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0527 (SFD)PERMIT APPLICATION City of La Dug a • 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' '1 hereby affirm that 1 am exempt from the Contractor's License Law for the followinq'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, (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.): 0 I. as owner of the properly, 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 to an owner of property who builds, or improves thereon, and who does such work himself or through his own employees, piovided that such improvements are not intended or offered for sale: If, however, the building or improvemnt 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 I, 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 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 0 Certified copy is hereby furnished. A Certified copy is filed with the City Building Inspection, Department or City E .' ,Department. Date Applicant PPLI A•T UUr�1lJ►.i�� . �t Eiv. Mistin Avenue, Suite 231 -C� _IJY(CO�MMUN TiY/Sr IL; ft 92705 JOI4 EA�DYDRIEG PACE xairms -rCI�TY/coMY U41X�TV�/ F OLA 92253' . •SOAK . PAG PRC - C 18000 TWN FIND SE S IT3RAi t40-3 LD 13i SMI Fee 6,48 se Property Dmmlopment Fee TRACT �WZDe La Paz* Ltd. OWNER NA .7CONTRACTOR-FIRM NAME ADDRESS CITY/COMMUNITY/STATE/ZIP 014 558-3766 `I°"` .TOTAL --FEE ARC/ENG FIRM NAME ADDRESS CITY/COMMUNITY/STATE/ZIP - - PHONE 11 LICNC OFjL aER IT ��11JJ BL ZON FSB SSB SSB RSB OFC ZONE ORD Y 1 LOT SZ END SIDE CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be completed it 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 anymanner so as to become subject to the Workers' Compensation Laws of California. Date Applicant NOTICE TO APPLICANT: If, after making this Certiticate.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 1 hereby certify that no excavation five (5) or more feet in depth into which a person is riquired to descend, w ill be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition of dismantling thereof, will be more than thirty-six (36) feet high. (Chap 3.2. Grp Z Art 2, Sec 341, Title 8, C.A.C.) 0 As owner -builder, I•will not employ anyone to do Ark 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. O.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 whictNhis permit is issued (Sec. 3097, Civ. C.). Lender's Name' _ Lender's Address Lcertify 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 information given is correct. I agree to comply with all state laws and county ordinances relating to buidling construction, and authorize a representative of the City of La Ouinta Department of Building and Safety to enter upon the property for which I have applied for this permit for the purpose of making inspections. Signature of Applicant or Agent Print Applicant/Agent Name Date APPL/PRMT#.l-M 1DATE ACCi-84 �� Permit to construct 1.662 Sq. Ft, of S/r/D with 400 Sq. Ft. of Garage Lew approved .Plans . Madianica1 Fee $ 18000 Plan Check Fee Paid C lamtrulcticn Fee 41240 kAlectrilcal IFee 31,77 SMI Fee 6,48 Plumbing Fee 58.50 Property Dmmlopment Fee 450,00 RECEIVE© i 023 v .14 •..amu .TOTAL --FEE ; 976.75 BLDG. DEPT. VALUATION? 92,461.20. r,1 Ah NO. OPERATION TATE INSPECTOR NO. OP ATION DATE INSPECTOR BUILDING APPROVALS MECHANICALAPPROVALS 1 Set Back 33 Ventilation System Ser - 2 Ftgs & Frmsl � (--rift-E `"�'G 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 rl� .. IV - 10A fireplace T.O. ❑ NON ADDITIONAL INFORMATION SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Lath 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 dPM 17 Rough Plumb • Ora 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 ♦ auku 28 Service Entrance 29 Wiring • 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service 32 Final �j—(cj�g 4?- . G