001142 (SATT)PERMIT APPLICATION
City of La Ouinta
. Department of Building and Safety
0
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 Try license is in lull force
and effect.
License Class Lic. Number..
Date Contractor • Al ery e&
• OWNER -BUILDER DECLARATION: • I hereby affirm that I am exemptJrom the Contractor's License Law for the
following reason (Sec. 7031.5. Business and Professions Code: Any city or countY'wnich 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 forthe alleged exemption. Any violation of Section 7031.5 by .any applicant fora permit
subjects the applicant to a civil penalty of not more than. five hundred dollars ($500.)
0 I, as owner of the property, 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, provided that such improvements are not intended or offer !d for sale. It, however, the
building or improvernnt 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 tc an owner of property who
builds or improves thereon, and who contracts for such projects with a contractor(!) licensed pursuant to the
Contractor's License Law.).
0 I am exempt under Sec. B. &'.C. (Attached Certificate). ,
Date Owner
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consentto self -insure, or a
,certificate of Workers' Compensation Insurance , or "a certified copy thereof (Sec. 38130. Lab. C.).
Policy No. Company /n
0 Certified copy is hereby furnished:
0 Certified copy is tiled with the City Building Inspection Department or City •. DepartJnent... -
Date Applicant
e
7siaj r�-,
APPLICANT NAME (L. F. Ml) M. D. Janes '
ADDRESS
2950 Airway Avenue
CITY/COMMUNITY/STATE/ZIP
Costa Mesa, CA 92353
JOB SITE ADORESS/SPACE-48 Q
1 Indic M
CITY/COMMUNITY/STATE/ZIP La
Quinta, CP_ 92253
BOK
PAG
PRC I
C
..
TWN
AND
SE
S
TRACTLOT
18915
69
3.64
'
MOD
1
SB
Bldg. 7
TRACT NAME' '
Reflections
OWNER NAME (L. F. MI) Applicant
CONTRACTOR -FIRM NAME Applicant
ADDRESS above
CITY/COMMUNITY/STATE/ZIP
above
C
PHONE .345-1436
LICNCI
,
ARCC,a�g,o
Rl,NAMn, Shleppey & Hexmalhalch
ADDRESS
18002 Sky -park Circle
CITY//COMMUNITY/STATE/ZIP -
.Irvine, CA 92714
PHONE
14- 250-06� 7
TOTAL
FEE
UCNC M
USE OF PERMIT
Condo
SL
ZON
FSB
SSB
Sse
ASS
OFC
ZONE ORD N
LOT SZ
END
SIDE
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be completed.if
the permit is for one hundred ($100) o. less. I certify thatin the performance of the work for which this permit is
issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of
California.
Date Applicant
NOTICE TO APPLICANT: If, after making this Certificate 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 required to descend, will be
made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or.
demolition or dismantling thereof, will be more.than thirty-six (36) feet high. (Chap 3.2. Grp 2, Art 2, Sec 341, Title 8,
C.A.C.) '
0 As owner -builder, I will not employ anyone to do work 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.
0 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
ame Lender's Address•�—
I certify that 1 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 7epresdntative of the City of La Ouinta Department of Building and Safety to enter
upon the property,fotyw•ich I hav dappl� for this.permiiforlhe purpose of making inspections. :
�, Ignatuie A Applicant✓oi Agent Date
Print-Applicant/Agent Name
APPUPRMT''n1li p
ir.I8"8t S.F.D.
Permit to construct 926 sq., ft. of
condo plus 235 sq. ft. of garage
as per approved plans.
Mech.'Fee
24.00
Plan Check Fee
246.00
Const'. Fee
289.00 "
Elect.'Fee
23.50 -
SMI Fee
3.64
Plumbing- .Fee
30.00
Prop, Devel. Fee
450.00
P A I D
DEC 2 7 19P
TOTAL
FEE
1,066
BLDG. DEPT. VALUATION 51,669.00
-
NO.
OPERATION --nTE INSPECTOR
NO.
O ,_.ATION DATE INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs & Frms
S
34
Plenums & Ducts
2A
Slab Grade
35
36
Furnace Compart.
Inlets & Outlets
3 Steel
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.
❑
NON
ADDITIONAL INFORMATION
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
12A Drywall
t3 Finish Grade
INSULATION Thick R"
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 P/I
STREET NAME
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding Ell I
30 Fixtures
31 Service
32 Final