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SFD & CFO (10876)77225 Loma Vista 10876 • i rim,{ ... - , . J .4' ? Jp; , 1 . P.O. BOX 1504 No. 10876 auilding - 78-105 CALLE ESTADO Address 77--225 Loma. V LA QUINTA, CALIFORNIA 92253 •- • ' Owner Jim Johhston Mailing BUILDING: TYPE CONST. OCC: GRP: Address A:P. Number City Zip Tel. sift 23,'i3Cl$d Tt4 Legal Description Contractor Project Description I' Rancho Capistrano. Dev. Address _ .,.a...... P. 0. BO980 CityZi p Tel.: t t7 i La Qu nta 92253, 564--0705 State Lic. City ' & Classif_ • 547975 Lic. # 1969 Sq- Ft. 4487.. No. • No. Dw. -Arch., Engr., _ Size • - •- -.Stories ,. Units Designer Oall ng McCallum New ❑ r' Add ❑ Alter ❑ Repair ❑ • Demolitiori'.❑ Address 5$ 4 Club Tel. 360!--0250,Permit € oes riot .rtclude any block awls, , City Zip State or pool. A. l.V 42210- Lic.# - • LICENSED CONTRACTOR'S DECLARATION •-' 3 I hereby affirm that I am licensed under provisions of: Chapter 9 (commencing` with Section ' gft00) of Division 3 of the.Business and Professions Code, and my license is in'full force and J ` . \ct. - i t SIGNATURE - DATE _ _ , •. ' —7— "'••`' , OWNER -BUILDER DECLARATION Estimated Valuation hereby affirlri that I am exempt from the Contractor's License Law for the followin338,814. 7031.5,Business - _ reason: (Sec. reason: and Professions Code: Any city or- county which requires a permit to construct, alfei, • improve, demolish, or repair any structure, prior to its issuance also y ; .• requires the applicant for such permit. to rile a signed statement that he islicensed pursuant to -PERMIT `•' - AMOUNT 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 .PlannChk. hep. _ .250. 00 ;..• - ` subjects the applicant to a civil penalty of not more than rive hundred dollars.($500). ' • `., ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk.. Bal. ,' 956. 0 5 do the work, and the structure is not intended or offered for sale: (Sec. 7044, Buisness and Professions Code: The Contractor's, License Law does not appy to an owner of property who, CiOTISt.1476. - - Q builds or improves thereon. and who does 7such work himself or through his own employees, _.provided that'such improvements are not intended or offered for sale. ff,•however, the building - 'Mech. _ • - - - Y 0. ' - - - ,:t t: • 1.3s i/00 or fmprovement-is sold within one year of. completion, the owner -builder will have the burden'- • of proving that he did not build or improve:lor the purpose of sale.)., •r-., • Electrical, : Z. 35, O I, as owner of the property, am exclusively contracting with licensed contractors to con- c' ..Plumbing.,' .,211 5th ,. struct •the project. (Sec. 7044, Business and Professions Code:. The .Contractor's License Law-. . " -does not appy to an owner of property who builds or improves thereon, and whocontracts for • .$•lVl_I_, .. •. •• - `:33 90 • . such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading •n7 . .O 1 am exempt under Sec. B. n & P.C. for this reason. v • g Driveway Enc. 20.00 Date Owner Infrastructure 60100.00 Arty in ]Publid 597 G4 WORKERS' COMPENSATION DECLARATION' r , 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.) Poly No.Company . 0 Copy is. filed with the city. '❑ Certified copy is hereby furnished. t :fid x .• TOTAL' 9955.84 9705.34 CERTIFICATE OF EXEMPTION FROM • WORKERS' COMPENSATION INSURANCE REMARKS (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 thg work for which this permit is issued, I shall not rt =s r.ew. -;.; r,r, d, , ' > =any erson in any manner so as to become subject to the Workers' Compensation p Laws of California. - • . . c-•. ., {, ,;, v yi p 1 ; 1 { 'v-,'05 r . . ;i J .S'tr.Pi3 :L 0 ITAI A : Rl ' Date Owner NOTICE TO APPLICANT. If, after making this Certificate of Exemption you should become " ZONE: _ BY:nne.:•nn 4 ti r;n'^J4 AM 4 Cr 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: V-+ _ _ - k° t. '"' -. sr' j t) t,/ ` ;, ' '#'( 7 I_ - , ,,, -1 St Front Setback from Center Line Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY I hereby is construction agency Side Street Setback frOm,Center Llne affirm that there a lending for the performance of the work for which this permit is issued. (Sec. 3097, Civil code.) . -, -Side Setback from Property,' Line Lender's Name , -- Lenders Address This is a building permit when properly filled out, signed and validated, and is subject to • FINAL DATE INSPECTOR expiration if work thereunder is suspended for 180 days. I certify that 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 I Validation: City, State, Zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SQ. FT. ® $ 2ND FL. SQ. FT. POR. SO. FT. ® GAR. SQ. FT. ® CAR P. SQ. FT. WALL SO. FT. ® SO. FT. ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM t BAR SINK i ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN. URINAL WATER PIPING NOTE: Not to be used as property tax valuation ROUGH PLUMB. BONDING FLOOR DRAIN MECHANICAL FEES FORMS WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APPJEQUIP. LAUNDRYTRAY AIR HANDLING UNIT CFM GAS (FINAL) TEMP. POLE 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 FINAL INSP. SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1+/e c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER VENTILATION 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 P ' ; Y HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING -0 ? DERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH)Ala TORAGE TANK w FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCKSTORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. LAI REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ =$ LUMBER GR. FINAL INSP. FRAMING A3 egt j' FINAL INSP. ROOFING 91 Cft 4"", -7/1 .2— Tp a—Qeriliv (?lcplll /` ` 01V 1 REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING I l 3 1.w O w INSULATION/SOUND O G FINISH GRADING^ FINAL INSPECTION)QW) CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL DESERT SANDS UNIFIED SCHOOL DISTRICT 82-879 Highway 111 NOTICE: Indio, CA 92201 Document Cannot Be Duplicated (619) 347-8631 Date 5/11/92 Type of Permit I La Quinta No. 11377 Permit # Log # Owner Name Jim Johnston No. 77225 Street Loma Vista city La Quinta zip 92253 Study Area 121 APN # Tract # Lot # Square Footage 14487 Type of Development Single Family Residence No. of units 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 11.58 1 X 487 or $ 7,089.46 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 Jim and Marilyn Johnston Trust Telephone 564-0705 Name on the check By James E. Livel Assistant Superintendent, Business Services Fee collected /espted by Shelley D. Bennett Payment Recei'vM *. p Signature Ctieckr4o.- 1t05' Collector. Attach a copy of county or city plan check application form to district copy for all`('waivere Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting;% , ^ • -•, 77225 Loma Vista 10876 77 kD Off 01, t u a Wu*nta This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building Code certifying that at the time of issuance this structure was in compliance with the various ordinances of the City regulating building construction or use. For the- following: BUILDING ADDRESS 77-225 Loma vista Use Classification -Single Family 'Dwelling Bldg. Permit No. 10876 Group R3 Type Construction VN Fire Zone Use Zone SR Owner of Building Jim Johnston .-,Address 77-225 Loma Vista City La Quinta, CA Lonnie Day By. Data; December 22, 1992 Building Official POST IN A CONSVICUOUS PLACE a I