9662 (PLBG) IIIIIIIIII _ , 57
IIIIIIVIIIIIII4 .4 a '_
IE _
T _ 7&105 C BOXLLE 1504 DO C C ��• 9962
Building 49_641 AVILA LA QUINTA,CALIFORNIA 92253 ff
Address f�
Owner /
MARTIN
Mailing BUILDING: TYPE CONST. OCC:GRP.
Address SA14E
A.P. Number
City Zip Tel.
LA QUIN.TA Legal Description
Contractor Project Description SEWER HOOKUP
ECONO$SEWER
Address
P 0 BOX 192
City Zip Tel.:
PALL DESERT
State Lic. City
&Classif. 450951 Lic.# 342 Sq.Ft. No. No. Dw.
Arch., Engr., Size Stories Units
-
Designer New ❑ Add ❑ Alter❑ Repair ❑ Demolition❑
Address Tel.
City Zip State
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/Professlons Code,and my license is in full/fo/rce an/d�
effect. � f � P�r�:.n-''�
SIGNATURE _J DATE
OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following Estimated Valuation C 1 500
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a V
permit to construct, atter, improve, demolish, or repair any structure, prior to Its Issuance also
requires the applicant for such permit to rile a signed-statement that he is licensed pursuant to PERMIT AMOUNT
the provisions or the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that.he ds exempt therefrom, and the basis
for the alleged exemption. Any violation of Section 7031.5 by'any applicant for a permit Plan Chk. Dep.
subjects the applicant to a civil penalty of not more than five hundred dollars.($500). Plan Chk. Bal..
❑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.
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, Mech.
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 Electrical '
of proving that he did not build or improve for the purpose of sale.),I .
❑1,as owner of the property,am exclusively contracting with licensed contractors to con Plumbing $30.00
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.1.
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
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 certi(je coy hereof,�Sec, BOB Labor Code.)
POII'cy_No. Company i,psl ,A zfsk 1-02
Copy is filed with the city. ❑Certified copy is hereby furnished.11
/J TOTAL $30.0,10
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS'COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation ,$f C$Q Af1-•`l.r-ID f {e
or less.) �3 I # 1 �4t'tf3i1�4r1
I certify that in the performance of thg work for which this permit is issued,I shall not w•,
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 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
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.) 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
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. 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 Address Validation:
City, State, Zip
CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES
1ST FL. SO.FT.@ $ UNITS
2ND FL. SO.FT.
YARD SPKLR SYSTEM
POR. SO.FT.® MOBILEHOME SVC. BAR SINK
GAR. SO.FT.® POWER OUTLET ROOF DRAINS
CAR P. SO.FT.
DRAINAGE PIPING
WALL SO.FT.@
DRINKING FOUNTAIN.
SO FT ® 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 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,TEM/PERM 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®1 Vi c SEWAGE DISPOSAL
SO.FT.GAR®3Vic HOUSE SEWER
GAS PIPING
PERMIT FEE PERMIT FEE PERMIT FEE
DBL TOTAL FEES MICRO FEE MECH.FEE PLCK.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 TANK9/Q, 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
LUMBER GR. FINAL INSP.
cu.yd..
FRAMING FINAL INSP. $ plus x$ =$
ROOFING REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION /
CERT. OCC. v
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
04
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c�'MoF �wS� 78-105 CALLE ESTADO — LA QUINTA, CALIFORNIA 92253 (619) 564-2246
FAX '(619) 564-5617
November 1, 1991
Riverside County Assessor
46-209 Oasis Street
Indio, CA 92201
Re: Parcel #617-530-012
TO WHOM IT MAY CONCERN:
In reference to permit #9962 issued August 27, 1991,.. an incorrect
address was given of 49-641 Avila Drive for a sewer hookup. The
correct address is 49-614 Avila Drive. Please change— your records
to reflect the correct address.
Your prompt attention to this matter is .appreciated.
Sincerely,
BUILDING AND AFETY DEPARTMENT
Tom Hartung
Director of Building and Safety
TH:es
LTRTH60
MAILING ADDRESS P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253