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9903-141 (PLBG)LICENSED CONTRACTOR DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my. License is in full force and effect. License # Lic. Class Exp. Date . ",P .r . Date Signature of Contracts` OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: 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 &.Professionals Code). ( ) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code). ( ) I am exempt under Section B&P.C. for this reason Date Signature of Owner WORKER'S COMPENSATION DECLARATION O`er`. I.hereby affirm under penalty of perjury one of the following declarations: Lo, 0 (.) 1 have and will maintain a certificate of consent to self -insure for workers' X. W. compensation, as. provided for. by Section 3700 of the Labor Code, for the Qperformance of the work for which this permit is issued. 0 0 ( ) I have and will maintain. workers' compensation insurance, as required by p'U - Section 3700 of the Labor Code, for the performance of the work for which this d Z permit is issued. My workers' compensation insurance carrier & policy no. are: Carrier Policy No. . d COLI•St.IN EAGLE M& (This section need not be completed if the permit valuation is for $100.00 oriess). ( ;) I' certify'tliat 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, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code,-kshall forthwith comply with those pr0isio s. Date: 5� S i Applicant f Li Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his application:. 1,. Each person upon whose behalf this application is made & each person at whose request,and for whose benefit work is performed under or pursuant to any, permit issued as a result of this applicaton agrees to,. & shall, indemnify & hold harmless the.City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is • correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property_for inspection purposes. Date 3l", Signature (Owner/Agent) " .�• '��--�—� -� — -. f r- ' BUILDING PERMIT PERMIT $ DATE VALUATION LOT TRACT JOB SITE APN ADDRESS ATV Y l;iIDA i.Yt3 3t8?.�o IN OWNER CONTRACTOR/DESIGNER/ENGINEER .� A pp fl ff i t tt oe 7 A i.�A dl:'1- a A I,.i-P, �Iri.; i.h 1,6�i3 i. �v 1`.riLi .7 1{_�� U ! ` e�, t�5..ii�i..) :S o:rF i'�, ER. ';C,;r., . 191493 Ce•1LLIV, 7'V1IV.iP1C_ � 94035 CtlStW)ti RD, LNKWO, CA 9222111 . LA. QI-A Ni."A i;:.'A 4'22:3.1- A-L2M D.i F,R:I' C;,A 922.61- (Tfiff 046%47((1 (111.N 14? USE OF PERMIT I'l.tJ�1:!l31.�it� 'Tic, l'u'l il'aD04" SEWFIA CCitiNECT (LC -N.VX3 PR!'IJ.Irt'T 09-02) Ci7i' TRAC, f !'WOi)'NT 1,430.70 3,.'3 PERMIT FEE SUMMARY I-'LAMOBIN0FrE -- SEWEF 1101-000-4iy-000 K -M).00 I C ONSI'Kf{;"'i'iON AND K.AN ('E.lECK LESS I'RE•.PMD FEES &0-00 , "#'CiTA.I., P1# RM1 IT FE 8)'11 U N 0 �:�tl.QbtB A(`., RECE PT 7 [ �/� j , DATE BY a, I v DATE FINALED INSPECTOR V INSPECTION RECORD OPERATION DATE I INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K. to Wrap F.A.U. Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final POOLS - SPAS BLOCKWALL APPROVALS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K for Finish Plaster Sewer Lateral7,T, Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test Appliances Final COMMENTS: Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fbdures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) s 4 4a" P.O. BOX 1504 Building 78-105 CALLE ESTADO Address 53-105 0breclAn LA QUINTA,_CALIFORNIA 92253 Owner Co°' chella Vallov rand BUILDING: .TYPE•CONST. OCC. GRP. Mailing Address 247 B. 11"a quits Way #2 � •..A.P.:!Number 't. City Zip Tel. k a 262 322-`1020 Legal Description Contractor Project Description stcaxr Construction ction Address Same City Zip Tel. ry State Lic. City & Classif. 38793,4 Lic. # 895 Sq. Ft. 1469 No. No. Dw. Arch., Engr., Size Stories Units Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. 4301 Garage City Zip State 1701 X 6.0 wood fence Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of.the Business and Profeisiions'Code, and my license is in full force and p effect. „rr+' +s�r«o.alya.sr'-'r,.�` �.1. �".f 7/�.�f . •. SIGNATURE J F DATE OWNER -BUILDER DECLARATION Estimated Valuation 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 $76.105 permit to construct, alter, Improve, demolish, or repair any structure, prior to its Issuance also - - requires the applicant for such permit to fila a signed statement that he is licensed pursuant to PERMIT AMOUNT the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) or Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis P. /.� for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit Plan Chk. Dep. $`250.00 subjects the applicant to, a civil penalty of not more than five hundred dollars ($500). - O I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. 64.05 do the work, and'the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. -364 n 00 Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building Mech. 36.00 or improvement is sold within one year of completion, the owner -builder will have the burden Electrical '74 .17 of proving that he did not build or improve for the purpose of sale.) ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing `"' 105.06 struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for S.M.I. 5.36 such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec. B. & P.C. for this reason Grading 20.00 Driveway Enc. - 20.00 Dale owner Infrastructure 1479.85 r WORKERS' COMPENSATION DECLARATION( I hereby affirm that I have a certificate of consentfto self,insu e, or a certificate of Worker's Compensation Insurance, or a certified copy th&6of.$(Sec. 3900, Labor Code.) Policy No. Company '� ✓�.•'""�� ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. TOTAL CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE _ (This section need not be completed if the permit is for one hundred dollars ($100) valuation - s,'gel;t�'i�4.f13?1id%f�¢ia'p8i'duf Q, '"z ni'^�`Rs..,+.k'•�j or less.) - - 1 certify that in the performance of thg 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 Certilicate . of .Exemption you should become ZONE: BY: subject to the Workers' Compensation provisions of -the' Labor"Code, you must forthwith . Minimum Setback Distances: comply with such provisions'or this permit shall be deemed revoked. Front Setback from Center Line Rear Setback from Rear- Prop. Line CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line 1hereby affirm that there is a construction lending agency for the performance of the Work for which this permit is issued. (Sec. 3097, Civil Code.) Side. Setback from Property Line Lender's Name Lender's Address FINAL DATE INSPECTOR . This is a building permit when properly filled out, signed and validated, and is subject to e! 9 � �n expiration if work thereunder is suspended for 180 days. I I/ .0 5, Cs - I certify that I have --read this application and state that the above information Is correct. Issued by: Date Permit 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. Validated by: Signature of applicant--Date- Mailing pplicantDate Mailing' Address Validation: ` "City;• State, Zip { WHITE - FINANCE, PINK -APPLICANT, GREEN BUILDING, GOLDENROD -ASSESSOR'S OFFICE; WARD COPY -FILE ;• CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL SO FT y Z UNITS SLAB GRADEa' RROUGH PLUMS/, , BONDING YARD SPKLR SYSTEM 2ND FL SO FT. @ FORMS SEWER OR SEPTIC TANK UGH WIRING —/j MOBILEHOME SVC. BAR SINK POR SO FT at GAS (ROUGH) METER LOOP HEATING (FINAL) POWER OUTLET ROOF DRAINS GAR SO. FT. @ TEMP. POLE GROUT DRAINAGE PIPING CAR P. SO FT. @ FINAL INSP. WALL SO. FT. @ WATER SYSTEM DRINKING FOUNTAIN GRADING cu. yd. $ —plus—x$ .g URINAL SO. FT. @ FINAL IN SP. JFRAMING / �/� ESTIMATED CONSTRUCTION VALUATION S 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)(DISHI APPLIANCE DRYER FIRE ZONE ROOFING GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FIREPLACE ILAUNDRYTRAY AIR HANDLING UNIT CFM KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP POLE, TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. @ c BATH TUB SO. FT. @ c WATER HEATER MAX. HEATER OUTPUT. B.T.U. SO. FT. RESID @ t V c SEWAGE DISPOSAL SO.FT.GARgr Vic HOUSE SEWER FINAL INSPECTION GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MEC FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB FEE STRUCTURE PLUMBING ELECTRICAL HEATING 8 AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADEa' RROUGH PLUMS/, , BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK UGH WIRING —/j DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ —plus—x$ .g LUMBER GR. FINAL IN SP. JFRAMING / �/� FINAL INSP. I ROOFING[ f(_ 9 / v` � 0 . REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR - GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESlINITIALS , GARDEN WALL FINAL V mpr.4 RECEIPT, NO. ssu�bd B Date. C Rancho Calif. '0 DISTRICT:- �0,'-Riversi de Indio 0 Hemet 0 Perris, 0 Blythe,,' 601-1 SANA 22 (Rev. 5/88). DISTRIBUTION: WHITE w'Office I file YELLOW Applicant PINK - Bldg. bept GOLDENROD'i Plans/Records j. ... .. COUNTY OF RIVERSIDE DEPARTMENT OF HEALTH Assessors Parcel No. - " yam- / 7 ENVIRONMENTAL HEALTH SERVICES 0 PERMIT APPLICATION FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM* 4plicaft,' Submit ihliforrn with four copies of a scaled plot plan 0 -20 scale) drawn to County speculations as indicated on the attached check list. rt A non-refundable filing, fee (see below) is required when the application is submitted. Check must be made payable to the County of Riverside. Approval of this application shall remain valid for a period not to exceed one year from date of approval. VERIFY ITEMS IN SECTION A FROM BUILDING & SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG Z I 0 Agent Contractor, Contact Person Phone Address & Phone P:. — 5T9 &P, Cm 5 7-.49 4) e, rvo AJ U.11 Owner Phone Mailing Address (J) 3.2 7- -Ij z -2 417 1C 7,VW,2 L) r r- ut,,14 C Ave,-*, State Zip Job Property Add Legal Legal Description Prop. (PM, Tract, Lot) ,Spelt) 6 C, C /q 5pz. 74 Z, 53 /V 5-40,8 4!60 AJ 'Lot Size Use of & A YL4, -4 Pe it P/P CU etc "'a , / L__ - ;]EEgMH Other 6) .71 A3 'ref&- 7- Slite Prop, etc. Sighature of Applicant Date CATEGORY: REV CODE FEE CATEGORY: REV CODE FEE CeISUBSURFACE DISPOSAL 123B<�_' �5. 0 SITE EVALUATION UPON REQUEST 7349 $42.00 0 MULTIPLE PARCELS WITHIN SAME (NO PLOT PLAN) LAND DIVISION 11 SEWER/SEPTIC VERIFICATION 7348 $11.00 0 .'&, 1st 4 Parcels (Each) 1238 $45.00 (Less than 1 yea* b.. Each Parcel after 4 7344 $16.00 0 PRELIMINARY ELECTIVE 7352 $45.00 .(Attach Uj 0 Rereview (2nd review same parcel) 7344 $16.00- EVALUATION DOH SAN 53) co 0 She Evajuation In Conjunction with 0 HOLDING TANK 7351 $45.00 Critical Area 7346 $86.00 0 ALTERNATIVE/EXPERIMENTAL 7345 $132.00 0 Site Evaluation Lot Less than SYSTEM 10,000 Sq. Ft. 7347 $86.00 Holding Tank Agreements Completed /-Do 13 Yes PKNO�� Certification of Existing S.D. System Required - No�_ 0 Yes E�N ��No_ A dCB 0earanoe required. (Attach Form 0 Yes DOH SAN.007, Santa Ana Region Only) Soils Percolation Report Required. 13 Yes CT Special Feasibility Boring Report Required. .0 Yes 1� No Detailed' Contour Pilot Plans Required (11 to 5 ft. interval) 0 Yes EYNo' Other' 0 Yes F?, Staff Si5sclalls4 Lot Inspection Required 0 Yes 0 NO Lot Inspection Date Soils boring report by 1 proles # Date Soils Map Page son Type Approved by Dee 0`00 z 0 No. of Systems TypJ.6f Syalenxq ❑0 olding Tank ❑0 Existing J ErNew 0 RepkKxwnervt No. Dwelling Units(/) Bedrooms, extawwft (1) Septic Tank Soil Rate Gmase/Sand I Intop 61 G 3W —Gal U.1 (2) Leach Line Sq. Ft *'�4' a�" Sidewall allowance install une(s) fL long it wide with Bed eq. ft .tom �Ire-h tL rock/ sq. It. per running fi, ;--N-A min. 7117=nches of om area Leachlines/bed special design for slope: (3) Pit Diameter No. Pits Pit Below Seepage Pit rDepth Other ApplicableInlet 6 (BI) Max. Allo>yable/Depth N/A Overburden factor No. 2 System 11111A- REMARKS: .......... This application I PPROVE I for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated on the accompanied plot plan, using ,the 'requirements set forth in SECTION C above. A building permit is necessary for , the installation of the Z O. above -designed system. No construction is permitted lr� the required reserved 100% exp ansion area. and sewer lines must be 50;Winr_d mfrom any w 01 �Septic tain* k* ell4lo 0k Leach: lines be 100', mmum'from any WeIIs,Including, expansio1are , Seepage pits must be 50' fro ny.wells, ncluNng expansion a. -4. i 0 'Signature 7-Iff; o"i'Heafth'Official rl&wtl V mpr.4 RECEIPT, NO. ssu�bd B Date. C Rancho Calif. '0 DISTRICT:- �0,'-Riversi de Indio 0 Hemet 0 Perris, 0 Blythe,,' 601-1 SANA 22 (Rev. 5/88). DISTRIBUTION: WHITE w'Office I file YELLOW Applicant PINK - Bldg. bept GOLDENROD'i Plans/Records j. ... .. a A < ` 4 P.O. BOX 1504 APPLICATION ONLY Building 78-105 CALLE ESTADO Address 5 3/o,5 0,09156 4 LA QUINTA, CALIFORNIA 92253 Owner co AC vii L 1,E J LX A)_D Mailing _ I Address oZ 1{7 25�,ff T7. City Zip' Tel. 9 z z 3 z z- /o za Contractor S p State Lic. City & Classif. 3 Lic. # Arch., Engr., ' Designer Address Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am Il�ensed under provisions of Chapter 9 (commencing with Sect 7000) of Division 3 of the Business and Profession Cod and my license Is in full force I effect. OWNER -BUILDER DECLARATION_, - / I hereby affirm that I am exempt from the Contractor's Llcense.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, pnor.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 ($500). 0 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, Buisness 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 Improvement 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.) ❑ I, 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 Sec. B. & P.C. for this reason . Date Owner / WORKERS' COMPENSATION DEGLARA/TION / I hereby affirm that I have a certificate of consent to self;insure, or a certificate of Worker's Compensation Insurance, a a certified coE.yrtz(5S 800, Labor Code.) Policy No. Company � � ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed .if the permit Is for one hundred dollars ($100) valuation or 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' Compensation Laws of California. Date Owner NOTICE TO APPLICANT. If, after making this Certificate of Exemption youshould 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 Ihereby 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's building permit when properly filled out, signed and validated, and is subject to expiration if 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 BUILDING DIVISION BUILDING: TYPE CONST. OCC. GRP. A.P. Number 7 7 4—"-- J/ 7 Legal Description .CorS . /�L E/ /7 T' GL.y /7T /8' Project Description -5110- ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Y Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: Sq. Ft. Size / �� 47 No. Stories / No. Dw. Units New, Add ❑ Alter ❑ Repair ❑ Demolition ❑ e-3 G,4,V Q r� G Estimated Valuation "7 1 p l PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. v S Const. oa Mech. 3 6 . Z)o Electrical L-/ / Plumbing pp S.M.I. , 3 Grading D . dd Driveway Enc. 'ZQ . dz: Infrastructure 67 Gl , �g ��i¢��6 , A7 •.4 r ' ?� `.'lata 11q, V13 TOTAL o"n REMARKS 10 CASH i TUI AL 1 z 0. ()U ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Y 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. ?,LUMBING FEES IST FL. SO. FT. ® $ UNITS SLAB GRADE ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL. SQ. FT. FORMS SEWER OR SEPTIC TANK POR. SQ. FT. ® MOBILEHOME SVC. BAR SINK ' GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. I SQ. FT. OTHER APP./EQUIP. DRAINAGE PIPING WALL SQ. FT. TEMP. POLE DRINKING FOUNTAIN SQ. FT. ® GROUT URINAL ESTIMATED CONSTRUCTION VALUATION $ FJNAL INSP. WATER PIPING NOTE: Not to be used as property tax valuation WATER SYSTEM FLOOR DRAIN MECHANICAL FEES _$ WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM KITCHEN SINK ABSORPTION SYSTEM. B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE,TEMIPERM LAVATORY. HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SQ. FT. ® c BATH TUB SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ: FT. RESID ® 11/4 c SEWAGE DISPOSAL LATHING SQ.FT.GAR ® 3/ac HOUSE SEWER MESH GAS PIPING PERMIT FEE INSULATION/SOUND 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 GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP./EQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FJNAL INSP. BOND BEAM WATER SYSTEM GRADING CU. yd. $ plus x$ _$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL or p, E. LEON SrnOGY 1i . Vt OL I if E OF f r AGiZICUL I U(Z L CO�MMISSIONL(Z t �D�nS_IU�Eq JAMES'O I V WALLACE U '`ASSIStArf rh}I}1155�U�ER W IG1 TSS 4E 'S0 o- CLE�IEVi ESE`VEhISiE SMEW S. 0`,613, Ilwy 86�• 8uiteF D.., I "'.Con 11e Ile CA 92236 q r q eq 619-342_=8L91 DATE CASE DEVEWPER' S NAMES 3 T 0 R R ADDRESS Rn b-A TELEPIiOM 3Z'2- ,, d Dear - Developer: -J y _ o �., C,4-- o 7 After reviewing your• lmi4tcapii�q :.plans, all plant n�atet al listed is not in violation of quara' time laws goveri�itig. EIieCoac1ie11aAVa�lley. If sub ititutiolis do occur and they differ firvin 'lent ltkater"ial listen, this_ office'nnast be notified ininedia tely . Thank you for protectiuig mia pceservui9-.'9ie Coachella V6,11ey"s pest-free envim mient. Agr cultural-'Camiss'ioiier : s UE•f iee cc: Indio acid Rivetside Office _ x v ^ u y Desert Sands Unified School District CERTIFICATION OF PAYMENT OF THIS 00 C Kr:St'CNOO :Tw_I_rTY tFFrES , r BE DUPLICATED TO: City of La Quinta DATE: U (�° ((' - Department of Community Development 78-105 Calle Estado La Quinta, CA 92253 ' t This is to certify that r - r.+. developer of AL-l_K I ) which -is located at -'% S ti, within this District, has paid sch of facility fees imp o, d pursuant.to the Gaut o ity genera t Governme t t C e ctios 53 8 n the am� b amount f cov ring a total of square feet o ) residenti 1"or industrial/commercia development and that buil in permits for-- this or-this footage in this development may now be issued by your jurisdiction':'=- -1 for DESERT SA DS UNIFIED SCHOOL DISTRICT r r Hoi). 0•K--4-- CJS 0r White =,Building Department • rYellow - Facilities Planning • Pink - Accounting • Gold -Developer - ~' w ;�• a .. :- .. [, (10)-37. \-