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0176 (SATT)APPLICANT NAME (L, F. MI) La Quinta Joint Venture. ADDRESS P.O. Box 780 PERMIT APPLICATION - ! • Z .� "f �. City of La Ouinta w• J : _ Department of Building and Safety e Y ' •, "_ ^ .4 This permit becomes void if work not commenced, within 180 days from date of issuance, OR, if work has been suspended or abandoned aor a period of 180 days. PAG CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be completed if LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 the permit is for one hundred (5100) o, less. I certif•_ that in the performance of the work for which this permit is (commencing with Section 7000) of Division 3of the Business and Professions Code, and my license is in full force issued, I shall not employ any person in any manner ,-o as to become subject to the Workers'CompensationLaws of and effect. o California.. ' License_ Class Lic. Number Date Applicant Date Contractor NOTICE TO APPLICANT: If, after making this Certificate o1 Exemption, you should become subject to the Workers' ' OWNER -BUILDER DECLARATION: ..I hereby affirm that I am exempt from the Contractor's License Law for the Compensation provisions of the Labor Code, you mast forthwith comply with such provisions or this permit shall be deemed revoked. i .following reason (Sec. 7031.5. Business and Professions Code: Any city or county which requires a permit to TRACT NAME - Santa Rosa Cove construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for DIVISION OF INDUSTRIAL,SAFETY PERMIT CERTIFICATION: such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Lawr ❑ 1 hereby certify th'at no excavation five (5) or more :eet in depth into which . a person is required to descend, will be (Chapter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code) or that he is exempt made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit demolition or dismantling thereof, will be more than -hirty-six (36) feet high. (Chap 3.2, Grp 2, Art 2. Sec 341, Title 8, subjects the applicant to a civil penally of not more than five hundred dollars ($500.): CAC) 0 I. as owner of the property, or my employees with wages as their sole compensation, will do the work, and the 0 As owner -builder, 1 will not employ anyone to co work which would require a permit from the Division of structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Industrial Safety, as noted above, unless such person has a permit to do such work from that division. Law does not apply to an owner of property who builds, or improves thereon, avid who does such work himself or , through his own employees, provided that such improvements are not intended or offered for sale. If, however, the 0 Division of Industrial Safety Permit No. building orimprovemntissold within one year ofcompletion, the owner -builder will have the burden of proving that Date Applicant• he did not build or improve for the purpose of sale.). CONSTRUCTION LENDING AGENCY: I hereby affirm ti -at there is a construction lending agency for the performance 0 I, as owner of the property: am exculsively contracting with licensed contractors to construct the project (Sec. of the work for which this permit is issued (Sec. 3007. Civ. C.). ' 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Lender's Name builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the M Contractor's License Law.). Lender's Address - 0 1 am exempt under Sec. B. 8 P.C. (Attached Certificate). I certify that I have read this application and state that the above information is correct. I agree to comply,with all' 'Date Owner - city and county ordinances and state laws relating tc building construction, and hereby authorize re sentatives WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to selWriiure, or a of this county to enter upon the above-mentioned property for inspection purposes. certificate of Workers' Compensation Insurance , or a certified copy thereof (Sec. 3800. Lab. C.). Signature of Applicant or Agent ( Date Policy No. Company ,,, I 1 'l CERTIFICATE OF COMPLIANCE AND AUTHORIZATION 3F ENTRY: I certify I have read this application and state that ,Certified copy is hereby furnished. panmen4,or•C47,e `�� the information given is correct. I agree to comply wth all state laws and county ordinances relating to buidling presentative the La Ouinta Department 0 Certified �ctopy is filfed with the City Building Inspection D i Department. Date' / r�Cp ~ `� , t' `� constructy n' �pdradtfiorize�a er of •:ity of of Building and. Safety to enter upon the property property lot whi It'I ha .e applied�.dor tthis„�ermit for the purpose of makings pections. w ' Applicant %� / .�0 ��% I�/��• /r Sig Applicant,or-'A ent r Date Print Applicant/Agent Name W APPLICANT NAME (L, F. MI) La Quinta Joint Venture. ADDRESS P.O. Box 780 CITY/COMMUNITY/STATE/ZIP La v4xnta, Ca 92253 JOB SITE ADDRESS/SPACE - • 49-961 Avenida Vista Bonita CITY/COMMUNITY/STATE/ZIP La Quinta, Ca 92253 BOK PAG PRC C Pink Applicant T—RNG $ 31.00-" SE S TRACT 4496-11 LOT 136 Plan Check Fee •180.50 MOD -1 SB - TRACT NAME - Santa Rosa Cove OWNER NAME (L. F, MI) CONTRACTOR -FIRM NAME , .Q Vanden .Corporation ADDRESS , P.O. Box 780 CITY/COMMUNITY/STATE/ZIP La Qui:nta, Ca 92253 PHONE a 619-'564. 1315 LICNC N 333762 . ARC/ENG FIRM NAME - - ADDRESS CITY/COMMUNITY/STATE/ZIP w PHONE a LICNC a ' .T USE OF PE MIT •.rq • ' Sane Family Dwelling '.OFC BL ZON FSB SSB 'SSB , Rse M T SZ END -.SIDE, 6 ZONE ORD LO r Arrow Printing 250/1-83 ' APPL/PRMT {Sy 1 '7 DATE - 6-16-•83 L Permit to construct, model P• -1-`D J' Dwelling 1,461 Sq.' Ft`. = Garage 423 sq; "Ft. Patio Cover x,12 Sq. Ft,, , .. White: Finance Canary: Assessor„ Pink Applicant Mech..' Fee $ 31.00-" Electrical Fee I '31.25 Plumbing Fee 48.50 Plan Check Fee •180.50 Building Pee 366.29 Property Dev. Fee 450.00 .• • Ju 00a Ci of La: Quin a . L • TOTAL1,107 FEE. . 54 r`o • r ` `- k + :� 4 ` •`Z ,. / VALUATION S, Ei24 e O V White: Finance Canary: Assessor„ Pink Applicant Tag Bldg'. R!pt _ 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 Idazln40 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. F7 ® i / `y C.a-iL fCc.i�- ajJ�(1ov' 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 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/L STREET NAME 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service '''• ' 32 Final "ArA