001150 (SFD)PERMIT APPLICATION
City of La Quinta
• Department of Building and Safety •
This permit becomes void if -work not commenced within 180 days from date of issuance: OR. Wwork has been ssuspended or abandoned for z: period of 180 days.
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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 my license is in full force
and effect.
License Class L—ic.Nu�mbeeF
Date /rC ' r .f� _,• Contiactor�_ v` •' �!'- V"J
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OWNER -BUILDER DECLARATION: I hereby "affirm{that I am exempt fromAhe 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.):
0 1. as owner of the properly, 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 the purpose of sale.). . .
O 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
builps or improves thereon, and who contracts for such projects with a contractors) licensed pursuant to the
Contractor's License Law.).
0 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 ,'ora 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 Inspe�ct�fon� Dep�aPtn�ie! of r City Department
Date Applicant '
APPLICANT NAME (L. F. MI) AndenCorp •
ADDRESS BOX 780
P.O.
CITY/COMMUNITY/STATE/ZIP La Quinta, CA 92253
JOB SITE ADORESS/SPACE 77-128 ' Via Huerta
CITY/COMMUNITY/STATE/ZIP La Quinta, *CA 92253
BOK -
PAG
PRC
C
# 0425 -which teras expired. This is
TWN
AND
SE
S
T14496-2
`19
15.50
Plan Check Fee
_03
sB
224.00
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TRACT NAME Santa Rosa Cove
OWNER NAME (L. F. MI)
CONTRACTOR -FIRM NAME • L'�Applicant
ADDRESS
above
CITY/COMMUNITY/STATE/ZIP '
above
PHONE 564-1315
L1333762
'
ARC/ENG FIRM NAME "
ADDRESS
CITY/COMMUNITY/STATE/ZIP -
PHONE N
LICNC .
USE OF PERMIT S. F. D.
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 a: to.become subject to the Workers' Compensation Laws of
California.
Date Applicant
NOTICE TO APPLICANT: If, after making this Certificate 3f Exemption, you should become subject to,the'Workers'
Compensation, provisions. of the Labor Code, you must Ibrthwith 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 fee-. 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 thir-y-six (36) feethigh. (Chap32, Grp 2, Art 2, Sec 341, Title 8,
C.A Q
0 As owner -builder, I vAll not employ anyone to do work which would require a permit from the Division of
Industrial Safety, as noted above, unless such person ias a permit.to do such work from that division.
0 DivVon of Industrial Safety Permit No.
Date Applicant
CONSTRUCTION LENDING AGENCY: I hereby affirm that :here 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 Address—
I certify that I have read this application and state that -he above information. is correct. I agree to comply with all
city and county ordinances and state laws relating to b gilding construction• and hereby authorize representatives
of this county to enter upon the above-mentioned pro rerty for inspection purposes.
Signature of Applicant or'Agent Date
CERTIFICATE OF COMPLIANCE AND AUTHORIZATIONOF ENTRY: I certify I have read this application and state that
the information given is•corrrect. I agree to comply with all state laws and county ordinances relating to buidling
construction apd au't`horize a "representative of the C6y of La Ouinta Department of Building and Safety to enter
upon the property or which1, have applied for this permit for the purpose of making inspections. ' .
Signature of Applicant or Agent Date
Print Applicant/Agent Name
APPVPRMT ;L01 S-20-84
S.F.D.
Permit to construct 2,326 sq. ft.
of S.F.D. with
attached garage.
This permit to
replace"Permit
# 0425 -which teras expired. This is
also a model change from G-3 to
Pa3
Mech. Fee
15.50
Plan Check Fee
29.12
Const. Fee
224.00
Elect. Fee
15.63
Plumbing Fee
26.25
TOTAL' :
FEE
310.50
VALUATION
BLDG.DEPT.
Ah
rI
NO.
OPERATION TE
-INSPECTOR
NO.
OP ,ATION DATE INSPECTOR
BUILDING APPROVALS
MECHANICAL 'APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs & Frms
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.
❑
43
Final
10A
f=ireplace T.O.
❑
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 J
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/L 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