10-1059 (PLBG) + 10837 (SFD)54561 Avenida Alvarado
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
IIIIIIIIIIIIIIIIIIIIIIIII 04 jTilt"um:4i
Application Number:
. Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
10-00001059
54561 AVENIDA ALVARADO
774-272-015-3 -000000-
PLUMBING
COVE RESIDENTIAL
875
Applicant:
661‘)/1-01-iL
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
ABRIANCE FRED
54561 AVENIDA ALVARADO
LA QUINTA, CA 92253
(760)832-4947
Contractor:
A+ MECHANICAL PLUMBING
81-370 PALUDOSA DRIVE
INDIO, CA 92201
(760)423-7237
LiC. No.: 935651
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/13/10
CITY OF LA QUINTA
FINANCE DEPT.
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 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 Class: C36 License No.: 935651
Date 0, 1410 Contractor: (t,)
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
any applicant tor a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
() 1, 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 and Professions Code: The
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the
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 or she did not build or
improve for the purpose of sale.).
( ) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
( ) I am exempt under Sec. , B.&P.C. for this reason
Date: Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, for the performance of the work for which this permit is issued. My workers' compensation
•
insurance carrier and policy number are:
Carrier EXEMPT Policy Number EXEMPT
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,
and agree that, if I should become subject to the workers' compensation provisions of Section
.. 3700, /r
of the Labor Code, - 1 shall forthwit comply with those provisions.
Date:'0'I `(ee —IV Applicant: W
'WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS (5100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this 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 application,
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees for any act or omission related to the work being
performed under or following issuance of this permit.
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 county ordinances and state laws relating to building construction, and hereby authorize representatives
of this county to enter upon the above-mentioned property for inspection pu oses.
Date:+b'0Signature (Applicant or Agent): ty V" E d1.4t n .
Application Number 10-00001059
Permit
Additional desc
Permit Fee . .
Issue Date . .
Expiration Date
PLUMBING
22.50
4/11/11
Qty Unit Charge Per
. Plan Check Fee .
Valuation . . .
BASE FEE
1.00 7.5000 EA PLB WATER HEATER/VENT
5.63
0
Extension
• 15.00
7.50
Special Notes and Comments
WATER HEATER CHANGE OUT 40 GALLON
ELECTRIC.
Other Fees
Fee summary
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
LQPERMIT
Charged
22.50
5.63
1.00
29.13
BLDG STDS ADMIN (SB1473) 1.00
Paid Credited Due
.00
.00
.00
.00
:00
.00
.00
.00
22.50
5.63
1.00
29.13
Bin #
City of La Quinta
Building & Safety Division •
P.O. Box 1504, 78-495 Calle Tampico • .
La Quanta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
i .—. I I') '
Project Address: . 14 — s' ( ( Aue4A Le ex
Owner's Name:
6r \ at/‘ c .
A. P. Number: er` r•
tJ01-
Address: S'� .. 6 ( Akke.%4 %A, A I u 2na,
Legal Description:
City,ST, Zip: La Q 0 iNL A C 53
Telephone 6 •• , > ib/'
Contractor A 4 a rt i C-.41` 1014(6
Address: $ (—1-76 Pa C�ci[o Or ,
Project Description: •w _ (OJ• f 110 e * I
• `�.
City, ST, Zip: rA t B C ` �
tJ.
Telephone:/fro X23223'a:.Yn¢�
� xf• •
.�a,�,
State Lic. # : `t3 s'6 51
City Lic. #c
.
Arch., Engr., Designer.
.
Address:
City, ST, Zip:
Telephone:
.., .4. �,
} .4 • I s `{ :f ,V c
�:IS;���, ;:; >t>a.. 4
` :. 4 ..6 ... Frw,� .z, ,
Construction Type: Occupancy:
State Lic. #
,
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
Units:
Telephone # of Contact Person:
Estimated Value of Project: eaL 5
APPLICANT: DO NOT WRITE BELOW THIS LINE •
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Caics.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
•
Called Contact Person
Pian Check Balance
Tide 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I. '
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees •
Total Permit Fees
Prescriptive Certificate of Compliance: Residential
CF -IR -ALT
Residential Alterations
(Page 1 of 5)
Project Name:
AID
Climate Zone #
# of Stories
General information d t 1Q
' `
f.cr& n
Site Address: [1 tf ' R o t,J a
Enforcement Agency: Date:
Building TypeJ'i Single Family 0 MultiFamilyFa
Circle the Front Orientation: N, E, S, W, or degrees
Conditioned Floor Area (CFA):
Project Type: EAlterations 0 Envelope 0 Fenestraatti9d 0 Roof 0 HVAC
Replacement or Change Out 0 Duct Replacement 'q ater Heater .
Framing
Material
and Size
NOTE: This form is not to be used for Newly Constructed Buildings or Additions
Insulation Values For Opaque Surfaces (for Furring use the Mass and Furring Strips Construction table below)
Assembly Alteration
❑ Opening of framed cavity alone - Alterations that involve the opening of the framed cavity ofa wall, ceiling, or floor must install the
mandatory minimum insulation value per §150 for the altered assembly. Fill in Columns A -C. and enter mandatory insulation value in Column H.
❑ Replacement of entire assembly- Replacement of an entire wall, ceiling, or floor assembly requires the installation of Component
Package- D insulationvalues in Table 151-C. Fill in Columns A - J.
Opaque Surface Details For the furred portioned of Mass Walls see Furring Strips Construction Table below.
A ] B 1 C 1. D.
E
F G. 1 11 1 1 1 J
Proposed
Standard
Values From JA4 Table
Tap/
ID
Assembly Name
or Type'
Framing
Material
and Size
Thickness,
Spacing,
or Others
U-
factors
JA4 Table
Numbers
Framed
Cavity
R -values
Continuous
insulation •
R -Value
JA4 Proposed
Assembly Assembly
Cell Values U -factor
>
Final
Asgembly
U -factor°•'
Comment
Mass
Thickness'
Assembly
Name or
T t ' .
Note: For furred assemblies, accounting for Continuous Insulation R -value, see Page JA4-3 and Equation 4-1. For calculating flared walls use the Mau and
Furring Construaion table below.
1. For Tag/ID indicate the identification name that matches the building plans.
2. Indicate the Assembly Name or type: Roof/Ceiling, Walls, Floors, Slabs, Crawl Space, Doors and etc...Indicate the Frame type and Size: For
Wood. Metal, Metal Buildings, Mass, enter 2x4, 2x6, or etc... see JA4 for other possible frame type assemblies.
3. Enter the thickness for mass in inches or Spacing between framing members enter; 16 "or 24 "OC: or- Other for all other assembly. description
such as Concrete Sandwich Panel, Spandrel Panel, Logs, Straw Bale Panel and etc....
4. Based on the Climate Zone: enter the Standard U factor from Table 151-B, C or D for each different assembly Name or type. '
5. Enter the Table number that closely resembles the proposed assembly.
6. Enter the R -value that is being installed in the wall cavity or between the framing; otherwise, enter "0".
7. Enter the Continuous Insulation R -value for the proposed assembly; otherwise, enter "0".
8. Enter the row and column of the U factor value based on Column F Table Number and enter the Assembly U -factor in Column J
9. The Proposed Assembly U factor, Column J, must be equal to or less than the Standard U -factor in Column E to comply.
Furring Stri' s Construction Table for Mass Walls Only
A B C D E
F G H I J K
L
M
Proposed Properties
Joint Appendix
of Masonry
Walls From Reference
Table
and
4.3.5, 4.3.6,
JA4 Table
Number'
Concrete
4.3.7
=
H
i-
v
Q > '
O
ur
Added
in
W
`o .l
c 6. o .a
X 2
Interior
Furring
Joint
9,
C
tt-
v
or
Space
Appendix
g
Y.i
E= o
'�
Exterior Insulation
from Reference
Table 4.3.13
L'
m
d
t
' ,
V
3
a >
>
Final
Asgembly
U -factor°•'
Comment
Mass
Thickness'
Assembly
Name or
T t ' .
Registration Number:
2008 Residential Compliance Forms
Registration Date.'Time:
HERS Provider:
August 2009
Prescriptive Certificate of Compliance: Residential
CF -1R -ALT
Residential Alterations
Page 4 of 5)
Project Name:
eA be a,rti c, -C
Climate Zone #
# of Stories
HVAC SYSTEMS - HEATING
Heating Equipment
Type and Capacity12-3
Minimum
Efficiency
(AFUE or HSPF)
Distribution
Type and Location°
Duct or Piping
Insulation
R -Value
Thermostat
Type
Configuration
(Central, Split,
Space, Package or Hydronic)
Extemal Tank
Insulation
R-Va(ue3
CI
-e CD r -A
n
. a 2
K
t R-16
I. Indicate Heating Type (Central Furnace, Wall Furnace, Heat pump, Boiler, Electric Resistance. etc.)
2. Electric resistance heating is allowed only in Component Package C. or except where electric heating is supplemental (i.e., if total capacity
< 2 KW or 7,000 Btu/hr electric heating is controlled by a time -limiting device not exceeding 30 minutes). See §!5l (b)3 exception.
3. Refer to the HERS Verification section on Page 4 of the CF- I R -ALT Form for additional requirements and check applicable boxes.
4. indicate Type or Location (Ducts, Hydronic in Floor, Radiators, etc.)
HVAC SYSTEMS - COOLING
Cooling Equipment
Type' and Capacity' 2
Minimum
Efficiency
(SEER/EER or
COP)
Distribution
Type and Location3
Duct or Piping
insulation
R -Value
Thermostat
Type
Configuration
(Central, Split,
Space, Package or Hydronic)
I. Indicate Cooling Type (A/C. Heat pump, Evap. Cooling, etc)
2. Refer to the HERS Verification section on Page 4 of the CF -/R -ALT Form for additional requirements and check applicable boxes.
3. Indicate Type or Location (Ducts, Hydronic in Floor, Radiators, etc.)
WATER HEATING
List water heaters and boilers for both domestic hot water (DHW) heaters and hydronic space heating. individual dwelling DHW heaters must be
gas or propane fired, and may not exceed 50 gallons. Hot water pipe insulation from the DHW heater to the kitchen(s) and on all underground
hot water pipes is required in all component packages in all climate zones.
Water Heater Type/Fuel
Type'
Distribution Type
Standard, Recirculatin Z
Number in
System
Tank
C acity (gal)
Energy Factor or •
Thermal Efficiency
Extemal Tank
Insulation
R-Va(ue3
CI
-e CD r -A
n
. a 2
K
t R-16
I. Indicate Type (Storage Gas, Heat Pump, Instantaneous, etc.) .
2. Recirculating systems serving multiple dwelling units shall meet the recirculation requirements of §!50(n). The Prescriptive requirements do
not allow the installation of a recirculating water heating system for single dwelling units.
3. The external water heating tank and pipes shall be insulated to meet the requirements of §I500).
SPECIAL FEATURES The enforcement agency should pay special attention to the Special Features specified in this checklist below.
These items may require written justification and documentation and special verification.
NEW ROOF ASSEMBLY - Radiant Barrier
The radiant barrier requirement of *151(f)2 does not apply to roof alterations.
Slab Edge (Perimeter) insulation 0 YES 0 NO
YES: In Climate Zone 16 in Component Packages D. R-7 insulation is required.
Heated Slab Insulation 0 YES D NO
YES: Slab edge insulation required for all heated slabs in all Climate Zones. See details in Table 118-A of the standards.
Raised Slab Insulation 0 YES 0 NO
YES: In Climate Zones 1, 2, 11, 13, 14 & 16, R-8 insulation is required; in Climate Zones 12 & 15, R-4 is required under component Package D.
Thermal Mass
To obtain Compliance Credit for the installation of thermal mass, use the Performance Approach.
Registration :Number:
2008 Residential Compliance Forms
Registration Date'Time:
HERS Provider:
August 2009
Prescriptive Certificate of Compliance: Residential
CF -IR -ALT I
Residential Alterations
F c b r
Project Name:
Climate Zone #
(Page 5 of 5)
# of Stories
HERS VERIFICATION SUMMARY The enforcement agency should pay special attention w the HERS Measures specified in this
checklist below. A completed and signed CF -4R Form for all the measures specified shall be submitted to the building inspector before final
inspection.
Duct Sealing & Testing HERS verification is required for this measure.
• YES • NO YES: In Climate Zones 2 and 9-16, if more than 40 linear feet of new or replacement ducts are installed in unconditioned
space. the ducts are to be sealed per §152(b)IDii and the newly installed ducts are to be insulated per §151(f)10.
O EXCEPTION: Existing duct systems that are extended, which are constructed, insulated or sealed with asbestos.
• YES • NO YES: In Climate Zones 2 and 9-16. if the existing space -conditioning system (HVAC equipment and ducting) is replaced, the
ducts are to be sealed per § 152(b)1 Di.
• YES • NO VES: In Climate Zones 2 and 9-16, if the existing HVAC equipment is replaced (including the replacement of the air handler.
. outdoor condensing unit of a split system. cooling or heating coil, or the furnace heat exchanger) the ducts are to be
sealed per §152(b)1E.
O EXCEPTION: Duct systems that are documented to have been previously sealed confirmed through HERS
verification in accordance with procedures in the Reference Residential Appendix RA3.
• EXCEPTION: Duct systems with less than 40 linear feet in unconditioned space.
0 EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
Refrigerant Charge - Split System HERS verification is requiredfor this measure.
• YES • NO YES: In Climate Zones 2 and 8-15, when the existing HVAC equipment is replaced (including the replacement of the air
handler, outdoor condensing unit of a split system A/C or heat pump. cooling or heating coil, or the furnace heat
exchanger) a refrigerant charge measurement shall be verified per §152(b)IF.
Central Fan Integrated (CFI) Ventilation System and Fan Watt Draw
The ventilation requirements of § 150(o) do not apply to existing residential homes.
Ducted Split Systems - Air Conditioners and Heat Pumps: Airflow HERS verification is required for this measure.
• YES • NO YES: In Climate Zones 10 through 15, when the existing space -conditioning system (HVAC equipment and ducting) is
replaced; the airflow and fan watt draw shall be verified per §l52(b)1Ci to meet the requirements of §151(f)7B.
Documentation Author's Declaration Statement
• I certify that this Certificate of Compliance documentation is accurate and complete.
Name: ,,t
LLGI l aw. La,i .e 5
Signature:
L)
Corn y M p _c t.ar) t L* es. 1 p, 014't b e
Date `I —
Address:
PQ()C'iup ,sa �
If Applicable 0 CEA or 0 CEPE'37o
(Certification #):
City/State/Zi
-1-"A-01tk R Co1 I/ CZ a(
Phone:
7 it h 7 3 --123"1
Responsible Building Designer's Declaration Statement •
• lam eligible under Division 3 of the California Business and Professions Code to accept responsibility for the building design identified on
this Certificate of Compliance.
• I certify that the energy features and performance specifications for the building design identified on this Certificate of Compliance conform
to the requirements of Title 24, Parts 1 and 6 of the California Code of Regulations.
• The building design features identified on this Certificate of Compliance are consistent with the information provided to document this
building design on the other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement
agency for approval with this building permit application.
Name: . %
c,oc<itay Ler
Signature:
CA jw-
:4.
omp it 1-e.0-✓ ..a r1 t(P6; t/\Gy
Date:
I 0 " 4
Address: .J
`6'J -3-7o ect loolos4 Or.
License: -J --“-y
Q33 -6S(
City/State/Zip-
o�s�C e 22_0 (
Phone:
'?6 D (-12:3 -"?2 37
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.
Registration Number:
Registration Date.Time:
2008 Residential Compliance Forms
HERS Provider:
August 2009
OM 05
BuddingBui54-561 Alvarado
Owner
Synercon Development Corp.
ot 4 adittad
P.O. BOX 1504
N10837
7&105 CALLE ESTADO (' L,
LA QUINTA, CALIFORNIA 92253
\\t_ 'L U
( (((' "`+c
Mailing
Address 74940 Hwy 111, Suite 429
City
1.W.
Zip
92210
Tel.
564-6929
Contractor
Synercon Dev/Tony Plescia
Address
Same
BUILDING: TYPE CONST. 1 OCC. GRP.•
A.P. Number
Legal Description Lot 3 Block 269
Project Description SPD
79 7.2 O/5
City
Zip
Tel.:
State Lic.
& Classif.
337400
City
Lic. #
Arch., Engr.,
Designer David Dietrick
Sq. Ft. 1546
Size
No.
Stories
No. Dw.
Units
New ❑ Add ❑
Alter ❑ Repair 0
Demolition 0
Address
45320 Driftwood Dr
Tel.
341--1426
Permit does not include -block
City
P.D.
Zip
92260
State
Lic. #
wall or pool
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chap er 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.
SIGNATURE
DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,Business and Prolessions.Code: Any city or county which regimes a
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
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 rive hundred dollars (8500).
o 1, 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, Busness 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
o1 proving that he did not build or improve for the purpose o1 sale.)
❑ 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.)
0 I am exempt under Sec B & P.C. for this reason
Date Owner
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
O, Copy is filed with the city. 0 Certified copy is hereby fumished.
CERTIFICATE OF EXEMPTION FROM .
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars (8100) valuation
or less.)
1 certify that in the performance of the 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: t, 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
Estimated Valuation
89,005
PERMIT
AMOUNT
Plan Chk. Dep.
250.00
Plan Chk. Bal.
255.70
Const.
594.50
Mech.
55.50
Electrical
126.01
Plumbing
141.00
S.M.I.
9.00
Grading
20.00
Driveway Enc.
20.00
Infrastructure
1964.36
TOTAL
REMARKS
3436.0/
31S6.0i
ZONE -
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
1ST FL.
SQ. FT.
SQ. FT.
SQ FT
SO. FT.
SQ. FT.
SO. FT.
SQ
VALUATION
®
$
BONDING
-
UNITS
STORAGE TANK
FORMS 1(
SEWER OR SEPTIC TANK
ROUGH WIRING.
DUCT WORK
2ND FL.
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
YARD SPKLR SYSTEM
REINF. STEEL
GAS (FINAL)
POR.
@
MOBILEHOME SVC.
WATER HEATER
SERVICE
FINAL INSP.
BAR SINK
GAR.
@
GRADING'
cu yd
x$ _$
POWER OUTLET
• LUMBER GR.
FINAL INSP. ?lf`l6/4 % e
/
ROOF DRAINS
-
FRAMING -(R /A up
FINAL INSP. °7/�/2n
.CAR
CAR P.
ROOFING 45--/
O' a/AXA..0
�G� L . SO
//i/ir1
git1 19.S
g✓ s(Aa'/11"vv
'M
-
REMARKS:
VENTILATION
PIPING
WALL
igi
FIRE ZONE ROOFING •
FIREPLACE
DRINKING FOUNTAIN.
®
SPARK ARRESTOR
GAR. FIREWALL
URINAL
n� `/�
HING 3 g2 00
���CCC
ESTIMATED CONSTRUCTION
$
MESH
WATER PIPING
NOTE: Not.to be used as-pioperty tax valuation
FINISH GRADING
FLOOR DRAIN
FINAL INSPECTION L/dti(Rtt
MECHANICAL FEES
.
CERT. OCC.
WATER SOFTENER
FENCE FINAL
VENT SYSTEM. FAN EVAP.COOL HOOD
INSPECTOR'S SIGNATURES/INITIALS
SIGN
GARDEN WALL FINAL
WASHER(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. . ..
.
SQ. FT. ® c
BATH TUB
SQ. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID @ 11/4 c
-
SEWAGE- DISPOSAL
--
SQ.FT.GAR @ 34c
HOUSE SEWER
•
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 U�
GROUND PLUMBING 7) ' .Z
Z PJNDERGROUND
A:C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS 1(
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 L//tee//n
e,
'GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING'
cu yd
x$ _$
• LUMBER GR.
FINAL INSP. ?lf`l6/4 % e
/
$ plus
-
FRAMING -(R /A up
FINAL INSP. °7/�/2n
ROOFING 45--/
O' a/AXA..0
�G� L . SO
//i/ir1
git1 19.S
g✓ s(Aa'/11"vv
'M
-
REMARKS:
VENTILATION
FIRE ZONE ROOFING •
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
n� `/�
HING 3 g2 00
���CCC
MESH
INSULATION/SOUND _51.3-••• P.
421.
( c'
FINISH GRADING
FINAL INSPECTION L/dti(Rtt
.
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
1111 IIIIIIIIIIIIIIIIIII 06
IE
NOTICE:
Document Cannot Be Duplicated
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
Indio, CA 92201
(619) 347-8631
Type of Permit
Date 4/24/92
No. 11342 I
Owner Name
APN #
Ty` pe of Development
•
Comments Alvarado: 54-5ff1 and 54-561
Synercon Development Corp.
No. Street. See Below
La Quinta
City La Quinta zip 92253
Tract #
Lot #
Study Area
Permit #
Log #
110
Square Footage
Single Family Residence
No. of units
13092
2
Each home 1546 square feet
At the present time, the Desert Sands Unified School District does not collect fees on
garages/carports, covered patios/walkways, residential addition, 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 1.58 X 3,092 or $ 4,885.36 have been paid to D.S.0 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 La Jolla Bank
Name on the check
By James E. Lively
Assistant Superintendent, Business Services
Telephone 564-6929
Fee collected /exempted by Shelley D. Bennett
�n /� Payment Received
tSignature a(� / /l1 Heti Check No. 5025056
Collector: Attach a copy of county or city plan check application form to district copy for ail waivers. %` a,
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting /
i iiiliii iiiii iii dill liil 0 7
IE
Received From:
Address.
Account No.
c
COACHELLA VALLEY WATER DISTRICT
CASH RECEIPT DETAIL
-..383#13'
Date
Lot(s)
Service Address Ll - (I's5/ ltI/L-1�.451Q
,ter(s) (,9 3/ vie,vice(s)
❑ Backflow(s)
❑ House Lateral(s)
❑ DetectorCheck(s)
❑ Meter Surcharge /�`_
t4 itation Capacity Charge 4, CO 1 /p� 5 4 U s J o
❑ W.S.B.F.C.
❑ Temporary Construction Meter
❑ Turn on Charge
❑ Uncollected Account - Name-
❑ Inspection Fee - Tract - -
Fee -
❑ Plan Check Fees Water / Sewer -
Tract -
❑ Bond Payment - A D - Bond
Assmt
❑ Customer Deposit
❑ Other
Remarks:
❑Copy to:
Tract
G.A. Code
TOTAL
$ 500,00
flee
c& (is -010'u
$ 5-6 ').c;�C)
Check
Money
Order
Water Service
Cashier
421 :1>
CVWD-438 (11/89)
CALVIN C. KAMINSKAS
Assistant Commissioner
(714) 275-3000
IIIIIIIIIIIIIIIIIIIIIIIII 08
IE
OFFICE OF
AGRICULTURAL COMMISSIONER
JAMES O. WALLACE, Commissioner
83-612 Avenue 45 Suite 7 •
Indio, CA 92201
(619) 342-8291
DAN RILEY
Sealer, Weights & Measures
(714) 275-3030
DATE u a I I) ( 1 i l — CASE NO . it L6 (// 7 A
DEVELOPER' S NAME: S ye rC- p .) "O'Ea c (Ay /14.e r cp t, p
7t �� i(I S- L4e
2--mabA,J W.--LLs CA
ADDRESS:
TELEPHONE:
(6(9) 6g79
6-L1 5 --co ( P\ L)A 66(
Dear Developer:
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.
Agricuura1 Commissioner's Office
cc: Indio and Riverside
4080 LEMON STREET, ROOM 19, RIVERSIDE CALIFORNIA 92501 — FAX (714) 275-3012
ai
Building
Address
111111111111111111111111 09 1 Ceitti at 4 attar
\(/
54--5-0 4LVVA,9. Dr
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Owners,,
=: 5 i11ele C.OM t < Cori
Mailing 4 ,
Address i% _ 740 44)//0.///. ,' S 0f7 c 1-29
City Zip
9 z z / o
Tel: Gil
5!04-,z--6929
Contractor
_ . Address
t
k
APPLICATION
PLICATION ONLY
BUILDING: TYPE CONS1T! OCC. GRP.
A.P. Number
Legal Description L0 T-
Project Description
1I31_6cz(„9
City
Zip
Tel..
State Lic.
& Classif.
City
Lic. #
Arch., Engrg,
Designer DAU!D c t e - f /G .
Sq. Ft.
Size
No.
Stories
No. Dw.
Units
New ❑ Add ❑
Alter 0
Repair 0
Demolition 0
Address
- 45-3 zit) 1 IFIVt)/) D/
Zip
197 %. D
Tel.
/ - /51-Z1,0
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 Professions Code, and my license is in full force and
effect. -
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License 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, 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
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 live 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
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.)
❑ I am exempt under Sec B & P.C. for this reason
Date Owner a
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
0 Copy is filed with the city. 0 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 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 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
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Iflfrastructure
,Mag -t/(dr
TOTAL
REMARKS
i
jiiJYl
• ..9.4.:;9 6 f". 17c. i)
f V 1 rye
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 4% Date Permit
Validated by:
Validation: , •
CONSTRUCTION ESTIMATE
NO.
ELECTRICAL FEES
NO.
PLUMBING FEES
1ST FL
SQ. FT.
SQ. FT.
SO. FT.
SQ. FT.
SQ. FT.
SQ. FT.
SO. FT.
VALUATION
@
$
STORAGE TANK
FORMS
UNITS
ROUGH WIRING
DUCT WORK •
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
2ND FL.
OTHER APP./EQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
YARD SPKLR SYSTEM
FINAL INSP.
POR
@
GRADING
cu yd
_$
MOBILEHOME SVC.
FINAL INSP.
$ plus x$
BAR SINK
FINAL INSP.
GAR.
®
REMARKS:
VENTILATION
POWER OUTLET
FIRE ZONE ROOFING
ROOF DRAINS
CAR P.
@
GAR. FIREWALL
LATHING
MESH
DRAINAGE PIPING
•
FINISH GRADING
WALL
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
DRINKING FOUNTAIN
@
URINAL
ESTIMATED CONSTRUCTION
$
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
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.
SQ. FT. ® c
BATH TUB
SQ. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR @ 3/4c
HOUSE SEWER
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 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
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu yd
_$
LUMBER GR.
FINAL INSP.
$ plus x$
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 SIGNATURES/INITIALS
GARDEN WALL FINAL
SYNERCON DEVELOPMENT CORPORATION
74-940 Highway 111, Suite 429
Indian Wells, California 92210
(619) 564-6929
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