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001092 (SATT)PERMIT APPLICATION City of La Ouinta ® Department of Building and Safety This permit becomes void if work not- commenced, within 180 days from date of issuance. OR, it 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 70001 of Division 3 of the Business and Professions -Code, and my license is in full force and effect. License Class-Lic..Number Date Contractor � I/ 1.4,>14119T R4,w OWNER -BUILDER DECLARATION: I hereby affirm that jam exempt from the''Oontractor's License La for the following reason (Sec -7031.5, Business and Professions Code: Any city or county which,requires, 1Tpermit to . construct, alter, improve, demolish; or repair any structure, prior to its issuan;e, 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 Pro'essions Code) or that he is exempt .,'therefrom and the. basis for the alleged exemption..Any violation o6 Section 7031.5 by any applicant for a,permit subjects the applicant to a civil penalty of not more -than five hundred;doilars,($500.): ❑ 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 offered for sale. If, however, the building or improyemnt 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.). ❑ 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 ownerof property who builds or improves'thereon, and who contracts1or-such projects with'a contractor(s) licensed pursuant to the Contractor's License Law.). O 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 . ❑ Certified copy is hereby furnished. , ❑ Certified copy is filed with the Ciiy Building Inspection: Department or City'-" Department. Date Applicant 1.2 APPLICANT NAME (L, F, Ml) - - M . 1). Janes ADDRESS ' 2950 Airway Avenue CITY/COMMUNITY/STATE/ZIP Costa Mesa, CA 92626 JOB SITE ADDRESS/SPACE CITY/COMMUNITY/STATE/ZIP La Quinta, CA 92263' BOK' PAG PRC C- 246100 TNN. RNG SE S TRACT . 18915 LOT 31 Plumbing Fee 30.00 MOD 1 SB Bldct .4 TRACT NAME Reflections OWNER NAME L. F. MI) ' Applicant CONTRACTOR -FIRM NAME Applicant ADDRESS - Above CITY/COMMUNITY/STATE/ZIP Above PHONE 11 ' LICNC • , 345-1436 by 066.14 ARC/ENG FIRM NAME - Carlson. Shlenpev Semalhal.ch ADDRESS 18002 Skvvark Circle CITY/COMMUNITY/STATE/ZIP .. Irvine. CA 9271.4 PHONE a LICNC 714-250-0607 1 USE OF PERMIT Condo BL ZON 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 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: ❑ 1 hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend;w ill be made in connection wiih 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.) ❑ As owner -builder, I will not employ anyone to dotwork 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.PerTit No. Date Applicant' CONSTRUCTION LENDING AGENCY: .1 hereby affirm that there is a construction lending agency for the performance of the -work for which this permit issued (Sec. 3097. Civ. C.). Lender's Name— Lender's ame Lender's Address I certify that thave read this application and state that the above information is correct. I agree to comply with all city and county ordinances and slate laws relating to building construction, and hereby authorize representatives of this county to enter upon the above=mentioned property foP 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.Oepartment of Building and. Safety to enter, upon e p�perty for which 1•haN applied -for s permit for the purpose of making inspections.; Signature of AIj0n't Agent Date Print Kppplplicant/Agent Name A APPVPRMT � A�C.A%Ei3J84 .S.F.D• Permit to construct 926 scr. ft'. of condo plus 235 sv. ft. of garage as per approved plans. Mech. Fee. 24900 Plan Check Fee 246100 Const.*Fee 289.00 Elect. Fee 23.50 SMI Fee 3.64 Plumbing Fee 30.00 Prop. bvel. Fee 450.00 �o TOTAL FEE by 066.14 BLDG. DEPT. VALUATION 51, 669.00 r--7 Ah NO. OPERATION 4TE :,_ INSPECTOR NO. .. OP TION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back 33 Ventilation System 2 Ftgs & Frms 34 Plenums & Ducts 2A Slab Grade $S 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 A • 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 PSL P) STREET NAME 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service 32 Final