0805 (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 Professions Code, and my license is in full force
and effect.
License Class - Lic. Number
Date Contractor
OWNER=BUILDER DECLARATION: I hereby affirm that Vam 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 pu rsuant 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.):
O 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 loan owner of property who builds, or improves thereon, and -who does such work himself or
through his own employees, provided that suchimprovements 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.).
0 1, 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. 8 P.C. (Attached. Certificate).
Date Owner s
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.):'
Policy No. Company.
O Certified c6py is hereby furnished: .. '
• Certified copy, is filed with the City Building Inspection Department or City Department.
Date Applicant
APPLICANT NAME (L. F. MI)
Lid, Development Corp.
ADDRESS
P.O. Box 1000
CITY/COMMUNITY/STATE/ZIP
La Quinta, CA 92253
JOB SITE ADDRESSISPACE
78--107 Ca11e Norte
CITY/COMMUNITY/STATE/ZIP - -
La Quinta, CA 92253
BOK
PAG
PRC
C
TWN -
RNG
SE
S
TRACT
18767
LOT
284,70
Constr, Fee
MOD
SB
Untt 26
'TRACT NAME
Duna La Quinta Phase II
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
Prop. Dev, Fee
ARC/ENG FIRM NAME
ADDRESS
CITY/COM MUN ITY/STATE/ZI F
'PHONE II
LICNC •
'
USE OF PERMIT
COMB. 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 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 I 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 theteol; will be more than thirty-six (36) feet high: (Chap 3.2, Grp 2, Art 2, Sec341, Title 8,
CAC.) a a.
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.lndustrial 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 I have read this application and state that
(the'iniocmation given is correct. I agree to comply -with all state laws and county ordinances relating to buidling
constructions and authorize a'represeentative:o`t thelCity of I,a Ouinta Department of Building and Safety to enter
upon the roperty for which I have pplied°lor this•"permit,for the purpose of making inspections..,_ �
Signature of 4plicani o—r ggent Date
Print Applicant/Agent Name
APPL/PRMT tl C
DATE '
6-25-84
Carob.
Permit `to build 2349
Sq. Ft, of
Condominium
Mech Fee
28.00
Plan Check Fee
284,70
Constr, Fee
438.00
glect-. Fee, ,.
36,54
SMI FSB
7.11
Plumb. Fee
55,50
Prop. Dev, Fee
450,00
:
TOTAL
FEE •
1,299.85
BLDG. DEPT. VALUATION 1 101,037.40
r-70
A&
NO.
law
OPERATION DATE INSPECTOR
NO.
OP RATION DATE INSPECTOR
BUILDING.APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs & Frms
d
34
Plenums & Ducts
2A
Slab Grade
35
1 Furnace Compart.
3
Steel.
36
Inlets & Outlets
4
Grout Blocks
37
Combustion Air
5
Bond Beam;
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
I!/
\\
•r
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath a
12 Internal Lath
12A Drywall a
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
17 Rough Plumt
18 Vents .
19 Sewage Disposal
20 Sewer
21 Water Heater
22 Water Softener
23 Water Service
24 Gas Test f
25 Final
Tank Pit L. Line
ELECTRIC APPROVALS--
REAR OF PROPERTY LINE_
P/L P/1
STREET NAME
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wit
29B Bonding
30 Fixtures
31 Service
32 Final