0799 (SATT)PERMIT APPLICATION
of La
"
Ouinta
'•City
i 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.
i - . • -. .. -. •fit
CERTIFICATE OF EXEMPTION FROM WORKERSTOMPENSATION INSURANCE; This section need not becompleted if'_ -
LICENSED CONTRACTORS DECLARATION:A hereby affirm. that -I am'licensed under provisions of Chapter 9 .,; `
-the,permit is for one hundred (8100) o, less. I'certify that in the performance of the work for which this permit is ,
(commencing with Section 7000) of Division 3 o the Business and Professions Code, and my license is in full force t
issued. I 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
.'Date Contractor
NOTICE TO APPLICANT:1f, atter 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 tofile'asigned statement•thatheislicensed pursuant tothe ,provisions oftheContractor's License Law
pl hereby certify61noexcavation five (5)ormore feet indepth into which aperson isrequired todescend, will be '
m
(Chapter 9(comencing'with section 7000) of Division 3of the Business and Professions Code) or that heisexempt
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 (36j feet high. (Chap 3.2, Grp 2. Art 2, Sec 341, Title 8;
subjects the applicant to a civil penalty of not more than five hundred dollars' (5500.):
C.A.C.) - -
O I, as owner o1 the property, or myemployees with;wages as their sole compensation, will do the work, and the
❑ As owner-tiuild; 1 will not employ anyone lo'do work which would require a permit from the'Division of
owner -builder: er
structure is not intended or offered for sale (Sec: 7.044,' Business and Professions Code: The Contractor's License .
Industrial Safety, 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
JMOO
through his own employees. provided that such improvements are not intended or offered for sale. -If, however, the • : ='
❑ Division of Industrial Safety Pegnit No.
• building or improvemnt is sold within one year of completiom the owner -builder will have the burden ofproving that .
Date Applicant.
he did not build or. improve,for the purpose of sale.).
• + "
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance
❑ I, as owner of the property, am exculsively contracting with licensed contractors to construct the project (Sec: ..
- of the worW 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 w.
Lender's,Name
,builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the
' Contractor's License Law.). .. _
Lender's Address
O 1 am exempt under Sec. B.•& P.C. (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
city and county ordinances and state laws relating to build ing•construction, and hereby authorize representatives i
CITY/COMMUNITY/STATE/ZIP
of this county to enter upon the above-mentioned property for inspection purposes. v i
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent tdself•insure, or a
LICNC •
certificate of Workers' Compensation Insurance , or a certified copy thereof (Sec: 3800. Lab. C.).
�• ;i
Signature of Applicant or Agent Date
Policy No. Company
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: • I certify l h ave read this application and state that
O Certified copy, is hereby furnished. _ a •'
the information given is correct. I agree to -comply with all state laws and county ordinances relating to buidling
Certified copy is filed with the City Building Inspection Department or'City Department.
cons iRtion, and authorize a yepresentaiive of the City of La Ouinta Department of Building and Safe tylo enterr
SSB
upon the property for which I had applied for this permit for the purpose of making inspections..
Date. Applicant
OFC..
Signature of Applicant or Agent Date—S
V
Print Applicant/Agent Name
APPLICANT NAME (L. F. MI) -
TM
ML DEvelo=ent•Corp.
ADDRESS ' • . - .• - ,
P.O. Box 1000 '
CITY/OOMMUNITY/STATE/ZIP ` ....
La Quinta, CA 92253
JOB SITE ADDRESS/SPACE
78-106 Calle Norte
CITY/COMMUNITY/STATE/ZIP -
La-0tintai CA 92253
BOK
PAG
PRC '•C
--
TWN
RNG
SE
S
NR
I I
Property Development Fee
600.00
I I
TRACT
LOT.
.J
SB
18767
"•-TOTAL ,•
FEE •
1,586.54
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Unit 20
TRACT NAME
Duna La Oui.tna Phase II
OWNER NAME (L. F. MI) •• • _
UIL Devleoopment Corp.
CONTRACTOWFIRM NAME -
Same '
ADDRESS .
P.O. Box 1000• "
CITY/COMMUNITY/STATE/ZIP
La Quinta, CA 92253
PHONE • " r�
LICNC M
345-2888
413636
ARC/ENG FIRM NAME s ..
ADDRESS -
CITY/COMMUNITY/STATE/ZIP
PHONE I
LICNC •
e ' •.
USE OF PERMIT '
Comb.—Elect, Plumb, Build
BL
'ZON
f FSB
SSB
SSB'.
.RSB
OFC..
,ZONE OWN .
•'
LOT SZ -
END -
-.SIDE
APPL/PRMT ATE
n � w.11 q 6-,25-84
Comb. .. .
Permit to 'Build 3523 Sq. Ft.
of
COudomiutum
Mech. Fee
19.00
Plait Check Fee
330.20`.
Construction Fee
508,00
Electircal Fee'
47,27
$MI FEE
9,07
Plumbing Feer
-73000
Property Development Fee
600.00
11 1 LJ
"•-TOTAL ,•
FEE •
1,586.54
t
VALUATION 129,628.00
BLDG. DEPT a
_ _. .. � �_. ..... __�`____ �- -- r- -, ��;G�arc_�ir�i e.:: �t.._. _. ... _ .. ._.-•--... _s._ ra.r ,c�.,...cud _.+��d
r-1
a
NO.
OPERATION ATE
INSPECTOR
NO.
OPERATION DATE INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System -
2
Ftgs & Frms
34
Plenums & Ducts
2A
Slab Grade
oZ�
7�
35
Furnace Compart.
3
Steel
9
36
Inlets & Outlets
4
Grout Blocks
37
Combustion Air
5
Bond Beams
J j
38
Compressor
6
Roof Deck
7
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.
❑
NPON ADDITIONAL INFORMATION
—2' l v� `
to
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath Q %
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick
Value
7A Walls (Batts)
126 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
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 O.O— 7
29B Bonding
30 Fixtures
31 Service
32 Final