0795 (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 licensed Under provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business and Protessions.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:): - .
❑ I, as owner of the property. or my employees with wages as their sole 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 19r the purpose of sale.).
❑ L. 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.).
❑ 1 am exempt under Sec. B. 8 P.C. (Attached Certificate).
Date Owner
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure, or a
ceftificate of Workers' Compensation Insurance ,-or a certified copy thereof (Sec. 3800. Lab. C.).
Policy No. Company .
❑ Certified copy is hereby furnished.
O Certified copy is filed with the•City Building Inspection Department or City Department.
Date Applicant
• APPLICANT i hL 1/RAO M= i1L'11i i CORP.
ADDRESS
P.O. Box 1000
CITY/COMMUNITY/STATE/ZIP
La Quinta, CA 92253
JOB SITE ADDRESSISPACE
78-114 C&Ue Norte
CITY/COMMUNITY/STATE/ZIP
La Quinta, CA 92253
BOK
PAG
PRC
C
SCAN Chech Fee
TWN
RNG
SE
S
TRACT
18767
LOT
12.29
Plumb. Fee
MOD
SB
-
Unit 16
TRACT NAME
Duna La Quinta Phase II
OWNER NAME (L, F. MI)
L14L Development Corp.
CONTRACTOR -FIRM NAME
Sme
ADDRESS
P.O. Box 1000
CITY/COMMUNITY/STATE/ZIP
La Quint&, CA 92253
PHONE . '
345-2888
LICNC .
413636
ARC/ENG FIRM NAME
ADDRESS
CITY/COMMUNITY/STATE/ZIP '
PHONE.
LICNC .
USE OF PERMIT
COMB.- ELECT.. IMM.. BUILDI.
BL
ZON
FSB
SS8
SSB
ASB
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) It, 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 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:
O 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.)
D 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 puiposes.
Signature of Applicant or Ageni 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
606uction`and'authorize a' representative of'the City of L ji Ouinta Department of Building and Safety to enter
uponithe property far which 1 have pp ied,for this/perm I or the purpose of making inspections.
ISignature of Applicant or Agent Date
Print Applicant/Agent Name
APPL/PRMT DATE
0 7 9 56-25-•84
COMB.
Permit to build 3868 Sq. Ft. of
Condominium
Mech, Fee
38.00
SCAN Chech Fee
404.95
Construction Fee
623.00
Elect. Fee
54.83
SMI Fee
12.29
Plumb. Fee
75.50
Prov. Dev. Fte
750.00
I LOU
TOTAL
FEE
1.958.57
VALUATION 175.256.80
BLDG. DEPT.
Ah
Ah
NO.
OPERATION IIATE
INSPECTOR
NO.
OPTRATION DATE INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs & Frms
34
Plenums & Ducts
2A
Slab Gradev�o
35
Furnace Compart.
3
Steel
�p
36
Inlets & Outlets
4
Grout Blocks
37
Combustion Air
5
Bond Beams
38
Compressor
6
Roof Deck
l7
'�
39
Appl. Clearance
7
Framing
40
Fire Damper
8
Vents
1-7
41
Smoke Detection Device
9
Garage Fire Wall
42
Commercial Hood
10
Fireplace P. L.
❑
43
Final
10A
fireplace T.O.
❑
OP'N ADDITIONAL INFORMATION
NO.
I
J!
.S �•
—
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick' Value
7A Walls (Batts)
126 Ceiling (Batts)
12C Ceiling (Blown)
ni
14 Final
PLUMBING APPROVALS
15 Ground Plumb
16 Water Piping
17 Rough Plumb-
18 -Vents ,
19 Sewage Disposal
20 Sewer 6
21' Water Heater
22 Water Softener
23 Water Service
24 Gas Test - • e
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 elle
29B Bonding
30 Fixtures
31 Service
32 Final