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001197 (SFD)PERMIT APPLICATION City of La Duinta Department of Building and Safety This permit becomes void it work not commenced within 180 days from date of'issuance. OR, if work has been suspended or abandoned fora 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 ProfessionsCode, and my license is in full force and effect. I License Class - Lic. Number Date Contractor OWNER -BUILDER DECLARATION: I hereby -affirm that I am exempt from the Contractor's License Law for the following 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 (SSOO.): r '. . 0 I, as owner o1 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 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 lhe,pi pose 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-uhil See: 1_0 B. B'P.C. (Attached Certif.cate). . Date' 0/r"'/6 Owner .7/-.,i �i. mss.' 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. 0 Certified copy is filed with the City Building Inspection Department or City Department... Date Applicant APPLICANT NAME1ir F. Y O' B..,...r.ho for r�� ll�J1 52-766 Eis�LWW..IILLLL ADDRESS Eisenhower ` . CITY/COMMUNITY/STATE/1L�P Qu nt , CA 92253 JOB SITE ADORESB/BPAC54-435 Eisler CITY/COMMUNITY/STATHZIF�t Quint,, -C 92253- +{.Gi BO`K 4 1432 P0522 C .�•t� TWN RNG SE S TRACT LOT10MOO C7anst. Fee 328:00 Elect. Fee se SMI Fee TRACT NAME None OWNER NAME (L. F. MI) AWlicaft - - CONTRACTOR -FIRM NAM ADDRESS above,' v CITY/COMMUNITY/STATE/ZIP� ., PHO�E��4-1069 1,163,64 LICNC . ARC/ENG FIRM NAME ADDRESS CITY/COMMUNITY/STATE/ZIP ' PHONE • LICNC • - - USE OF PERMIT singlefamily f mlUng BL ZON FSB SSB SSB RSB 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 that in the performance of the work for which this permit is issued. I shall rot employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date - Applicant - NOTICE TO APPLICANT: IL 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, iv ill 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. Sec341, 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. Q. Lender's Name Lender's Address I 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 Opinta Department of Building and Safety to enter u% the pr6perty,'fofwhieti" have applied for this permit fo the purpose of makirig.inspections.f Sighature of Applicant or Agent Date Print Applicant, Agent Name APPUPRMT n, { i 1 q7 1023-85 1 S•F•L• Permit to caonstnict 1244 sq. ft. of s.f.d. plus 100 set. ft., of porch and and 420 sq. ft. of garage as per appy plans. Grading Permit 22.00 Mach. Fee ' 16.00 Plan Check Fee 264-.42- C7anst. Fee 328:00 Elect. Fee 28.70 SMI Fee 4.52 Plu[rbing Fee 50.00 Prop. Devel. Fee 450.00 1,163,64 Plan Check Dep. (200.00)1-10-85 963.64 47 TOTAL 3 FEE • + BLDG.DEPT VALUATION 64,7U4.0-0 NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back 33 Ventilation System 2 Ftgs &. Frms j 34 Plenums & Ducts 2A Slab Grade 35 Furnace Compart. 3 Steel 36 Inlets & Outlets 4 GrouvBlocks 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' /�/-'s 2.'Ss11� Py ' 'L'/L �go/ s V SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Lath 12 Internal LathZ 12A Drywall 13 Finish Grade INSULATION Thick Value 7A Walls (Batts) 12B Ceiling (Batts) 12C Ceiling (Blown) 14 Final PLUMBING APPROVALS 15 Ground Plumb o2 [o 16 Water Piping 17 Rough Plumb 7 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 APPRO ALS REAR OF.PROPERTY LINE P/L P/I STREET NAME 26 Power Pole /A l 27 Conduit 28 Service. Entrance 29 Wiring 8 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service 32 Final V--"