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0266 (SATT)PERMIT APPLICATION City of La Ouinta 1rx 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 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 of the Business and Professions Code, and my license is in full force and effect. 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) orthat 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 live hundred dollars (5500.): ❑ 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 improvemnl is sold within oneyear of completion, theowner-builder will havethe burden of proving that he did not build or improve for the purpose 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.). ❑ 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. J 1,o=Certified copy is filed with the City Building Inspectio Department or CityI� Department. Date Applicant .7°r r AFPLLI�CAN� uxrt1t�Il Joint Venture AJ,.Q• Box 780 CLa MQUI, Ta, Ca 92253 JOB SIET--y 5/sAvenida Vista Bonita CITY/COMMUNITY/STATE/ZIP LaQuinta, Ca 92253 BOK PAG PRC C Patio cover TWN RNG SE S TRACT v144961-2 LOTMOD 37 271.70 Construction Fee ti-? SB 36.90 T�ACT Santa Rosa Cove OWNER NAME (L. F. MI( CON NAME a 'e'l . FIRflCorpoip Corporation 1 ADDRESS � Box 780 CIYg M]ifu Y.n {rad Ca7G2S.S ' PHONE619-564-131 . 75762 -J U ARC/ENG FIRM NAME ADDRESS CITY/COMMUNITY/STATE/ZIP PHONE w LICNC w ' WrTy Te Family Dwelling BL ZON FSB SSB SSB RSB OFC ZONE ORD N LOT SZ END SIDE CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENS.,TION INSURANCE: This section need not be completed if the permit is for one hundred (5100) o, less. I certify tha. in the performance of the work for which this permit is issued, I shall not employ any person in any manner so asto become subject to the Workers' Compensation Laws of California. Date Applicant NOTICE TO APPLICANT: If, after making this Certificate -f Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must f rrthwith comply with such provisions or this permit shall be deemed revoked. DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATI-+N: ❑ 1 hereby certify that no excavation five (5) or more feetin 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) 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 vork 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. O Division of Industrial Safety Permit No. 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. Q. Lender's Name Lender's Addre 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 building construction, and hereby authorize representatives of this county to enter upon the above-mentioned proaerly for inspection purposes. Signature of Applicant or Agent Date CERTIFICATE OF COMPLIANCE AND AUTHORIZATION 01 ENTRY: I certify I have read this application and state that the information given is correct. I agree to comply wiL, all state laws and county ordinances relating to buidling construction�,and,authho"ize,a representative of the C ry of La Ouinta Department of Building and Safety to enter upon the propel y forewhicb-1,'have,applied for this p;rmit for the purpose o1 making'ihspections: 'lgnat f Apdngent Date Print Applicant/Agent Name APPUPRMT ri V0,5DATE 7--20-83 Permit to construct Model G -3-A Dwelling 1,893 Sq. Fta Garage 433 Sq. Ft. Patio cover 140 Sq* Fte Mech. Fee $ 23.00 Plan Check .Fee 271.70 Construction Fee 418.00 Electrical. Fee 36.90 SMI Fee 6.62 Plumbing Fee 69.00 Property Dev. Fee 450.00 -J U ix n U City of La Q!jIntaTFEE` . S1, 275.22 W VALUATION 594, 617. 80 Arrow Printing 250/1$3 White: Finance Canary: Assessor Pink: Applicant Tag: Bldg. Dept. NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPf;f 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 fireplace T.O. ❑ NOADDITIONAL INFORMATION 2 Q / Q �/�`✓ �•� L SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Lath 12 Internal Lath 12A Drywalli2%� 1.3 Finish Grade INSULATION Thick Value 7A Walls (Batts) 12B Ceiling (Batts) 12C Ceiling (Blown) 14 Final PLUMBING APPROVALS 15 Ground Plumb 16 Water Piping 17 Rough Plumb of 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/I STREET NAME 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring .2023 AF 29A Grounding Wire 29B Bonding 30 Fixtures 31 - Service 32 Final L"