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0535 (SFD)PERMIT APPLICATION , City of La Ouinta t• ' Department of -Building and Safety • CITY/COMMUNITY/STATE/ZIP - - - r�� �, CA 92705 AC�E JOS ±� ADD/ QRE&SiSPr� v.i•�iG " .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 o1.180 days. " y • .. ' • - CERTIFICATE OF EXEMPTION FROM WORKERS.COMPENSATION INSURANCE: This section need not be completed if LICENSED CONTRACTORS DECLARATION: I hereby affirm that -,I am licensed under provisions of Chapter 9 the permit is for one hundred ($100) o, less: I certify that in the performance of the work for which this permit is ' (commencing with Section 7000) of Division 3 o1 the Business and Professions Code,'end my license is in lull force •' •!• issued,] shall -not employ any person inany mannerso as to become subject to the Workers'Compensation Laws of and effect. California. License Class Lic. Number. Date Applicant ^ Date ContractorNOTICE'TO APPLICANT: It, after making this Certificate of Exemption. you should become subject to the Workers'. -+ >. i' '• ' OWNER -BUILDER DECLARATION: I hereby affirm that I am exemptlrom 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. - '- • - v • ' •• - - - ' 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 that heislicensed pursuant tothe provisions oftheContra ctor'sLicense Law 01 hereby certify that ndexcadationfive (5)6rmorefeet indepth into whichaperkriisrequired todescend, will be (Chapter 9 (commencing with section 7000) of.Division 3 of the Business'and Professions Code) or that he is exempt' made in connection with work'authorized by this permil, 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 (36) feet high. (Chap 3.2, Grp 2 Art 2, Sec 341; Title 8. subjects the applicant to a civil penalty of not moreahamjive hundreddollars, ($500.): .. C.A.C.)- 0 Las owner o1 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 or offered for,sale (Sec. 7044, Business and Professions Code: The Contractor's License, Industrial Safety; as noted above, unles's such person has a permit to do such work trom.that division. Law does not apply to an owner of property who builds, or improves thereon, acid who does such work himself or through his own employees. provided that such improvements are 661 intended or -offered for sale. It, however, the.., 0 Division of..Industfial Safety Permit No. building or improvemnt is sold within one year of completion, the owner -builder will have the burden of proving 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' 0 I, as owner of the property, am exculsively contracting with licensed contractors to constructthe project (Sec.' of the work for which this permit is issued (Sec. 3097, Civ. C.)': w 7044. Business and Professions Code: The Contractor's License Law does not apply to an owner of property who tender's Name ' builds or improves thereon, and who contracts'tor such projects with a contractors) licensed pursuant to the. ' Contractor's License Law.). __ Lender's Address 0 1 am exempt under Sec: ..B. 8 P.C. (AttachedCertificate). 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 building construction, and hereby authorize representatives - ' of this county to enter upon the above=mentiofied property for inspection purposes. 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.). - Signature of Applicant or Agerit Date Policy No. Company CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have read this application and state that 0 Certified copy -is hereby furnished. :r>.^1 - the' information given is correct. I agree to comply with all state laws and county ordinances relating. to buidling ' 0 Certified copy,ls filed'with the City Building Ins liony,D partmenl.or.City ;'= •'• Depyrtment. construction, and authorize a.'representative of the City of La,Ouinta'Department of Building and Safety to enter "mssDate '+ ' upon the property for whi ch I have applied for this permit for the purpose of making inspections.g inspections. Appli�;nt �..,. s • Signature of Applicant or Agent Date APPLICANT M Ii. . M 00 N. Tustin Avenue,, Suite 231 CITY/COMMUNITY/STATE/ZIP - - - r�� �, CA 92705 AC�E JOS ±� ADD/ QRE&SiSPr� v.i•�iG CITY/COMMUNITY/STATE/ZIP ErzCA �92253 BOK I 'PAG PRC C. ConstructicmFee T'MIN PING SE S TRACT LOT 56.00 Property Development F MsA . se TRANAME T CT Uta De La Paz, Ltd.OWNER . SwoeNAME �(�L. F. MI� )bm CONTRACTOR -FIRM NAME - - • ' - _ . ADDRESS - CITY/COMMUNITY/STATE/ZIP - I P(iiu) 558-3766 \ c ©22 $ • .76 `IDNG " ARC/ENG FIRM NAME •'• ADDRESS CITY/COMMUNITY/STATE/ZIP PHONE " LICNC 27 &O 7 / D MIT�JG.EA.7.�.+atFa• .' BL ZONFSB SSB SSB RSB OFC. ZONE ORD " ": f LOT SZ .END SIDE Print Applicant/Agent Name APPL/PRMT ` l�4ATE Condo . Pelt to omstruct 1,973 Sq. Ft; of S/F/D with 400 Sq. Ft. of Garage Per Approved Plans Mechanical F S 1 O.OV Plan. tick Fee' Paid ConstructicmFee 455.50 Electrical Fee •35.66 SNIT Fee '7,60 Plumbing Fee 56.00 Property Development F 450400", 4• Y re g% r - F E6 b 1983 City c'f -La Quin.,z TOTAL FEE c ©22 $ • .76 VALUATION $ 1081819.80 • • BLDG.DEPT. t A a NO. OPERATION MATE INSPECTOR NO. OP RATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL PPROVALS 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 R Value 7A Walls (Batts) • 12B 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 glop A 27 Conduit • • 28 Service Entrance 29 Wiring 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service 32 Final