001232 (RC)j City of_14,0uinta,J ,.
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 o1 the Business and Professions Code, and my license is in full force
and effect.
License Class
Date Contractor
Lic. Number
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 ($500.):
❑ I. as owner of the property, or my employees with wages as thei ,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 orimprovemntissoldwithinoneyearolcompletion. 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 owner of property who
buil(fs or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the
Contractor's License Law.).
❑ 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
O Certified copy is hereby furnished.
❑ Certified copy is filed with the City Building Inspection Department or City Department
Date
Applicant
APPLICANT NAME (L. F. MI) !'e.,... Smith
ADDRESS P.O. Boat 1131
CITY/COMMUNITY/STATE/ZIP -1a �l int , CA 92253
JOB SITE ADDRESS/SPACE 78-039 Calle Estado
CITY/COMMUNITY/STATE/ZIP Ta n�j,�,�y„a, M 92'53
�'{iLlaK>< LJWN
BOKbq
PAd 8�
P-594
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RNJG
SE
S
TRACT
LOT
4
35.00
MOD
SB
Plumbing Fee
TRACT NAME
OWNER NAME (L. F. MI) Applicant .
CONTRACTOR -FIRM NAME Applicany,
1•
ADDRESS aow
ab
CITY/COMMUNITY/STATE/ZIP abfV .
PHONE • 564-0061
rh
LICNC .
ARC/ENG FIRM NAME
ADDRESS
CITY/COMMUNITY/STATE/ZIP
PHONE .
422 . r- !
LICNC •
USE OF PERMIT Intaxior Alt. Cafe
BL
ZONFSB
SSB
SSB
RSB
OFC
ZONE ORD 0
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. l 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, 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.)
❑ 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.
❑ 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.). v
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 Ouinta Department of Building and Safety to enter
upon the property for which I have applied for this permit>r tthe purpose of making inspections.
Signature of Applicant or Agent
Print Applicant/Agent Name
Date
APPUPRMT v n i ?,37.
2•DAT�-8b 3' J41SIC
Pez7!u.t to ao interior aiteratims tar
care as Per approved Pians.
Mech. Fee
58.00
Plan Cock Fee
128.12
Const. Fee
110.50
Elect. Fee
35.00
sties Fee
1.05
Plumbing Fee
90.00
_ A112)
rh
TOTAL
FEE
422 . r- !
VALUATION .0,000.Uv
BLDG. DEPT.
NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION DATE INSPECTOR
BUILDING APPROVALS
_
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System;
2
Ftgs & Frms
� ",-�s1
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.
❑
44
Final
10A
fireplace T.O.
❑
OP'N
NO.*
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 3— t-
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 �y -�$ G
Tank Pit L. Line
ELECTRIC APPROVALS
_
REAR OF PROPERTY LINE".
P I L pill
STREET NAME
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31- Service
32. Final _2
RICHARD W. POST
ATTORNEY AT LAW
74-947 HIGHWAY 1 1 1
SUITE 214
INDIAN WELLS, CALIFORNIA 92260
(619) 340-3077
April 26, 1984 ,
Building Inspector, City of La:Quinta
Thomas Hartung
P.O. Box 1504
La Quinta, California 92253
Re: 78-039 Calle Estado
La Quinta, California
Gentlemen:
Please be advised that the above named property
is the _subject of an Unlawful Detainer action
filed by,my client, Charles L. Bellows, against
William A. Bailer and Mary Estelle Bailer as
Case Number Indio 13021.
You are hereby requested to forward to this
office a copy of any inspection reports or other
information concerning the above real property
made on or after April 25, 1984.
As per my converstaion with Mr. Phil Coggins of
your office, any information regarding this
property may be pertinenZ'!=to the Unlawful Detainer
action filed by my client and therefore subject
to Discovery by all parties concerned in the above
litigation.
Thank you in advance for your cooperation in this
matter and if you have any questions regarding the
above action please do not hesitate to contact my
office.
Very truly yours,
Richard W. Post
Attorney for Charles L. Bellows, Plaintiff
RWP/ps