0810 (SATT)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 ot'180 days. "
CITY/COMMUNITY/STATE/ZIP
La Quints, CA•92253
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be completed if
LICENSED CONTRACTORS' DECLARATION: Thereby affirm that F am licensed under provisions of:Chapter 9
the permit is for one hundred ,(5100) o: less.] 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,.l shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of '
and effect.
California.
License Class Lic. Number
Date Applicant
• Dater -• Contractor.
NOTICE TO APPLICANT:'If, after making this Certificate of Exemption„you should become subject to the Workers'
OWNER -BUILDER DECLARATION: I 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 PERMIT CERTIFICATION:,
•, such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law
01 herebycertifythat noexcavation five (5)ormore feet indepth into whichaperson isrequired todescend,wiflbe
(Chapter 9 (commencing with section 7000) ol•Division 3 of the Business and Professions Code)or that he is exempt
made in connection with work authorized 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, Sec341, Title8,
'*. subjects the applicant to a civil penalty of not more than five hundred dollars (S500J: - r^ ..
CAL.) -
.AL.);0.1,
0 1.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 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
- - - • -
through his own employees: provided that such improvements are not intended or offered for sale. If, however, the
- - ” O Division of Industrial Safety Permit No.
building orimprovemntissold.withinone year ofcompletion, the,owner-builder will have the burden ofprovingthat- -
Date Applicant
he did not build or improve for the purpose of sale.).
• - r- J.1
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) Iicensea pursuant to the
-
Contractor's License Law.).
Lender's Address
0 1 am exempt under Sec. B: 8 P.C.y(Attached Certificate): , :
I certify that I have read this application and state that the above information is correct. I agree to comply with all
Date Owner +.r
•• . •. . city.and county ordinances and state laws relating to building construction, and hereby authorize representatives .
• • ENO
of this county to enter upon the above•lrnentioned 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.).
4,, Signature of Applicant or Agent - - Date
Policy No. Company
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have read this application and state that
0 Certified copy;is,hereby furnished.
the information givenlis correct. I agree to comply with all state laws and county ordinances.relating.to•buidling -
0 Certified'copy is filed with the City Building Inspection Department or City Department.
'consUuction, and authorize a representative the City of La Quinta Department of Building and Safety to enter .
Date Applicant
upon the property for which I have applied I this perm'Plor.the purpose of making inspectionLs.
/app
Ji.1.v1/�-�`
b!
Signature of Applicant or Agent ; Date v
f
Print Applicant/Agent Name '
(L. F. MI).
APPPppL�IIyyDevelopment
I L Corp.
ADDRESS /� -
P.O. B= 1000
CITY/COMMUNITY/STATE/ZIP -
La Quanta, CA 92253
JOB SITE ADDRESS/SPACE • -
78-117 Ca11e Norte
CITY/COMMUNITY/STATE/ZIP
La Quints, CA•92253
80K
PAG
PRC
C
28.00 -
-28,00-
TNM'
RNG„
SE.,
S
TRACT
•18767'
LOT
SMI Fee -
x7.11
MOD
s8
.
Unit 31
TRACT NAME
Duna La Quinta Phase II
OWNER NAME (L. F. MI) .. • . ....
LML Development Corp.
CONTRACTOR•FIRM NAME • c r ... ,
Same
ADDRESS,
P,O. Box 1000
CITY/COMMUNITY/STATE/ZIP .. - .•
La Quinta, CA 92253
PHONE .•
345x2888.'
LICNC .
413636
... •g.
.-
ARC/ENG FIRM NAME
ADDRESS. -
CITY/COMMUNITY/STATE/ZIP ^ - .• ., ,
PHONE N
LICNC .
UScu-�PERMIT Elect.:- Plumb, ' Build. -
a111i177
BL
'.7 ZON
r FS8
SSB
SSB
RSB
'. ZONE ORD, .i ••
LOT SZ ^.
_
• • ENO
,SIDE:'if:
APPL/PRMT !C A ,. DATE•
R}(A 6-25-84
•
Comb.
Permit to build 2349 Sq. Ft.
of Condominium
Meeh. -Fee
28.00 -
-28,00-
P J. -M
Plan Clieick Fee
284.70
Construction Fee.
438.00
_elect. ze-e
36.54”
SMI Fee -
x7.11
Plumb. Fee.
55.50
Prop. Dev. fte"
450.00
TOTAL
•,FEE
1,299.85'
r - - .. . !-•. VALUATION 101,037.40 '` "
(�
BLDG.DEPT,
1♦
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 Grade
101KIN
i
35
1 Furnace Compart.
3 dAteel
g �'O
36
Inlets & Outlets
4
Grout Blocks
37
Combustion Air
5
Bond Beams
38
Compressor
6
Roof Deck
�f �f
39
Appl. Clearance
7
Framing
40
1 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`
NJ I a L SS
I
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath _
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick al
Value
7A Walls (Batts)
12B Ceiling (Batts)
12C Ceiling (Blown)
14 Final
PLUMBING APPROVALS "
15 Ground Plumb L
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 PA
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring J/3.0 hos
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final
STREET NAME