12659 (SFD)t:
a
Address 54-825 Obregoa
Owner
•CV
P.O. BOX 1504 N o .
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
1.2659
Chad GUman
BUILDING: TYPE CONST. � OCC: GRP.
Mailing
53-733 Obregon
774.-�293�0$6
A.P..Number
Lot 4 Block 279
C•ty
�'� �tl,�?2'Cc'7�.a CA
Zip
92253
Tel.
564-4956
Legal Description
Project Description SFD2 '
Contractor
Unrose Corporation
Address
72-850 Samara Rates
„
CA
l 7 99ert,
Zip
'sslp 922rao'
Te
1346-2840
State Lic.
City
& Classif. 1B 533670
Lic. #
Sq. Ft. No. t*' ::•' No. Dw.
Size 16' 6 Stories- _ Units
Arch., Engr.,-
New ❑ Add ❑ - ", `Alter ❑ Repair ❑ Demolition ❑
Designer _ aUft3='o:3E'. Corp; -
Address _
Tel.
T'•
+`
City
Zip
State
s
Lic._ #
:c s
LICENSED CONTRACTOR'S DECLARATION
r
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
17 00) of Divsisionn,3 the�B iness•and•Professj-ons
of Code, and my license is in full force and
'
- •i
a
- ,
1SIGNAT' RE/ - DATE
OWNER•BUILDERDECLARATION IEstimated
hereby affirm that I am exempt from the Contractor's License Law for the following
Valuation r.'� 00I
$96 P e
reason: (Sec. 7031.5, Business and Professions Code: Any city orf county which requires a
..
!-
permit to construct, alter, improve, demolish, or repair any structure,Iprior to its issuance also
requires the applicant /or such permit to lila a signed statement that he is licensed pursuant to
PERMIT AMOUNT
the provisions o/ 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 o/ Section 7031.5 by any applicant for a permit
Plan Chk'Dep.� � ,.,Z��i•-f3�
subjects the applicant to a civil penalty o/ not more than live hundred dollars.(S500).
Plan Chk. Bal. _ ',`, - • 68-
-
O 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
Const. .;_ 6Ci0
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. I/, however, the building -
Mech. 62. 00
-
Electrical ],3!, 3-6.
m
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 o/ sale.)
Plumbing j 1��.
❑ 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',
S. M. 19. .
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.)
Grading 20.00
0 I am exempt under Sec. B. & P.C. for this reason
Driveway Enc. 00
Date Owner
Infrastructure 2,a143.82'
Precise Plan 25.00
0
WORKERS' COMPENSATION DECLARATION
1 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
1
CCo is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL _ 3's 692.5fa 3,442.56
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
REMARKS
(This section need not be completed i/ the permit is for one hundred dollars ($100) valuation
or less.)
-
I 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: 1l, alter making this Certificate of Exemption you should become
ZONE: BY: -
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop: Line _
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.)
Side Street Setback om CenterLine ^'-•?T
r—•• !! _-i
Side Setback frond - perty � g
.
, t
Lender's Name
FINAL DATE I S9 CTOR
Lender's Address
This is a 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
J lelml
{ -
read this application and state that the above information is correct.
I
Issued by: Date f
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-.811
1
mentioned property for inspection purposes.
� r
Validated by'.
Signature of applicant Date—
v J
y
Mailing Address
Validation: f
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. rPLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
SLAB GRADE
2ND FL. SQ. FT.
BONDING
YARD SPKLR SYSTEM
STORAGE TANK
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
DUCT WORK
ROCK STORAGE
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
OTHER APP.IEOUIP.
DRAINAGE PIPING
CAR P. I SQ. FT. ®
TEMP. POLE 1-14/4 y 40
WALL SQ. FT.
GROUT
DRINKING FOUNTAIN
SQ. FT. ®
FINAL INSP.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
WATER PIPING
NOTE: Not to be used as property tax valuation
=$
FLOOR DRAIN
MECHANICAL FEES
FRAMING �2- -?3?cl w
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
REMARKS:
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEM/PERM
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/. c
SEWAGE DISPOSAL
MESH
SQ.FT.GAR ® 3/ac
HOUSE SEWER
nn
INSULATION/SOUND.945':-qq
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 / ZZ,-J�
4bJNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE 1-14/4 y 40
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP. ?fdCu.
FRAMING �2- -?3?cl w
FINAL INSP. ,9.L (�
v i 7
ROOFING �_�(O^ l y c�
Pre w1p -9, -4;
c�
Wait F-T&S
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWAL0:Z—j69
LATHING
MESH
nn
INSULATION/SOUND.945':-qq
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
tom.
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111 .
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated 619-775-3500
Date 1/10/94 1 Type of Permit I La Quinta
No. 112607 1 Permit #
Log
Owner Name Chad Guzman
No. 54825Street Avenida Obregon
city La Quinta Zip 92253 Study Area 110
APN # 774-293-016 Tract # I Lot i 0 Square Footage 11676
Type of Development Single Family Residence No. of units 0
Comments
At the present time, the Desert Sands Unified School District does not collect fees on
garages/ carports, covered patios/walkways, residential additions under 500 square feet,
detached accessory structures or replacement'mobilehomes. It has been determined
the above-named owner is exempt from paying school fees at this time due to the
following reason:
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to Government Code 53080
in the amount of 1.65 x 1676 or $ 2,765.40 have been paid to D.S.U.S.D. for
the property listed above and that building permits and/or Certificates of Occupancy for
this square footage in this proposed project may now be issued.
Fees Paid By Chad Guzman Telephone 564-4956
Name on the check
By Dolores A. Ballesteros
Superintendent"
Fee collected /exempted by Vickie J. Durrett+
Payment R, c,
Signature, L ,.,,CheckNo. 0769
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting; ,
Or it;
CALVIN C. KAMINSKAS . i a o DAN RILEY.
Assistant Commissioner
o ' 6 e Sealer, Weights & Measures
n �
(714) 275.3000 (714) 275 3030
OFFICE OF
AGRICULTURAL COMMISSIONER
JAMES O. WALLACE. Commissioner
83-612.Avenue 45 Suite 7
Indio, CA 92201
(619) 342-8291.
DATE I I — % CASE NO. P C /f w S 0//0
DEVELOPER'S NAME:
ADDRESS s 72 - f:'S�O
�u `7 2 2-
TELEPHONE:
TELEPHONE: (G y) 3 Y6 - z 8.�a
0�,
Dear Developers
After reviewing your landscaping plans, all plant material listed is not in
violation of quarantine laws governing the Coachella Valley. If substitutions
do occur and they differ from plant material listed, this office must be notified
immediately.
Thank you for protecting and preserving the Coachella Valley's pest-.free environment.
Agricultural Conmiss oner's Office
cc: Indio and Riverside
4080 LEMON STREET, ROOM 19, RIVERSIDE, CALIFORNIA 92501 — FAX (714) ?75-3012