - M
O Certified copy is filed with the City Building Inspection°Department or City Department.
Date Applicant
APPLICANT. lE L. F, MI( � Com•
ADDRESS "T�'n+,,��,�. {�
P.O. LMii 1000
CITY/COMMUNITY/STATE/ZIP
Quinta, CA 92253
JOB SITE ADDRESS/SPACE
o Ca11e Norte
CITY/COMMUNITY/STATE/ZIP
La ftinti GAI7-253
BON
PAG
PRC
C
Plan Check Fee
TNM
RNG
SE
S
TRACT
IR767
LOT
65.50
S1i1 Fee
MOD
SB
Unit 32
TRACT Duna ELa Quinta Phase 11
OWNER NAME '
Development Corp,
CONTRACTOR -FIRM NAME
Same
ADDRESS
P.O. BOX 1000
CITY/COMMUNITY/STATE/ZIP
La Quinta, CA 92253
PHONE . I
345-2888
I LICNC .
413636
'
ARC/ENG FIRM NAME -
ADDRESS
CITY/COMMUNITY/STATE/ZIP
PHONE .
1139$.5 5
LICNC II
USE OF PERMIT
COMB. Elect, Plumb, Build,
BL
ZON
FSB
SSB
SSB I
RSB
OFC
ZONE ORD .
LOT SZ
END
SIDE
CERTIFICATE OF EXEMPTION FROM WORKERS COMPENSATION INSURANCE, This section need not be completed II
the permit is for one.hundred (5100) o. less. I certify that in the performance of the work for which this permit is
issued. I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of
California.
Date Applicant
NOTICE TO APPLICANT: It, after making this Certificate of Exemption, you should become subject to the Workers'
Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall
be deemed revoked.-,
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
0 1 hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be
made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or
demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap 3.2. Grp 2, Art 2, Sec 341, Title 8.
C.A.C.)
0 As owner -builder, I will not employ anyone to do work which would require a permit from the Division of
Industrial Safety, as noted above, unless such person has a permit to do such work from that division.
0 Division of Industrial Safely Permit No.
Date Applicant
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance
of the work for which this permit is issued (Sec. 3097. Civ. C.). r
Lender's Name
Lender's Address
I certify that I have read4his application and state that the above information is correct.I agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of this county to enter upon the atiove=mentioned property for inspection purposes.
Signature of Applicant or Agent Date
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have read this application and state that
the information given is correct. I agree to comply with all state laws and county ordinances relating to buidling
canstrcuo
un;,and authorize a'representative/of the City of La Ouinta Department of Building and Safety to enter
upon the property for which I have applied for this permit for the purpose of making inspections
Signature of Applicant or Agent V v Date
Print Applicant/Agent Name
APPL/PRMT n�1 6-75
M
COM.
Permit to build 2684 Sq. Ft. of
Condominium .
Mech Fee
37.00
Plan Check Fee
313.95
Construction Fee
483.00
Elect. Fee-
40.73
Plumb. Fee
65.50
S1i1 Fee
8.37
Prop. Dev. Fee
450,00
TOTAL
FEE
1139$.5 5
BLDG. DEPT'.
VALUATION t19,414.40
a
r
NO.
OPERATION DATE
INSPECTOR
NO.
OP TION DATE INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs & Frms
34
1 Plenums & Ducts
2A
Slab Grade
35
Furnace Compart.
3a
4&teel36
Inlets & Outlets
4
Grout Blocks
37
Combustion Air
5
Bond Beams
38
Compressor
6
Roof Deck
39
Appl. Clearance
7
Framing
—; 14
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.
❑
OP'NO.
ADDITIONAL INFORMATION
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SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
12A Drywall p9
13 Finish Grade
INSULATION Thick
Value
7A Walls (Batts)
126 Ceiling (Batts)
12C Ceiling (Blown)
14 Final
PLUMBING APPROVALS
15 Ground Plumb zmv
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
p/L P/I
STREET NAME
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final