0539 (SFD)PERMIT APPLICATION
City of
Department of Bu
La Ouinta/
11Safety i
na `.
JO&LI ADDgES �P".'S6
CITY/COMMUNITY/STATE/ZIP '
,dcx'�+ Mod, CA 92705
This permit becomes void it work not commenced within 180 days from date otflssuance.
OR, If work has been suspended or abandoned for a period of 180 days.:
PRC
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CERTIFICATE OF EXEMPTION FROM WORKERS" COMPENSATION INSURANCE: This section need not be'Lwmpleled if . .
'LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed• under provisions of Chapter -9
the permit'is forone hundred ($100) o. less. l certify -that in the performance of the work for which this permit is,
' (commencing with Section 7000) of Division 3 of the Business and Protessions.Code, and my license is in full force - ,-_
issued. I shall not employ any person in any manner so asto become subject to the Workers'CompensationLaws of .,
and effect.
California.
• License Class ' Lic. Number
Date Applicant
Date Contractor = • •_->•= •-
NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you.should become subject to the Workers'
m -
OWNER -BUILDER DECLARATION: I hereby affirm that i:am exempt' from the Coniraclor'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 lo.file a signed statement that he is licensed pursuantto the provisions of,theContra * ctor'sLicense Law
`01 hereby certify thatnoexcavation five (5)ormore feet i6depthinto which aperson isrequired todescend, will be =
' (Chapter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code) or that heis exempt,
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-siz (36) feet high. (Chap 3.2, Grp 2, Art 2, Sec 34.1. Title B.
subjects the applicant to a'civil penalty of not,more than fivehundred dollars ($500.):
C.A.C.)
0 1, as owner.ol the property, or my employees with wages as their sole compensation, will do the work, and the
O As owner -builder, I will not employ anyone to do work which would require a permit from the Division of
structure is not intended orr offered for sale (Sec. 7044. Business and Professions Code: The Contractor's License.
Industrial Safety, as 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
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' 'through his own employees. provided that such improvements are not intended or offered for sale. If, however, the .
0 Division,pl Industrial Safety Permit No.
,building orimprovemntis sold . within one year of completion, the owner -builder will have the burden of proving that
Date Applicant
`•!r •Pe did not build or improve for the purpose of sale.). , -
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a constiuctionlending agency for the performance '
.0 I, as owner of the property, am exculsively contracting with licensed contractors to construct the project (Sec:
of the work 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
Lender's Name
builds or improves thereon, and who contracts for such projects with a'contractor(s).licensed pursuant to the-
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.Contractor's License Law.): _.
Lender's Address
0 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. ) agree to comply with all
Date ' Owner
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
or this county to enter upon the above mentioned property for inspection purposes.1.
WORKERS' COMPENSATION DECLARATION: 1 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.):
Signature of Applicant or Agenf Date
Policy No. Company
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF'ENTRY: I certify l have read.thisapplicationand state that •.
' 0. Certified copy, is hereby furnished.. :ti. • . < . '. ••
the information given is correct. 1 agree'to comply with all state laws and county ordinances relating to'buidling ,.
O'Certified copy is filed with the City Building Inspection'Department o'r. City pepartment.'.
construction, and authorize a'representative of the City of La Duinta Department of Building and Safety to enter
'
upon the property for•which I have applied for this permit for the purpose of'making inspections. �-
Date. Applicant.
Signature of Applicant or Agent Date'
ICri1NAM tj'E\i1sLYtiFrf�lJfLl
r1. .
40 N. Tistin Avbnue,• Suite •231
CITY/COMMUNITY/STATE/ZIPurua,�,a 92705
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na `.
JO&LI ADDgES �P".'S6
CITY/COMMUNITY/STATE/ZIP '
,dcx'�+ Mod, CA 92705
BON
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iACT s0 -40-B
LOJ 7
'6.48'
Pltunbing Fee
MOD
SB
450000-
50,00 -REE
TRACT NAME
liagmia De La Paz, Ltd.
Obi Mtil A(L. F. Mlq..,. ).nse
CONTRACTOR -FIRM NAME .. - .
ADDRESS
CITY/COMMUNITY/STATE/ZIP
PHOii4) 558=3766 \
:f La Quinn
.
LICNr .
ARC/ENG FIRM NAME • +
ADDRESS
CITY/COMMUNITY/STATE/ZIP
PHONE II
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END
SIDE
Print Applicant/Agent Name
APPUPRMT9 7 w1,E-A p
1.
Condo'r
Permit to eenstruct 1,662 Sq.
Ft. of S/F/D
with 400 Sq. Ft. of Garage Per Approved Pians
�ca1. "Fee
$ 18,00'
Plan Check Pee
Paid
Fee
412.00
F1ectrical Fee
31.77
SM Fee
'6.48'
Pltunbing Fee
58.50
Property Development Fee
450000-
50,00 -REE
R E C��
.0VCRY
FEB
:f La Quinn
.
``• TOTAL
FEE =
$ 976.75
BLDG. DEPTVALUATION. $ 92,461.20•
.
Ah
Ah
NO.
OPERATION DATE
INSPECTOR
NO.
OPE ATION DATE INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
.2
Ftgs & Frms
/ — (—Yci
C
34
Plenums & Ducts •
2A
Slab Grade
35
Furnace Compart.
3
Steel
36
37
Inlets & Outlets
Combustion Air
4 Grout Blocks
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
Commetcial Hood
10
Fireplace P. L.
❑ `
43
Final
10A
Fireplace T.O.
❑
NO
ADDITIONAL INFORMATION
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick "R.
Value
7A Walls (Batts)
12B Ceiling (Batts)
12C Ceiling (Blown)
14 Final
PLUMBING APPROVALS
.15 Ground Plumb. j j — (— Y4 7-6
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 C��g 4
Tank Pit L. Line
ELECTRIC APPROVALS
REAR OF PROPERTY LINE
P/L _ PiI
STREET NAME
26 Power Pole
27 Conduit •
28 Service Entrance •
29 Wiring
29A Grounding Wire [ (^ / . $c t 9— (�
29B Bonding
30 Fixtures
31 Service
32 Final