11697 (AR)f -`n-
P.O. BOX 1504 N Q . .1169 7
Building 78-105 CALLE ESTADO
Address 52--799 E7k31`''egon LA QUINTA, CALIFORNIA 92253
Owner
Steve,- R. Brant
Mailing
Address P.O. Box 1302
City Zip Tel.
La Quinta, C11 92253 5v4 -a1032
Contractor
Owner/Builder
Address
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number
Legal Description
Project.Description ROOIR addition
City
BY:
Minimum Setback
Distances:
Zip
Tel.:
Rear Setback from Rear Prop. Line
State Lic.
& Classif:
City
Lic. #
Sq. Ft. 72'
Size, -
No. No. Dw.
Stories Units
Arch:, Engr.,
Designer
New ❑ Add ❑' .
Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
Validation:
City
Zip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION'
I hereby affirm.that I am licensed under provisions of. Chapter 9 (commencing with Section '
70 OO) of Division 3 of the Business and Professions Code, and my license Is in full force and
effect.
,r <
SIGNATURE DATE
OWNER;BUILDER DECLARATION '
I hereby affirm. that 1 am exempt from the Contractor's License Law for the following
reason: (Sec. 703.1.5,Business • and Professions. Code: Any city or county which requires a
permit to construct, atter, 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
• Divfsfon'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 tpermft
' subjects the applicant to a civil penalty of not more than five hundred dollars. -($500)...
p 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; Bulsness and
" Professions Code: ,The Contractor'sLicense 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 improvement is sold within one year of completion,. the owner -builder will have the. burdenn
of proving that he did not build or improve for the purpose of sale.)
b 1, as.owner of the property, am exclusively contracting with licensed contractors to con- -- •
struct 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 Seca • B, &"P.C:,for this reason
Estimated Valuation
Estimated
��+s
3 f 765.60
'
- PERMIT
AMOUNT
.Plan Chk. Dep.
Plan Chk. Bal.,
,
40.95
Const.
031900 '
Mech.
'
Electrical
'17. 5 2
Plumbing -
" S.M.I.
40
Grading
Driveway Enc.
��Date r� % Owner �'`r �' —� '"`-'LL" "�
' - -
Infrastructure
WORKERS' COMPENSATION DECLARATION
I hereby affirm ;that I have a'certificate of consent to self -insure, or a'certificate of
Worker's Compensation,insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company '
❑ Copy is filed with the city. ❑ Certified copy is -hereby furnished. '
TOTAL 121.87
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
.(This section need not be completed If the permit is for one hundred dollars ($100) valuation • Af` tri Fi st:7,-'- ` ^ "%?.7-,}"wl� ;,j, :i .,-;i1 •icy?i..- , j e+
or less.) 3. '_Hv�Y'1 -3.• 001 rff_ I. I. N: l:,vt
"1 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' Compensation "
Laws of California.
Date - Owner
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.
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, Civil Code.)
Lender's Name
Lender's Address
This is a building' permit when'properly filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 180 days.
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 city to enter the above-
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
ZONE:
BY:
Minimum Setback
Distances:
Front Setback from.Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE
INSPECTOR
Issued by:
Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
UNITS
-
2ND FL. SO. FT.
Gl
YARD SPKLR SYSTEM
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO, FT, ®
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT.
DUCT WORK
DRAINAGE PIPING
WALL SQ. FT.
DRINKING FOUNTAIN.
SQ FT ®
HEATING (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM. FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GRADING
Cu. yd.
$ -plus-x$_=$
LAUNDRY TRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM. B.TM.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER. B.T.U.
SO. FT..® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
FIREPLACE
SQ.FT.GAR ® 3/ac
HOUSE SEWER
SPARK ARRESTOR
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE / PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADEpp
Gl
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
P4
SEWER OR SEPTIC TANK
ROUGH WIRING.
DUCT WORK
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
Cu. yd.
$ -plus-x$_=$
LUMBER GR.
FINAL INSP.
FRAMING ! (� L i/1
!�
FINAL INSP.
ROOFING Kr
o
3
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
/ N
'IImaI demm w +%
INSULATIONISOUND L�
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
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`MEMORANDUM ;
ho-, . a �!. . , s f.jir• ,� ..
TO: Tom:Hartung �.
FROM: j#'BrucFe "Pelle.ti.er
t
DATE: January.9,"1992
RE: 52-790.0bregon
Please be advised, that themhazards previously.di.scussed at the
above address have been° resolved: -by the' bank r;epre,senta>tives. The
dwelling is now secure. ;,,•
I have'contacted 'the reporting party..that initially -:reported the
incident. They will - us know :if.,,a_riy,, other'=*problems; arise.
.BP/lc
1.;.
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