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MECH (08-0538) Separate contents77305 Loma Vista 08-0538 P.O. BOX 1504. 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253'. Application Number: 08-00000538 Property Address: 77305 LOMA VISTA APN: 658 -200 -005 - 58-200-005-Application.description: Application. description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 11300 Applicant:)/ Architect or Engineer: LICENSED CONTRACTOR'S DECLARATION VOICE'. 760 777-7012 FAX (760) 777-7011 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 4/01/08 t I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professio Is Code, and my License is in full force and effect. License Class: C20 Li ense No.: 374937 ..Date: Contract r: ER-BUILDE LARATI0 ' I hereby affirm under penalty of perjury that I am exempt from the Contractor's Sta nse 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 for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: (_ 1 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, 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 novintended 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.). (_) I, 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.). 1 1 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: LQPERi\IIT Owner: . CABRERA LINDA 77305 LOMA VIST 4 LA QUINTA, CA:' 3 (760)771-416 ol Contractor: C' CR 100F PALM DESERT AIR 42081 BEACON HILQFP%+lj' PALM DESERT, CA 92211 (760)346-0677 Lic. No.: 374937 ------------------ WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 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 STATE FUND Policy Number 238-0004656-07 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, ///[/aa. )ndd'Gagree that, if I should become subje a v\ orkers' compensation provisions of Section -C (3700 of the Labor Code• I s fall with comp) i eee-9 sions. Date: '////'/ 1 + Applicant: WARNING: FAILURE TO SECURE WORKERS' C ENSATION C E IS UNLAVkIFUL,ALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1$100,000). 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 informatio correct. I agree to comply with all . city and county ordinances and state Taws relating to buildieconion, andhe eby authorize representatives of this cou ty o enter upon the above-mentioned properton purpo Date: Signature (Applicant or Agen t s ' LQPER1N4IT - - Application Number . . . . . 08-00000538 Permit MECHANICAL Additional desc . Permit Fee'-. 24.00 Plan Check Fee 6.00 Issue Date.. . . . . Valuation 0 Expiration'Date 9/28/08 Qty Unit Charge' Per -Extension BASE FEE 15.00 1.00 9.0000 EA MECH B/C <=3HP/100K BTU 9.00. ---------------------------------------------------------------------------- Special Notes and Comments REPLACE (1)HVAC SYSTEM 18.50 SEERS Fee summary Charged ------------------------------------- Paid Credited Due Permit Fee Total 24.00 -------------------- .00 .00 24.00 Plan Check Total 6.00 .00 .00 6.00 Grand Total 30.00 .00 .00 30.00 LQPER1N4IT - - 1 3 ' Certific to of Compliance Prescript' ethod - HVAC -only Alteration CF -1R -ALT Pr ' itle: - ate: 3 444V P rrolAreSS: -- CII ate ZO e: Docu a atiZAr:-Tel e%ph%one' J ^ m y me: // •v v, / © CaICERTS 2005 Eriforcdm6hUA en ,' ` se Onl ByidingPermitaY ck.'F4 a• x -c^. 7t h- S Y:. sr`'rFR , yA4y ''t id { k31 •'A 's 7. ,; F an`checksDate •.rs.9 .a ,"#.;':, ,iac >»y u cg :, rs .+ ';, rSxv c v4:..•x+ aEt3 "<,h✓ Field Check D{athe,Ftc a`"!t,k i;' 1 ,G F 'Y S'x b4L`' ` 'S'' };'e• r L f $ IMPORTANT: This CF -1 R -ALT form is only for use when a VAC -only alteration is made to an existing home Use one form for each system being altered.' This is s stem`# of/ systems altered in this house. Check all lines that apply. Check only lines that aRI21y. - ; Scope of Alterations: :1 ❑ An Air Handler is to be installed or replaced. Duct sealing to be determined. Continue to next line. 2/V Furnace Heat exchanger is to be installed or replaced. Duct sealing to be determined: Continue to next line. 3b An outdoor condensing unit is to be installed or replaced. Duct Sealing and/or TXV(RCA) to be determined. Continue to next line. _ 4 cooling or heating coil is to be installed or. replaced. Duct Sealing and/or TXV(RCA) to be determined. Continue to next line. IAT 5 ❑ More than 40 feet of new or replacement duct are to be installed in uncnnditioned space. Duct sealing to be determined. ❑ Check here if the gliM duct system is also to be new or replaced. Continue to next line.- " 6 ❑ If none of lines 1-5 are checked, neither Duct Sealing nor TXV RCA are required. Go to Section 5. Section 1 - Duct Sealing (Only if any of Lines 1 2 3 4 or 5 are checked. Skip if Line 6 is checked. 7. ❑ This system is in Climate Zone 1, 3, 4, 5, 6 7 or B. No duct sealing is required. Go to Section 2. 8 ❑ This system has less than 40 feet of ducts in unconditioned space. No duct sealing is required. Go to Section 2. 9 ❑ This system was previously sealed and tested, and was certified by a HERS rater. , r No duct sealing is required. Attach revious CF4R form..Go to -Section 2. 10-0 This ducts stem is sealed or insulated with asbestos. No duct sealing is required. Go to Section 2. Note: If the entire ducts stem is to be new or replaced, Lines 11-14 do not apply. _ 11 ❑ In Climate Zones 2 12 and 16: An 0.92 AFUE furnace will be installed in lieu of duct Sealin and TXV if a livable . 12 ' U, In Climate Zones 10,, 13 and 15: An SEER 14 AND EER 12 condenser will be installed with TXV(RCA) D added duct insulation R4 wrap on existing ducts, R-8 new ducts in lieu of duct sealing. Go to Section 2. 13 ❑ In Climate Zones 9, 10, 11, 13, 14, or 15: An SEER"14 ANQ EER 12 condenser will be installed with TXV(RCA) ` D a 0.92 AFUE furnace will be installed in lieu of duct sealing. Go to Section 2. -14 0 In Climate Zones 2, 9, 11, 12,14 or 16: An SEER 14 AND EER 12 condenser will be installed with TXV(RCA) D.an 0.82 AFUE furnace will be installed with increased duct insulation in lieu of duct sealing. Go to Section 2.' - 15 OF INone of lines 7-14 above are checked. Duct Sealing is Required. Continue. ` Section 2 - TXV(RCA) (Only if Lines 3 or 4 are checked, otherwise got to Section 3 16 ❑ The system being altered is a package unit. No TXV(RCA) is required. Go to Section 3. - ' - 17 ❑ This system is in Climate Zone 8 and a 14 SEER air conditioner or 0.82 AFUE furnace is being installed., , No TXV(RCA) is required., Go to Section 3. 18 ❑ . This system is in Climate Zone 1 3 4 5 6 or 7. No TXV(RCA) is required. Go to Section 3. 19 ❑ Thissystemisin Climate Zone 16 and line 14 is not checked. No TXV RCA is required. Go to Section•3. 20 ❑ is system is in Climate Zone 16 and line 14 is checked and not fine 16. TXV(RCA) Is required. Go to Section 3. 21 is system is in Climate Zone 2 or 8-15 and line 11, 16. or 17 is not checked.'. TXV(RCA) Is required. Go to Section 3. Sedion 3 - HERS Rater verification 22 If line 15 is checked, HERS verification is required for Duct Sealing. 23 If line 12, 13, 14, 20 or 21 are checked and not line 16 or,17, HERS verification Is required for TXV(RCA). G Y 2q[ ❑ Ilf line 12, 13 or 14 are checked, HERS verification Is required for 12 EER. Section 4 - Equipment Efficiencies 25 ❑ If lines 11, 12, 13, 14 or 17 are checked, upgraded equipment efficiencies are required. List In Section 6. Section 5- Duct R -Values ° If more than 40 feet of duct is being installed or replaced, duct R -value must meet or exceed Package D requirements. I26o 27 ❑ Ilf less than 40 feet of duct is being installed or replaced, duct R -value must meet or exceed R4.2 Section 6 - see next page Version 03-10-06 Page 1 of 2 . This form can only be used on projects being verified by CaICERTS certified raters:- , ,www.caIoerts.com_ ; . - ,. r -.. `fes• ° Ali „ r 4- r r , _ .. L1 , J •y . ;,' ' F ' A iY JM t• - ` ^ ' A.n1 y V • l, . •° 17+ + .• : d ,FIS F _..+,fie t., ± ... '. 7 ti •' ry' •t .., `. y , _ •3 . C I' ng -,=Prescriptive method - HVAC -only Alteration CF -1 R -ALT Certificate omp la Project Tit . ,[i Date: © CaICERTS 2005 IMPORTANT: This CFA R -ALT form is only for use when an HVAC nIy alt ation is made to an existing home Use one form for each system beingaltered. This is system # of systems altered in this house. Section 6 - Minimum Requirements for Equipment to be Installed/Altered. Installed equipment must match type/location and meet or exceed efficiencies/R-values. 28 Configuration: JWSplit system ❑ Package Unit 29 ❑ Air Handler as furnace, AFUE: ❑Heatpump FAU ❑Hydronic FAU ❑Other 30 4? Heat E Than er 31Outdoor 32tkP 33 13 Condensino Unit 4U3AIC ❑Heatpump lEfficiencv SEERMSPF: EER if d : Cooling or heating coil C OHeatpump ❑Hydronlc Duds Location: Length (ft): R -value: All mandatory measures apply to any altered component. See MF -1 R - ALT form. Compliance Statement: This certificate of compliance lists the building features and specifications needed to comply with Title 24, Parts 1 and 6 of the California Code of Regulations, and the administrative, regulations to implement them. This certificate has been signed by the individual with overall project responsibility. The undersigned recognizds that compliance using duct sealing, verification of refrigerant charge, and TXV require installer testing and certification and verification by an approved HERS rater. Home Owner or Authorized Agent Documentation Author Name: Name: • Address: Company Name: City/State/Zip: AddressRALM DESERT AIR CONDITIONING COMPANY DA'42081 BEACON HILL Phone: City/State/Zip: 7 (760) 346-0677 Phone: Signature: Signature: Enforcement A en(Building Department) Notes/Comments: Name: Title: Department: ' Phone #: Fax #: Signature or Stamp: Required forms: CF -1 R -ALT: by anyone. Required at time of permit application. Copies to home owner, enforcement agency, HERS rater. CF -6R -ALT: by installing contractor. Required to close permit. Copies to home owner, enforcement agency, HERS rater. CF -4R -ALT: by HERS rater. Required to Gose permit. Copies to home owner, enforcement agency, installer. The CF -4R forms for a sample group shall not be released until all testing and verification is completed and passed for the entire group. Pant+ 9 of 9 Version 03-10-06 This form can only be used on projects being verified by CaICERTS certified raters. www.calcerts.com Din # Qty Of ,a Quin Building Sr Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application aq# Tracking Sheet Permit # nn [?j`d Project Address: Owner's Nam . A. P. Number: Address: 773 Legal Description: City,ST, Zip Telephone-2w%%/' i:...<>•% :•sew>s < :<>«'s' v r ` '< ': Contractor: CONDITIONING COMPA .BERTAIR Address: PALM DESERT, CA 92211-510 Project Description: / City, ST, Zip: v Atc Telephone: n}:•I,.r?•:try•%,4:.: L?iin1:4 j;iy,+v.l.`:i,.i..: : `>#<;::;.;.>:::::::»:<:: :;>~< ;:scr•<::r: :::; ... City Lie. # State Lie. # : , 3 Arch., Engr., Designer: Address: City.,. ST, Zip: Telephone: ''•f P :•> ,::::: •:; <:>::;>:< ::>:;:: ;:;,.;:>:>:::>::>:. State Lie. #: ::•:LAv:•%?>.YvTiii: iii'l.G4iJ Lv:Jei: iiiinii::• Construction Type: Occu an Project type (circle one): New Add' Alter)Repair Demo Name of Contact Person: Sq. Ft.: #Stories: # Units: / Telephone # of Contact Person: 7— 3Y Estimated Value of Project: d APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2°" Review, ready for correctionsdssue 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 I A.I,P.1P Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees P.O. BOX 1504 N.O. ` • 11518, Building 77-305: L`c3 Vista 7&105 CALLE ESTADO r Address = - :1.. -LA OUINTA, CALIFORNIA 92253 wrier t'.herokee . HomeE BUILDING:,TYPE CONST. OCC: GRP. Mailing Address A.P. Number - City Zip Tel. Legal Description Project Description Block wall 'Contractor • vina Const. , Address '' ,4 74-055 Goleta • City'Zip " ' Tel.: Palm. Desert - 92260 340-0302 State Lic. City & Classif. ;. Sq. 62`'30 `"' Lic. # Ft. -Size - No. r . No. Dw. Stories- Units Arch., Engr., New ❑ Add'❑ Alter ❑. ' :'Repair ❑ Demolition ❑ Designer = .: Address; Tel. City _ Zip State r Lic. #'/ LICENSED CONTRACTOR'S DECLARATION sr I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 70 Division of Division 3 of the Business and Professions Code, and my license is in full force and effect. ti? .,7 .SIGNATURE - DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt -from the Contractor's License Law for the following Estimated Valuation reason: (Sec. 7031.5, Business: and.*Pro/essions 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 PERMIT •*'' •. AMOUNT • ' ' ' ` ' provls/ons of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of ' Division 3 o/ the Business and Professions Code, or that. he is exerript therefrom, and the basis •. for the alleged exemption. Any, violation o/ Section 7031.5 by -any applicant. for a permit , . *7._ . _Plan Chk. Dep. - 1_.: 'subjects the applicant to a civil penalty o/ not more than live hundred doliars.($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 I •Const. n s • _ 54y00 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 Electrical - 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', - - ., ❑ 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.I.••• _ -.30 does not apply to an owner o/ 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 ❑ 1 am exempt under Sec. B. ti P.C.,for this reason Driveway Enc. Date Owner Infrastructure • WORKERSCOMPENSATION DECLARATION v . • 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.. ❑_ Certified copy is hereby furnished. TOTAL S4.30 REMARKS 1 ^ d CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSAT.ION INSURANCE..• - }` - - (This section need not be completed it the permit is for. one hundred dollars, (8100) 'valuation - or less.) . 3 . f,. I.,- I certify that in the performance of thg'work for which this permit is issued, I shall not ; % °'ii»t ' t>iie - employ any person in any manner so as to become subject to the Workers" Compensation Laws of California. •. e- - , x y :`• ` I Date ` Owner .Exemption. NOTICE TO APPLICANT: Il; after making -this 'Certificate o/ 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 Sek tbacDi§lances : 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 whic ' work for h this permit -is issued: (Sec. 3097, Civil Code:). _ - Side Setback from Property Line Lender's Name FINAL DATE INSPECTOR 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. • 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 thebove •a. - IT 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. SQ. FT. ® $ 2ND FL. SQ. FT. @ POR. SQ, FT, ® GAR. SO. FT. ® CAR P. SQ. FT. ®, WALL SO. FT. ® SO. FT. ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN. URINAL WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES HEATING (ROUGH) WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER ROCK STORAGE GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED METER LOOP LAUNDRY TRAY AIR HANDLING UNIT CFM REINF. STEEL 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. SQ. FT. RESID ® 1% c SEWAGE DISPOSAL SO.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 I/ 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 APPJEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM ` a WATER SYSTEM GRADING cu. yd. $ plus x$ =$ LUMBER GR. FINAL INSP. 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 ;.i ,• s; Building -7.7305 LO -KA VISTA A.•1.1....... ner CHEROKEE Mailing Address City Zip Contractor . P b1 F POOLS Address 50975 INDIO City Zip INDIO,,CA. 92201 P.O. BOX 1504 N o . 1.1 6. _ 7&105 CALLE ESTADO : LA QUINTA, CALIFORNIA 92253 BUILDING: TYPE CONST. OCC: GRP. . A.P. Number Tel. + Legal Description Project Description POOL AND SPA .345-5070 State Lic. City Minimum Setback Distances: &Classif. C53_476807 Lic.# Sq. Ft. No. No. Dw.' Side Street Setback from Center Line Size Stories — Units - Arch.; Engr.,- NeW.❑ Add ❑-. Alter ❑ Repair -0 -Demolition ❑ Designer ` 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 Divisiohl3ebt4he.Business and.Professions Code,/and my license is in full force a d effect. • " ; """ R ,SIGNATURE IrUATE OWNER -BUILDER DECLARATION I hereby affirm that l am exempt from the Contractors License Law for the following `.reason: (Sec. 7031.5,Susfness and Professions'. Code: Any. city or county which requires a' permit to construct, alter, improve, demolish,•oi-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.provfsfons o/ the Contractor's License Law, Chapter 9 (commencing with Section 7000) of . )Division 3 0l the Business and Professions Code, or that. he is exempt therefrom, and the basis ;;tor. the alleged .exemption. Any vfolation.of .Section .7031.5 'by 'any applicant'lor a. permit - `-X subjects the applicant to a civil penalty of not more than rive hundred dollars ($500). ❑ I, as owner of the property, or mg 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 o/ property who. builds or imp.rovas 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 -budder will have the burden • , of proving that he did not build or bnprove for the, purpose o/ sale.) - Estimated Valuation $ 1416000 - ..PERMIT • ' - AMOUNT - - - Plan Chk: Dep. • `' .•. _ Plan Chk. Bal. 99.'45. COr1St. ' -15 E'i O -Mech. - I .+ ' 24 i'00 Electrical__ • . •' 45 a0 ._ ' a Plumbing 27.00. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- '•• slruct 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.I.- • such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) -• ❑ lam exempt under Sec.. B. & P.C. for this reason •• 1 (}Q - Grading _ .- Driveway Enc. 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 G S 'j 7 e 01copy is filed with the city. ❑ 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 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: ff, after making'•this Certificate o/ 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 " 1 hereby affirm that there is a'construction lending agency for the performance of the i• 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.44 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 Infrastructure TOTAL $349.85 REMARKS. , -i , \ ,'\ - '\ h. C lt 4t •T P" .ice a ZONE: BY: Minimum Setback Distances: Front Setback from. Center Line y 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 IST FL. SO. FT. @ $ 2ND FL. SO. FT. POR. SO. FT. ® GAR. SO. FT. ® CARP. SO. FT. WALL SO. FT. SO FT ® ESTIMATED CONSTRUCTION VALUATION $ UNITS t' MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN. URINAL WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES HEATING (ROUGH) WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER DUCT WORK GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM HEATMO (FINAL) 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 BOND BEAM SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1 Vi c SEWAGE DISPOSAL LUMBER GR. SO.FT.GAR ® V4c HOUSE SEWER FINAL INSP. ROOFING 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 -J& 0 UNDERGROUND a G A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TA/NK ROUGH WIRING. DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) /A G METER LOOP c [[[ LsC HEATMO (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. FINAL INSP. FRAMING FINAL INSP. ROOFING / /CJ �re9 I Vt •—� REMARKS: VENTILATION . FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION Zqg CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESJINITIALS GARDEN WALL FINAL y' •v'v`J ' ' Contractor Cherokee Homes Address 79-811 Country Club City Zip 92201 State Lic. & Classif. B 47E, Arch.; Engr Designer 'Address City f) LICE I hereby affirm that I am lic zip 7 .. Project Description SSD Tel::. .345-6225 City Lic. # -5 DO '- State Lic. # ATION " at 9 (commencing with Section d my license is in full force and Sq. Ft. No, No, Size - 3¢ Stories Units New ❑ Add ❑ -Alter ❑ Repair ❑ Demolition❑ Permit aces- gat include block walls —or ;, oo ... • , SIGNATURE' r. \ DATE- • ' OWNER -BUILDER DECLARATION j I hereby I No. 11057. . P.O. BOX 1504 affirm that am exempt from the Contractors License Law for the following" r• reason: (Sec. 7031.. 5,Business and Professions Code:, Any, city or. county which requires a ' Building7 Address' - ® u 7&105 CALLE ESTADO Loma ta LA QUINTA, CALIFORNIA 92253 L ' Owner -. PERMITt AMOUNT - the provisions of the Contractor's License. Law, Chapter 9 (commencing with Section 7000) of - ; Don Howard d .,. •. •"subjects the applicant to a civil penalty of not more than five hundred dol/ars.($500).-- ❑ I, 'Plan Chk. Bal. Mailing Const. `^ 1175. ' Q' BUILDING: TYPE CONST. -'• OCC: GRP.. - Address % 9-811 ' Country Club ? •. 1] G ry provided that' such improvements are not, intended or offered for sale. ff. however, the budding or improvement is -sold within one year o/ completion, the owner -budder win have the burden.. Electrical t 776.18 +•+ of proving that he did not build or improve for the purpose of sale.) - ., A.P. Number ,Zi G..I O 1, as owner of the property, am exclusively contracting with.licensed contractors to coo- City .. • B.D * • 211. 50 - • Zip 92261 Tel. 345--6225 Legal Description T IiLT • 25.23 -7' OT Contractor Cherokee Homes Address 79-811 Country Club City Zip 92201 State Lic. & Classif. B 47E, Arch.; Engr Designer 'Address City f) LICE I hereby affirm that I am lic zip 7 .. Project Description SSD Tel::. .345-6225 City Lic. # -5 DO '- State Lic. # ATION " at 9 (commencing with Section d my license is in full force and Sq. Ft. No, No, Size - 3¢ Stories Units New ❑ Add ❑ -Alter ❑ Repair ❑ Demolition❑ Permit aces- gat include block walls —or ;, oo ... • , SIGNATURE' r. \ DATE- ' OWNER -BUILDER DECLARATION j I hereby I Estimated Valuation affirm that am exempt from the Contractors License Law for the following" r• reason: (Sec. 7031.. 5,Business and Professions Code:, Any, city or. county which requires a ' +f 1 1 252, 4 2 • 10 t1 .. ,permit to construct, alter, improve, demolish, , or repair any structure, prior to its issuance also ' .requires the applicant for such permit to 1716 a signed statement that he is licensed pursuant to -. PERMITt 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 tPlan `Chk Dep:.. d .,. •. •"subjects the applicant to a civil penalty of not more than five hundred dol/ars.($500).-- ❑ I, 'Plan Chk. Bal. 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. `^ 1175. ' Q' - Professions Code: -The Contractor's License Law does not apply. to an owner. o/ property who v.a builds or improves thereon and who does such work himself or through his own employees, ME?Ch. ? •. 1] G ry provided that' such improvements are not, intended or offered for sale. ff. however, the budding or improvement is -sold within one year o/ completion, the owner -budder win have the burden.. Electrical t 776.18 +•+ of proving that he did not build or improve for the purpose of sale.) - ., ,Zi G..I O 1, as owner of the property, am exclusively contracting with.licensed contractors to coo- Plumbing * • 211. 50 - • - . 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 fora S.M.I. ' - • \ ' 17. 71 , such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) - .. Grading Zit 00 • -.❑ lam exempt under Sec. - B. & P.C.•for this reason'. . + t ' Driveway Enc. —0-- - `Date Owner Infrastructure 5679.47 ' _. Arts -in Ptablit; 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.) ; Policy No. • • :Company `r Copy is filed with the city.' ❑ Certified copy is hereby furnished.. TOTAL -8751.21 CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE REMARKS ?rya e etl f - (This section need not be completed if the permit is for one hundred -dollars (5100) -valuation -c ` 9 i =• • f- • , -t:, „ t`i.. .,I ! ; F'f-t.:` ' r i) .k or less.) - ... - _ I certify that in the performance of the work for which this permit is issued, I shall not employ any pperson 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 'Compensation. • ' BY: - subject to the workers' provisions of the Labor code, you must forthwith comply with .such provisions or this permit shall be deemed revoked: • • ,ZONE: ;Minimum Setback Distances: - 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 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 I have read this application and state that the above information is correct. , ' 'I Issued : b Y Date Permit agree to comply with all city and county ordinances and state laws relating to building `i 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. SQ. FT. ® $ 2ND FL. SQ. FT. ® POR. SO. FT. ® GAR. SQ. FT. ® CAR P. SQ. FT. WALL SQ. FT. @ SQ FT ® ESTIMATED CONSTRUCTION VALUATION $ UNI MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN. URINAL WATER PIPING NOTE: Not to be used as property tax valuation STORAGE TANK FLOOR DRAIN MECHANICAL FEES DUCT WORK WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER REINF. STEEL GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM FINAL INSP. 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+/. c SEWAGE DISPOSAL FIRE ZONE ROOFING SQ.FT.GAR ® 3/ic HOUSE SEWER FIREPLACE 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[�G l 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) l? 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. FINAL INSP. (( FRAMING q l/ Oj v ` r412ibiQ FINAL INSP. ROOFING(/ ll P,�up /a n `� �� c VdL REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL RING Q MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION/ c CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL P.O. BOX 1504 APPLICATION ONLY Building 7 3 0.- _ ; OM,4 78-105 CALLS ESTADOR NIA 92 • Address , A QUINTA, CALIFORNIA 92253 , Owner BUILDING: TYPE CONST.,OCC. GRP: Mailing " Address F City Zip Tel. _ Legal Description L _ -• Con racfoy Project Description ` City... _ .. ZI._ - o State Lic. ' City _ M` & Classif. Lic. # Sq. Ft. y No. No. Dw. t Size i Stories Units ' ,___Arch .•Engr: „... _ . Designer : fG New ❑ Add- ❑ Alter ❑- - Repair ❑ Demolition.❑ g Address Tel. City - _ .tate j JZip Lic. # . LICENSED CONTRACT0 S CLARATIO.N_ •. . -,. - .. I hereb ff" irm that I am/licensed unde`r pro,• ion of Chapter 9'(commencing with Section 7000) _ of iv'sion 3 of ttfe Business anProf sio Code, and license is in full'force and' effect:- r \ • SGNATU DATE- ' _ OWNEKBUIIAER DECLARATION -' Estimated Valuation I'hereby affirm that I am exempt from the Contractors License Law for Ihe-following reason: (Sec. 7031.5,Business.. and Professions Code: Any city. or county which requires a " permit to construct, atter, Improve, demolish, or repair any structure, prior.to Its issuance also _ requires the applicant for such to file that he Is licensed -PERMIT permit a signed statement pursuant to - •- - ----- - --AMOUNT the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 301 the Business and Professions Code, or that. he is exempt therefrom, and the basis for the 'alleged Any Section 'any - Plan Chk. Dep.-- - exemption. violation of .7031.5 by applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). - 0 1, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. -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.) - . _ - - _ _ _ ^ d O I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 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•l. --' - ---• - - ' •' .- _ _ __ such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) t Grading ❑-I am exempt under Sec. - B. & P.C.- for this reason - - - 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 - 0,1 _ _ V j qy • v•w 4 W* H_ i T r L i -250 00--- O Copy is filed with the city. O Certified copy is hereby furnished. _ TOTAL CERTIFICATE OF EXEMPTION FROM REMARKS ' a - 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 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 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 t 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 1 -have read this application and state that the Labove 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 thisIcity to enter the above-. mentioned property for inspection purposes. Validated by: i w Signature of applicant Date .Mailing Address — - Validation: - City, State, Zip - -- + - - - - - BUILDING DIVISION CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ 2ND FL. SQ. FT. POR. SQ. FT. ® GAR. SQ. FT. ® CAR P. SO. FT. @ WALL SO. FT. ® SO. FT. ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING NOTE: Not to be used as property tax valuation BONDING FLOOR DRAIN MECHANICAL FEES FORMS WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APPJEQUIP. LAUNDRYTRAY AIR HANDLING UNIT CFM TEMP. POLE 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 ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER REMARKS: 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 APPJEQUIP. 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 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 DESERT SANDS UNIFIED SCHOOL DISTRICT 82-879 Highway 111 NOTICE: Indio, CA 92201 Document Cannot Be Duplicated (619) 347-8631 Date 6/5/92 Type of Permit I La Quinta No. 11458 Permit # Owner Name Cherokee Log # No. 77305 street Loma Vista city La Quinta zip 92253 Study Area 121 APN # I Tract # I Lot # Square Footage 1 3589 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 1X1&589 lor$5,670.62 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 Cherokee Homes Name on the check Telephone 34.5-6225 By James E. Lively Assistant Superintendent, Business Services. Fee collected /exempted by Shelley D. Bennett;` j Payment Rece%vec? -i :. Signature i-1 -Check Nfl. qc en Collector: Attach a copy of county or city plan check application form to district copy or alla: _waive Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting I