001111 (SATT)PERMIT APPLICATION
City of La Ouinta
O Department of Building and Safety •
This permit becomes void if work not commenced within 980 days from date of issuance, ORJf work has been suspended or abandoned for a period of 180 days. .
,ENSED CONTRACTORS DECLARATION: 1 hereby affirm that l'am licensed under provisions of Chapter 9
tmmencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force'':
d effect.
sense Class Lic. Number
ue Contractors' 1 /N J ii
NNER-BUILDER DECLARATION: I hereby affirm that 16am exempt from -the Copiractor's License'Law for the
flowing reason (Sec. 7031.5. Business and. Professi . s Code: Any city or county which requires a permit to
)nstruct, alter, improve, demolish• or repair any structure, prior to its issuance, also requires the applicant,,or
ich permit to file a signed statement that he is licensed pursuanttothe provisions of the Contraclor'sLicense Law
;hapter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code) or that he is exempt
ierefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
rbjects the applicant to a civil penalty of not more -than five hundred dollars ($500.):
11, as owner•of the property, or my employees with wages as their sole compensation, will do the work, and the .
:ructure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License
aw does not apply to an owner of property who builds, or improves thereon, and who does such work himself or-
Irough his own employees, provided.that such improvements are not intended or offered for sale. If, however, the
Jilding or improvemnt is sold within one year of completion, the owner -builder will have the burden of proving that.
D did not build or improve for the purpose ol,sale.). .1
I I, as owner of the property am exculsively contracting with licensed contractors to construct the project (Sec.
344: Business and Professions Code: The Contractor's License Law does not apply to an owner of property who
Ads or improves thereon: and who contracts for such projects with a contractor(s) licensed pursuant to the
ontractor's License Law.).
I I am exempt under Sec. B..B P.C. (Attached Certificate).
ate Owner
IORKERS' COMPENSATION DECLARATION: 1 hereby affirm that I have a certificate of consent to self -insure, or a
wificate of Workers' Compensation Insurance or a certified copy thereof (Sec. 3800. Lab:.C.)...
Dlicy No. Company
,-Certified copy is hereby furnished.
I Certified copy is filed with the City Building Ins p ction DepartmenLor City_!� Department.
ate .Applicants W/Ti.owa,#,
APPLICANT NAME (L, F, MO M.D. Janes
ADDRESS -'
2950 Airway Avenue
CITY/COMMUNITY/STATE/ZIP '
Costa Mesa, CA 92826
JOB SITE ADDRESSISPACE
CITY/COMMUNITY/STATE/ZIP
La Quinta, CA 92253
BOK
PAG .
PRC
C
24.00-
4.00Plan
TWN
RNG
SE.
S
TRACT18915
LOT 50-1
SMI Fee
3.64
1D
58
91dg.. 6
TRACT NAME
Reflections
OWNER NAME (L', F. Mq Applicant
CONTRACTOR -FIRM NAME
Applicant
ADDRESS
above
CITY/COMMUNITY/STATE/ZIP
hbove
PHONE A �
345-1436
LICNC 1
ARC/ENG FIRM NAME
Carlson, Shleppey & Hezmalhalch
ADDRESS
18002 Skypark Circle
CITY/COMMUNITY/STATE/ZIP ,
Irvine,iCA 92714
PHONE N
714-250-0601
.LICNC 0
USE OF PERMIT
Condo '
BLTON
FSB
SSB
SSB
RSB
OFC'
ZONE ORD
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 that in the performance of the work for which thispermit 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 I 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 agencyfor the performance
of the work for which this,per ft is issued (Sec. 3097, Civ. C.)e-�
Lender's Name �,/_.
Lender's Address
,.certify 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. 'have applie or tbis•permit f6r the purpose of making inspections.
'Signature of A'p ficanfor genu v Date
Print Applicant/Agent Name r
APPUPRMT, >
- 121717/ 8 4 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-
4.00Plan
PlanCheck Fee
246.00
Const. Fee
289.00'
Elect. Fee
23.50
SMI Fee
3.64
Plumbing"Fee
30.00
Prop. Devel. Fee 450.00
.PAS
TOTAL
FEE
1,066,A:4
VALUATION 51,669.00
1
BLDG.DEPT.
r1
NO.
OPERATION TE INSPECTOR
NO.
OP TION DATE INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
/�
33
Ventilation System
2
Ftgs & Frms
S
34
Plenums & Ducts •
2A
Slab Grade
jr
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.
❑
NON
ADDITIONAL INFORMATION
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick R"
1V"alueIAt"-%
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 J
Tank Pit L. Line
ELECTRIC APPROVALS
REAR OF PROPERTY LINE
PSL P!I
STREET NAME
26 Power Pole
27 Conduit
28 Service Entrance
'29 Wiring •
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final