0798 (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 e1 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 ($500.):
❑ I• as owner of the properly, or my employees with wages as their sole compensation, willdo 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 i mprovemnt 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.).
❑ 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.).
❑ 1 am exempt under Sec. B. 8 P.C. (Attached Certificate).
Date Owner
WORKERS' COMPENSATION DECLARATION: I hereby affirm that l have a certificate of consent to self -insure, or a
certificate of Workers' Compensation Insurance , or a certified copy thereof (Sec. 3800. Lab. C.).
Policy No. Company.
O Certified copy is hereby furnished. s
O Certified copy is filed with the City Building Inspection Department or City Department.
Date ... Applicant
APPLIC NIVxy It.0 later Corp.
YY
ADDRESS
P.O. Box 1000
CITY/COMMUNITY/STATE/ZIP
La Quinta, CA 92253
JOB SITE ADDRESS/SPACE
18-118 Calle Norte
CITY/COMMUNITY/STATE/ZIP
La Quinta, CA 92253
BOK
PAG
PRC
C
19.00
TWN
RNG
Construction Fee
508.00
TRACT
18767
LOT
SNI Fee
9.07
MOO
SB
unit 19
TRACT NAME.
Duna La Quinta Phasell
OWNER NAME (L. F. M1) .
Ulf. Devel o meat Corp •
CONTRACTOR -FIRM NAME
Same
ADLaQuinta, CA 92253
CITY/COMMUNITY/STATE/ZIP '
PHONE .
345-2883
LICNC M
413636
'
ARC/ENG FIRM NAME
ADDRESS
CITY/COMMUNITY/STATE/ZIP '
PHONE .
LICNC •
'
USE OF PERMIT
C011B.-- Elect. Plumb. 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 i n 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 l heieby 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.)
'❑ Agowher-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.
❑ 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.) agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of this count1to enter upon the above-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
construction „and authorize a'representative of the City of La Ouinta Department of Building and. Safety to•enterr
upon the property for which I have applied for this permit fo the purpose of making Inspections. r�
9
Signature of Applicant or Agent Date
Print Applicant/Agent Name
APPUPRMT n 7 q A DATE
l8 6-25-84
C0I3.
Permit to Build 3523 S4. Ft.
of Condominium
Meeh. Fee
19.00
Plan Check Fee
330.20
Construction Fee
508.00
Electrical Fee
47.27
SNI Fee
9.07
Plur,bing Fee
73.00
Prop. Dev. Fee
600.00
PAX
TOTAL
FEE
1,586.54
BLDG. DEPT. VALUATION 129,628.00
i -
r1
NO.
OPERATION ATE
INSPECTOR
NO. O ATION DATE INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33 Ventilation. System
2
Ftgs & Frms
34 Plenums & Ducts
2A
Slab Grade
T
35 Furnace Compart.
3
Steel
Q
36 Inlets & Outlets
4
Grout Blocks
37 Combustion Air
5
Bond Beams
38 Compressor,
6
Roof Deck
7111W
39 Appl. Clearance
7
Framing
p
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.
❑
NPON ADDITIONAL INFORMATION
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath �rp
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick
Value
7A Walls (Batts)
12B Ceiling (Batts)
12C Ceiling (Blown)
14 Final
PLUMBING APPROVALS
15 Ground Plumb
16 Water Piping O
17 Rough Plumb
18 Vents .
19 Sewage Disposal
20 Sewer 6
21 Water Heater
22 Water Softener
23- Water Service
24 Gas Test Q /?
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