1983-002148800 Avenida Anselmo
IIIIII I III III VIII IIII 33 v PERMIT APPLICATION L g—
City of La Ouinta .
IE Department of Building and Safety
This permit becomes void if work not commenced within 180 days from date of issuance, OR, it 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 z `
Date
Contractor
OWNER -BUILDER DECLARATION: 1 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 (SS00.):
❑ 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, howeveyhe
building or improvemni 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.).
❑ 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.
Vk+.
4° erhfied copy is filed with the City Building Inspectionor City , Depart 'Department.
Date It r
/ Applicant rX y _ .. 4 r,
/\ !y
APPLICANT NAME zl / r min
ADORES-- Ave
1117777 /4 eelzgo
CITY/COM MUN I T Y/STATE/ZI P
JOB SITE AADDRESS/SPACE
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CITY/COMM UN ITV /STATE21 P
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PRC
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LOT
• TOTAL
FEE
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TRACT NAME
OWNER NAME (,
CONTRACTA/FOp-Fls/ RM,,_N fy►//
11
ADDRESS
CITY/COMMUNI.TY./STTATTEE//'fiP J//J
PHONE N
LIC{JC N _
ARC/ENG FIRM NAME
ADDRESS
CITY/COMMUNITY/STATE/ZIP
PHONE N
LICNC N
USE OF PERMIT .60/
BL
ZON
FSB
SSB
SS8
RSB
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ZONE ORD
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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 as to become subject to the Workers' Co mpensation 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 owne(-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.
0 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.).
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 Iftiave°applied for this permit for the purpose of making inspections.
j Signature of Applicant or Agent `" Date `til
Print Applicant/Agent Name
x r L JJ
.root 9 70 :27`1
w
Mh
City of La Quinta
• TOTAL
FEE
Arrow Printing 250/1-83 White: Finance Canary: Assessor Pink: Applicant Tag: Bldg. Dept. VALUATION
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
fireplace T.O.
❑
NOADDITIONAL INFORMATION
G <
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/1
STREET NAME
26 Power Pole
27 Conduit
28" Service Entrance
29. WirinjP f' k
29A Grounding Wire
296 Bonding
30 Fixtures
31 Service
32 Final
IIIIIIIIVIIIIIIVIIIIIII 34
IE
E. W. Wright
P. 0. Box 1068
La Quinta, CA 92253
Phone 564-4300
Feburary 23, 1983
City of La Quinta
Mr. Phil Coggins, Building Inspector
P. 0. Box 1504
La Quinta, CA 92253
Re: Kimball residence at 48-800 Anselmo (L.Q.C.C.)
Dear Phil,
Attached please find the soils engineers compaction field report and the
civil engineers letter certifying rough grade on the above property.
If these enclosures meet with your approval, we would appreciate your
making an inspection of the temporary service ( underground ) located
in the utility easement at the N/E corner of the lot.
Please call me if there are any problems or questions concerning these
matters.
n ,
Ed. fight
cc: Norman C. Wieme
1532 S. Upas
Escondido, CA 92:025
C
TELEPHONES
(819) 348-8015
(819) 323-4573
Planning, Engineering, Surveying
POST OFFICE DRAWER E
PALM DESERT, CA 92281
Feb. 22, 1983
City o6 La Quinta
P. 0: Box 1504
La Quanta, Ca. 92253
ATTN: Phil Coggin.6, Buitd.i.ng Im6pectot
RB:- Lox 83, -La Quinta Go26 Ctub F.st. #1
Thin texteA wilt 5eAve to cent%6y that Lox 83, La Quinta GoZ6
Ctub Fstatez No. 1 has been tough graded in basic con(6otmance to the
approved gtading .plan/.6 to ptan. A tectangutcuc oAea 35 6t. deep and
50 bt. wide is at etevat,ion 45.8 bot cowst)cucti.on o6 the swimming
poo..
Sincetceey,
Jamez D. Fe.ino
RCF 24176
BUENA ENGINEERS, INC.
1731-A Walter Street
`• VENTURA, CALIFORNIA 93403
TO Z�l At-e=�ZY
THE FOLLOWING WAS NOTED:
DATE _
♦ 5
J08 NO.
?
j
/
PROJECT
L G_ OG
LOCAT N 09
CON ACTOR
OWNER
WEATHER
TEMP.
O at
Oat
AM
PM
PRESENT AT SITE
-
COPIES TO, XJ UA�
SIGNEDki
!
JOB CARD
This inspection record shall be placed
.in a conspicuous place on the job
DEPARTMENT OF BUILDING
AND SAFETY
CITY OF LA QUINTA
Owner
Location
Use of building—
Date
ISSUED
Land Use No. Zone
PERMIT NUMBER QD a /
Inspector must sign all spaces pertaining to this job.
NOTE: The Uniform Building Code authorizes a special charge
for reinspection when the work is not ready for inspection.
Inspections Inspector Date
Set backs
Lot rough grade .g .
ig
Forms & footings
Ground Plumbing
Slab grading
Steel (if required) _„".„ w z
Do not pour floor until above has been signed
Concrete tickets must be left for inspectton for all pours.
Roof deck
Framing
Rough Plumbing
Rough Wiring
Plenums/ducts
Cover no work until above has been signed
Insulation blown
Wall batts
Ceiling batts
Cover no insulation until above has been signed
Exterior Lath 1 70 le- –.:__ I /L t e sY
Interior Lath `
Drywall
Fireplace P/L
FireplaceT/O AWV— _ 1!/A !,! pt?
Gas piping test I - _ I W I-, /ez” 4-�,
Sewerhookup
Septic tank
Water Service
Electric Service
SEC16bN T20 -1457(b) TITLE 24 OF. CALIFORNIA
ADMINISTRATIVE CODE MUST BE COMPLIED WITH
PRIOR TO FINAL INSPESWQN,
FINAL INSPECTION Kf
DO W) -T OCCUPY THIS BUILDING
UNTIL AFTER FINAL INSPECTION
Arrow Printing 250/1-83