001200 (SOL)PERMIT APPLICATION
City of La Quanta
Department of Building and'Safety
53 - �2
This permit•becomes void if work.not,commertced within 180 days.from date of issuance; OR, it work has been suspended or abandoned for, a'period•of 160 days.,
LICENSED CONTRACTORS DECLARATION: I hereby affirm that i am licensed; under, provisions of.Chapter 9 -
(commencing with Section 70001 of Division3 of.the Business and Professions Code; and my license is In full force
and effect.
License Class Lic.,Number '
Date Contractor" �—
OWNERBUiLDER'DECLARATfok: 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
tChapter,9 (commencing with section 7000) of Division of.the Business and Prolessions Code) or tbat he is exempt
therefrom and the basis for the alleged. exemption. Any violation of Section 7031:5 by any applicant.fora permit.
subjects the applicant to,a civil, penalty of not moreahan five hundred dollars (5500.);
❑ I, as owner of the propertyror, 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 riot apply to an owner of property' who builds, or improves thereon, and who does such work• himself or
through his own employees, provided thatsuch improvements are not intended,or,offered forsale. If, however, the
building or improvemntts sold within one year of completion, the owner-builder.will have theburden otproving that
he did not build or improve for thepurpose of sale.).
❑ l• as owner of the property, am exculsively contracting with licensed contractors to construct the project (Sea .-
7044, Business and Professions Codes The Com ractor's License Law does not applyto'anowner of property who
builds or improves thereon, and who contracts for such projects with a contractors) licensed pursuant to the.
Contractor's, License Law.).
❑ I am exempt. under Sec. R 3 P.C. (Attached Certificate).
Date- Owner
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to selt-insure, or a
certificate of Workers' Compensation Insurance , or a certified copy thereof (Sec. 3600. Lab.. C.).
Policy'No. Company .
o Certified copy is hereby furnished. .
13 Certified copy isfiled with the City Building Inspection, Department or City Department.
Date Applicant
APPLICANT NAME (L, F. MQ Hydor InlAistxies
ADDRESS- 7434 Trade Street Suite B,
CITYICOMMIINITY/STATE/YIP can Diego,CA Qy'y -
,O9-.SITE.ADDRESS/SPACB 53=820. Ave. CDrteZ
CITYICOMMLNITYISTATE/XIP le Ql nt$p CA 92253 -
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SMI Fee
.50
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TRACT NAME
OWNER NAME (L..F, MI) :Egn acid Da L^
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CONTRACTOR -FIRM NAME jiy��'"'�**ii
AAbove
ADDRESS .
CITY/COMMUNITY/STATE/ZIP Bove
-KVZ9 -693=81 86
L 387
ARC/ENO FIRM NAME
ADDRESS .
CITY/COMMUNITY/STATE/ZIP
PHONE e
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LICNC I
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USE OF PERMIT - tool . r. Panej'Q
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END
SIDE'
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be completed it.
the permit -is for one 'hundred .($100) a., less. I certify that in the performance of the work for which this permit is
issued, I shall not employany person in any manner -so asto become subject tothe,Workers'Compensation Laws of .
California.
Date Applicant,
NOTICE TO APPLICANT: If. after making thisZertifirati of Exemption..you should become subject to theWorkers' . - • .
Compensation provisions of the Labor Code, you must forthwith comply, with such provisions or this permit shall u,
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
madein connection with work'authorized by this permit, and thatno building structure, scaffolding; falsework, or
demolition or dismantling thereof; will be more thanthirty-six (36) feet high. (Chap 3.2, Grp 2 Arl3; Sec34IJAJelk
CA.C,)
❑ As owner4uilder,'1 will not employ anyone to do work;which would require a permit.from the•Division of
.-7nduetrial Safety; asmoted:above, unless such person'has'a permit to do such work from that division.
T ❑ 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
Lcerttfy.that phave:read this application and state that e,above information is correct 1, agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
otthis county to enter upon: the above-mentioned property for inspection purposes.
Signature of "Applicant or Agent Date
CERTIFICATE OF COMPLIANCE'AND AUTHORIZATION OFENTW: I certify I have read this application and state that
the.information given is correct.) agree to comply with all state laws and county ordinances relating to buidling
construction, a¢aytho�r�i p a Yepresentatige,of I e.City of La Quints Department of Building and Safety to enter
UP on the progeny for alFiich l have lied fortis permit for.the purpose of maki spection
Signature of Applicant or Agent Data
J
Print Applicant/Agent Name
APPL/PRMT flal olx5-85go
1 i'1 Cl
Pipit to 'install
scill panels as
..
CIMISt. Fee
50.50
Plan Check
32.Fs2,, •
SMI Fee
.50
TOTAL ---
FEE 8 ;
p ev
VALUATION
BLDG. DEPT.
NO.
OPERATION DATE INSPECTOR
NO.
OPERATION 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
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.
❑
NPON
ADDITIONAL. INFORMATION
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
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
17 Rough Plumb
16 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/
STREET NAME
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final