0794 (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 of 180 days.
LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensedunder provisions of Chapter 9
(commencing with Section 700) of Division 3 of the Business and Professions Code, and my license is in lull force,
and effect.
License Class Lic. Number
Date Contractor -
OWNER -BUILDER DECLARATION: I heieby 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 thath 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)orthat he is exempt
therefrom and the basis,for thealleged 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 ($500.):
0 I. as owner of the property, or my employeeswith wages as theirsole compensation, will do the work, and the
structure is not intended or<offered for sale (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 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 ISec.
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.). �.
O 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 certified copy thereof (Sec. 3900. Lab. C.). '
Policy No. Company
0 Certified copy is hereby furnished. r u
0 Certified copy is filed with the City Building Inspection Department or City Department.
Date Applicant
APNTz(IAME e�,.FLpI�>Q.nt Corp ..
ADORESS, 13Ox IUUU -
T.n A 'a43
FA
C ITY/COMMUNI TY/STATFJZI P
JOB SITE AODRESS/SPACE- ,
ib--Ulb calle Norte
CITY/COMMUNITY/STATE/ZIP
La a. CA 92253
Out t
BOK
PAG .
PRC
C
- -
TNM
PING
SE
.S
TRACT
18767
LOT
9.56
Plumbing Fee
MOD
SB
'
unit'15
TRACT NAME
Duna La Quinta Phase Il
OWNER NAME (L, F. MI) '
LM Development Corp.
CONTRACTOR -FIRM NAME ••
Same
ADDRESS
P.O. Box 1000
CITY/COMMUNITY/STATE/ZIP
La Quinta, CA 92253
PHONE a
345•-2888
LICNC .
413636
'
ARC/ENG FIRM NAME
ADDRESS
CITY/COMMUNITY/STATE/ZIP
PHONE.
1,617.66
LICNC 0
.,
USE OF PERMIT
COMB.- ELECT„ PLUMS. Build'
BL
ZON FSB SSB SSB
RSB
OFC
ZONE ORD •
LOT SZ
END
SIDE
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be completed if
the permit is for one hundred ($100) 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: If, after making this Certificate of Exemption, you should become subject.to the WArkers'„
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 l 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, GrII2, Art 2, Sec341, Title B,'
C.A.C.)
O 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 Safety 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.).
Lender's.Name
Lender's Address
I certify that I have read this 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 above-mentioned property for inspection purposes.
Signature of Applicant or Agent Date
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify 1 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
connstruchon�and authorize a'representallva�6f the;Cily of La Quinta Department of Building and Safety to enter
upon the _property for,Which I have applied for this permit for the purpose of making inspections.
I Signature of Applicant or Agent °f Date
Print Applicant/Agent Name
APPL/PRMT DATE
W94 6-25-84
COMM.
Permit to Build 3657 Sq. Ft of
Condominium
Mech Fee
19.00
Plan Check Fee
341.58'
Construction'Fee
525.50
Electrical Fee
49.02
SMI Fee
9.56
Plumbing Fee
73.00
Prop. Dev. Fee
aeo.00
X n
TOTAL
FEE
1,617.66
BLDG. DEPT. VALUATION [36,386.90
Ah
Ah
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
35
Furnace Compart.
3
Steel
S 3
-
36
Inlets & Outlets
4
Grout Blocks
37
Combustion Air
5
Bond Beams
38
Compressor
6
Roof Deck
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
/
�J—
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
12A Drywall /r(%
13 .Finish Grade
INSULATION Thick R
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 ,
21 Water Heater
22 Water Softener
23 Water Service
24 Gas Test i
25 Final
Tank Pit L. Line .
ELECTRIC APPROVALS
REAR OF PROPERTY LINE
PSL P)
STREET NAME
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire 3
29B Bonding
30 Fixtures
31 Service
32 Final