0238 (SATT)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, if work has been suspended or abandoned fir a period of 180 days.
LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9
(commencing with Section 7000) o1 Division 3 of the Business and Professions Code, and my license is in full force
and effect.
License Class
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 isexempt
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.):
O 1, 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 i mprovemnt 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
builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the
Contractor's License Law.).
O 1 am exempt under Sec.
Date Owner
B. 8 P.C. (Attached Certificate).
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
Company
O Certified copy is hereby furnished.
.D Certified.copy;is filed with theCil'y Building Inspection Departmefnt or Cliy Department.
Date r 6 ; Applicant
APPLICANT NAME (L. F. MI) •r
,-,aJui,nta .point Venture
ADDRESS
!.A. Box 7$0
CITY/COMMUNITY/STATE/ZIP
La Quinta, Ca 92253
JOB SITE ADDRESS/SPACE
44«-5/4 Avenida Vista Bonita
CITY/COMM UN ITY/STATE/ZI P
La Quinta, Ca 92253
BOK
I PAG
PRC
C
462 sq. rt,
TWN
PING
SE
S
TRACT
# 14496-k2
LOT
g
Plan Check Fee
305.83
MOD
MO
SB
x3leetric al fee
TRACT NAME
�Anta 1 osa Cove
OWNER NAME (L. F. MI)
CONTRACTOR -FIRM NAME
linden Corporation
ADDRESS
P.O. Box 780
CITY/COMMUNITY/STATE/ZIP
T.a ;'±uinta, Ca 92253
PHONE N
611.9-564-1.315
450.00
LICNC N
333762
MMOMkb
ARC/ENG FIRM NAME
ADDRESS
CITY/COMMUNITY/STATE/ZIP
PHONE N
51, 371.01.
LICNC N
USE OF PERMIT
Jingle Family idwelling
BL
ZON
FSB
SSB I
SSB
RSB
OFC
ZONE ORD N
LOT S2
END
SIDE
Lf41�-,5"y
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be completed it
the permit is for one hundred ($100) o, less. I certify :hat in the performance of the work for which this permit is
issued, I shall not employ any person in any manners - 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 CERTIFICtTION:
O 1 hereby certify that no excavation five (5) or more het in depth into which a person is required to descend, will be
made in connection with work authorized by this pernit, and that no building structure, scaffolding, falsework, or
demolition or dismantling thereof, will be more than t iirty-six (36) feet high. (Chap 3.2, Grp 2, Art 2, Sec341, Title8,
C.A.C.)
O As owner -builder, I will not employ anyone to db work which would require a permit from the Division of
Industrial Safety, as noted above, unless such persrn has a permit to do such work from that division.
O 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. 30'7, Civ. C.).
Lender's Name
Lender's Address
I certify that I have read Misapplication and state that the above information is correct. I agree to comply with all
city and county ordinances and state laws relating tc building construction, and hereby authorize representatives
of this county to enter upon the above-mentioned p•operty for inspection purposes.
Signature of Applicant or Agent Date
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION IF 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 aorTwrh"av
uthorize a representative of the ;ity of La Ouinta Department of Building and Safety to enter
upon the �ope��fhichl e,a'pplieddlfor:this3ermitfortthe'purpose of, making inspections.
'41Signature-of Applicant or Agent Date
Print Applicant/Agent Name
APPUPRMT�' t` I4 �%i CSty
-?ATE
I�26-83
Permit to construct
'Tadel
Ujolling
21,296 Sq. Ft,
Ga,race
462 sq. rt,
Patio Cover
1.78 Sq. F`t�
Nech. 'rug,
$ 23.00
Plan Check Fee
305.83
Construction ree
470.50
x3leetric al fee
42.16
SMI Fee
8.02
.'lumbinq Vee
71.50
'roporty Dev. Fee
450.00
MMOMkb
V C: E13LED
1Y83
pj— n t;z\
b A
IA -1
City of La Quinta
TOTAL
.
51, 371.01.
VALUATION s 114 , 066 . so
Arrow Printing 250/1-83 White: Finance Canary: Assessor Pink: Applicant Tag: Bldg. Dept. Il
NO.
OPERATION DATE INSPECTOR
NO. OPERATION 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.
❑
OP'N ADDITIONAL INFORMATION
NO.
(/
�✓�%�/" 3/ / (�7 /
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
17 Rough Plumb
18 Vents
19 Sewage Disposal
20 Sewer J?
21 Water Heater
22 Water Softener
23 Water Service
24 Gas Test
25 Final
Tank Pit L. Line
ELECTRIC APPROVALS
REAR OF PROPERTY LINE
PIS
STREET NAME
P/1
26 Power Pole
27 Conduit
28 . Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final
iK