07293 (RER)Address 65-105 Riviera
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
No. 47293
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(Ibis section need not be completed if the permit is for one hundred dollars (8100) valuation
or foss.)
certify that in the performance of lhg work for which this permit is issued, 1 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. ff, 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
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.) -
Lendet's Name
Lenders Address
This is a building permit when property filled out, signed and validated, and is'subject to
expiration if work thereunder is suspended for 180 days.
certify that I have mad 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
REMARKS rt,� :� t7 T,a zc► I :dry. r_•n _ i P►
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 INS E TOR
Ago
Issued by: Date Permit
Validated bv:
Validation:
BUILDING: TYPE CONST. OCC: GRP:
A.P. Number PGA WEST
Legal Description Tract 21381-2 Unit F47 Lots 2 3
Project Description Stub for futum spa, gas & elec rend.
Install *indan In wall, misc. elec. additi-on w/AC
Mailing
Address 55.105 Riviera
City
La Quinta
Zip ]Tel.
92253
371-8577
ntractor
Ad
. Address.
in office, non bearing ,lead. insul.
& drytiall.
City
Zip
Tela
State Lic.
& Classif.
City
Lic. # .
Sq. Ft. 2851 No. 1 No.
Size Stories Units
Dw.
Arch.; Engr.,
Designer
New ❑ Add ❑ Alterig Repair ❑
Demolition ❑
Address
Tel
City
Zip
State
Lic. If
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
700tH of Division 3 of the Business and Professions Code, and my license is in full force and
effect
SIGNATURE DATE
OWNER -BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractors License Law for the following
reasons (Sec. 7031.5,Busi ness and Professions Lode: Any city or county which requires a
Permit to construct, after, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to hie 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 penally of not more than five hundred dollars ($500).
❑ 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
bur3ds or unproves 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 irprovemernt is sold within one year of completion, the owner -budder wig have the burden
of proving that he dad not build or irprove for the purpose of sate.)
❑ 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 contacts for
such projects with a contactor(s) licensed pursuant to the Contractor's License Law.)
0 1 am exempt under Sec B. & P.C. for this reason
Estimated Valuation
��>�
t
-
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal. $M3.0
Const.
��•
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Date owner
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. O Certified copy is hereby fumished.
TOTAL
$2M.77
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(Ibis section need not be completed if the permit is for one hundred dollars (8100) valuation
or foss.)
certify that in the performance of lhg work for which this permit is issued, 1 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. ff, 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
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.) -
Lendet's Name
Lenders Address
This is a building permit when property filled out, signed and validated, and is'subject to
expiration if work thereunder is suspended for 180 days.
certify that I have mad 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
REMARKS rt,� :� t7 T,a zc► I :dry. r_•n _ i P►
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 INS E TOR
Ago
Issued by: Date Permit
Validated bv:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
SLAB GRADE
2ND FL. SQ. FT.
BONDING
YARD SPKLA SYSTEM
STORAGE TANK
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
DUCT WORK
ROCK STORAGE
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
OTHER APPJEOUIP.
DRAINAGE PIPING
CAR P. SQ. FT. ®
TEMP. POLE
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
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DiSH)
APPLIANCE DRYER
REMARKS:
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.
SO. FT. RESID ® 11/a c
SEWAGE DISPOSAL
MESH
SQ.FT.GAR ® 3/ac
HOUSE SEWER
INSULATIONISOUND
GAS PIPING
PERMIT FEE
PERMIT FEE
PERM R 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 APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
7 j
(/i INAL INSPf 21-e
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
PGA WEST RESIDENTIAL ASSOCIATION, INC.
January 30, 1990
Donald & Diane Adolph
55-105 Riviera
La Quinta,. CA 92253
Dear Mr. & Mrs..Adolph:
Thank you for your Architectural Variance submitted.
Please be advised that your recent request for remodeling your
garage has been approved upon'the following conditions:'
1. Obtain building permit from City of La Quinta..
2. Any damage to common area as a result of construction be
repaired prior.to occupancy.
3. No material -is to be delivered or left -in the street during
construction.
4. Any material left. in the driveway is to be stockpiled neatly
so it will not be.unsightly to the neighbors.
5. NO commercial business venture is to be operated out of this.
residence. See CC&Rs for additional information.
Please direct any questions to Noel Rentz, property. manager.
Sincerely,
Architectural/Landscape Variance Committee
P.O. Box 12710, Palm Desert, California 92255, Telephone 619-341-0393 FAX 619-346-5632