PLBG (9802-135) + SFD (10319)52280 Avenida Madero
9802-135
10319
LICENSED`CONTRACTOR DECLARATION.
I hereby affirm un ler, penalty of perjury that I am licensed under provisions -of
Chapter 17 (comm4cing with Section 7000) of Division 3 of the Business and
Professionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
;
J 31 3. A 10131;
-
Date gnature of Contractor
r l
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 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 & Professionals Code)., .
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
() I am exempt under Section , B&P.C. for this reason
Date Signature of Owner
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.
60A 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 & policy no. are:
Carrier Policy No.
S`t'ATH FUND 1154612-97
(This section need not be completed if the permit valuation is for $100.00 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, and agree that if I should become
subject to the workers' compensation provisions of Section 3700 of the Labor
Code, I shall fo hwith comply with those provisions.
/'Date: Applicant
V
Warning: Failure to secure Workers Gompensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $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.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
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 applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
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 State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
Signature (Owner/Agent) - '' Date
PERMIT# CONTROL#
BUILDING PERMIT x
DATE VALUATION LOT 91M24X TRACT G5$7
_.
2/26/98 u.400.00
JOB SITE } 1;
APN
ADDRESS,w
52-280 A.V''ENiDA MADEf-to
I . '773-242-005
OWNER
CONTRACTOR/DESIGNER/ENGINEER
AL (iOVAR
JAMES R. MASON
522$0 AV'E11%DA 114ADER0
75745 VfA MELODiA .
LA t2Z.i1`i JTA CA 92253
PALM DESERT CA 922,60
(619)5(4-2430 CBL# A W
USE OF PERMIT
SEPTIC ABANDON - SEWER HOOKXP
'V'ALUATION 1,400.00 LS
I
EST INIA 'ED COST OF CONSTRUCTION
1,4041.01)
VERMff FEE SUMMARY
PLUMBING ,FEES — SEWER 10:1-000-419-000 t 0:037"
r >K
c
W
SUB -TOTAL CONSIRUC7110N IAND PLAN CHECKOAM.
LESS PRE -PAID FEES
$1:.00
TOTAL PERMIT FEES DUE NOW
S30.00
RECEIPT
DATE
BYf f J f
DATE FINALED
INSPECTOR
INSPECTION' RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
r;lab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
POOLS - SPAS
BLOCKWALL APPROVALS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final I
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
App''ances
Final
COMMENTS:
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
F'rdures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COACHELLA VALLEY WATER DISTRICT + y ry
CASH RECEIPT DETAIL
I Received From: f.
Date J n
Address: i GG//
LI)66-
Account No L4t(s)1 Tra t
Service Address A71L y G.A. Code
i
❑ Meter(s) $
❑ Service(s)
❑ .Backflow(s) 4 ,
❑ House Laterals)
❑- DetectorCheck(s)
❑ Meter Surcharge
XSanitationCapacity Charge Ski51,
c
(. ❑ W.S.B.F.C.
f ❑ Temporary Construction Meter
❑ Turn on Charge
E.' ❑ Uncollected Account - Name
❑ Inspection Fee -Tract -
R
Fee -
❑ Plan Check Fees Water I Sewer -
Tract -
❑ Bond Payment - A.D. - Bond
'
Assmt.
f
f
❑ Customer Deposit
❑ Other
TOTAL $ l ]
i" Remarks:
❑ Copy to:
.
i'
Cash—'qWater
G
Service
f
Check
/ 1
";. Cashier cr,
Money
Order
t
r CVWD-A3a
`
r r "
c
SANCO ,
PUMPING SERVICE ( 2502 Morongo Trail
';Palm Springs, CA. 92264
(619)327-8859
s,
SO7,TO
SHIPPED TO +
TERMS•.DATE
S REET NOV STATE
STREET NO.
CITY TATE ZIP,
CITY STATE ZIP
MSALESMAN
CUSTOMER
/
ORDER
TERMS•.DATE
j
MSALESMAN
i
at p i
J.. oe
J.'
:. Y ..flr '
Nk
.P t
It v
!
t ' , ' .
••1:X . Ar; y: tat
x 'i . 4. Yea Y-
1
C
'- ,, PAYMENT 'DUE UPON RECEIPT'r
f
' + t 1 w ''' c3 i., r t .kP r -,n..{' r •tG a t t fi r ' Y
.:.e...:....a...1.'4:.t13!'!..r`"9 iXn, :n:, i TC rt:w a,x:+n•.... t. .l..k.: u.:.r ,.. ..•tt .:a.,.:. . :. ic 47'" 0. .. a f :....d•r, .;_t-.'.Ytk. .fir#,!R,:;a.su.". :..^• .c x. _.~,. .,-.r :,ems..... -r.
Building
Address 52-:2$0 Madero
Owner -
ExDec a` ions
Mailing
Address =4360 :7arii i ez
City Zip
LaQ°s nta 92253
Contractor
Same i
Address ,
City Zip
State Lic.
& Classif. ' ;.B 13Q6
Arch., Engr.,
Designer -
Address
City Zip
I hereby affirm that 1
7000) of Division 3 of i
7&105 CAL LE ESTADO O ( 10'319,:
LA QUINTA; CALIFORNIA 92253
BUILDING: TYPE CONST. OCC: GRP..
A.P. Number
Tel
564-0793 Legal Description '
Project Description • SFD
Tel.:
City
Lic. # 0105
Tel'
I
State
LIC. # -
i'DECLARATION - •
of Chapter 9 (commencing with Section
Code; and m^yiaens4 is in full force and
oaTF
Sq. Ft. .1557
Size -
No.
Stories
•
No. Dw.
Units
New ❑ Add 0" Alter ❑ Repair ❑ Demolition ❑
Perm t does not include block w411 or
pool
+x'
OWNER -BUILDER -DECLARATION '
I hereby affimn 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, after, Improve, 'demolish, or repair any structure, prior to its issuance also
- requires the applicant for such permit to file a signed statement thathe 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-
rlor 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 hundied dollars ($500).-
❑ I, as owner of the property,•or my employees with wages as their sole compensation, will,_
- do the work, and the structure isnot intended or offered for sale. (Sec. 7044, Buisness.and
-Professions Code: The Contiictor's License Ld 'does not apply to an owner -of property who..
•.builds or. improves thereon and who does such work himselforthrough his "own -employees,
r, provided that such improvemeniV ie not iintended or offered'.for safe. If,.however, the building ,
i _ or Improvement is sold within one year of completion, the owner -budder will have the burden .
of provingthat he did. not build of improve for,the purpose of sale.), -
Estimated Valuation r 6 i o ;
- PERMITr s , AMOUNT'
-
Plan Chk. Dep. -- •.250-00'
Plan Chk. Bal. - 278 . 8'$
COr1St. ;. t
° - - - 6 2 1 450-
Mech. -t}g • '
"
Electrical' • O
,
x..Plumbing + 160 0 5. .
O I, as owner of the property, am exclusively contracting with licensed contractors to con-
`. rstruct 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).ficensed pursuant to the Contractor's License Law.) .
❑ I am exempt under Sec. B: 8 P.C. for this reason
" S•M•I: •- - 9 • 60 '
Grading . Ott _
,
Driveway Enc. 20.00
Date owner
Infrastructure 2020 > 34
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.) -
+ 1 x. k t _
i
P019*
Pollc,,y No. .Company
Copy is filed with the city. .❑ Certified copy is hereby furnished.
TOTAL - 3558332 .• 3309.32
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
REMARKS',
.j J 1,1tp.-
j-, r( j Al:
' (This section need not be completed if the permit is for one hundred dollars (S100) 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.
ZONE: BY: - -
Minimum Setback Distances: w -
FronfSetback from'Center Line
Rear Setback from Rear Pr'op.'Cine
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.) - -
Side Street Setback from Center -Line"
-, Side Setback from Property.Line •
Lender's Name
Lender's Address-
FINAL DATE INSPECTOR 1'
r a .
ISSUed b Date `" "• Permit'
y. .•
Validated by:
' - 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 infonoation•is correct.
' 'I agree to comply with all city and county ordinances and state laws relating to.building
construction, and hereby authorize representatives sof this city to enter the above-.
mentioned property for inspection purposes.-
' Signature of applicant Date
Mailing Address
_
Validation* i ,•
' City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SQ. FT. ®
CARP. SO. FT.
WALL SQ. FT. ®
SQ 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
ROUGH PLUMB.
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GAS (ROUGH)
LAUNDRY TRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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.
SO. FT. ® c
BATH TUB
BOND BEAM
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1% c
SEWAGE DISPOSAL
LUMBER GR.
SO.FT.GAR ® 3Sc
HOUSE SEWER
FINAL
3
ROOFING ' D
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 5 Q/
`
GROUND PLUMBING
RGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
WS R SEPTIC TANK
12,ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL 7
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP. LV
FRAMING / l F L
FINAL
3
ROOFING ' D
/I//N►SP.
O
^O
49
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LA I G t' 2[ (
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION C Ot
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
1.
- P.O. BOX 1504 - APPLICATION ONLY
Building // Q '78-105 CALLE ESTADO
Address g V //Il r4//GICs U LA QUINTA, CALIFORNIA 92253
Owner
47
Mailin UX I // / lel O /j J1 . BUILDING..- TYPE -CONST' OtCC: GRP.
A Address s tet• t oZT i'! //' Z—
/ A.P. Number
City Zip,Tel.., _ - --
` C (JIIn c i ! S3 J6 ` — 793 Legal Description
Contractor
- Project Description
i Address •
..City _
State Lic.
& Classif.
Arch., Engr., -
Designer•-_
Address
IZip ITel..
City
Y06-
City
06-
City - --
Tel.
Zip State -
Lic. #;
LICEN EDCONTfiACTOR .DEF}AR& ON.- -
Sq. Ft. No. No. Dw.
Size- Ss 7 _ Stories..,. -- -/: Units
New ❑ Add ❑ _ Alter, ❑:...-_,_ ,Repair.❑ ....-_ __..Demolition:❑ _
I hereby affirmSifat I am lice sed under provisig s q C ap l? 9 (commencing with Section
of ivisio 3 e Busine and rofess n de, n my license is in full force and
effect.
i effect. -- _
....-
-
P SIGNATURE - DATE
' OWN ER- BUILDER DECLARATIOti' -. -
I he ffirm that I am exempt from the Contractor's License Law for theeffollowing
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 lo,its issuance .also
. requires. the applicant for such permit to rite 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 lora permit--.
subjects the applicant to a civil penalty of not more than five hundred dollars.($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will
`do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Professions Code: The Contractor's License Law does not apply to an owner of property who f!
builds or improves. thereon and who does such. -work himself or through his own employees,.
provided that such improvements are not intended or offered for sale. If, however, the building
or Improvement 1s sold within one year & completion, the owner -builder will have the burden
„ of proving that he did not build or improve for the purpose of sale.)
Estimated Valuation
-^- PERMIT —
Plan Chk. Dep. .
Plan Chk; Bal.
Const.
Mach.
1 Electrical
Plumbing
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and -Professions Code: The Contractor's License Law
does not apply to an owner of property, who, builds or improves'thereon,•and who contracts for "
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ i t d I __ _ -
S.M•j• -
Grading_
AMOUNT'
_ 7 - -
am exemp un at Sec. B. & P.C. for this reason
-
Driveway Enc.
Date Owner - t
, -Fsfrastructur ZI
WORKERS' COMPENSATION DECLARATION.
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
a,
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
-
o
005 i$z 10 54 1-,05-9,44, i A
Policy No. .Company-• -
IV ta"Jrl 1 1 Li I i
opy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL
- - - CERTIFICATE OF EXEMPTION FROM
WORKERS'COMPENSATIONINSURANCE
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 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 California.
of
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
I hereby affirm that there is a construction lending agency for the performance of the
from Center Line
- - - -- - -
whic
work for Wthis permit is issued. (Sec. 3097, Civil Code.) I
Side Setback from Property Line
Lender's 'Name
y
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.
-
- 1, - - - - --- --- - -
I certify that I have read this application and state that the above Information is correct.
Issued by: -
I
Date Permit -
I agree to comply with all city and county ordinances and state laws relating to building
-construction, and hereby -authorize representatives -of this city to enter the above-.
- - -
mentioned property for Inspection purposes. -
Validated by:
Signature of applicant Date
.Mailing Address -
Validation:
t
City, State, Zip
- - - - - - --
BUILDING DIVISION
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
2ND FL. SO. FT.
POR. SQ. FT. ®
GAR. SQ. FT. ®
CAR P. SQ. FT.
WALL SQ. FT.
SQ. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
r
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 APPJEOUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
9 1
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 ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/4c
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 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
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 12/27/91
No, 11076
Owner Name Expectations
Type of Permit I La Quinta
Permit #
Log #
No. 52280 street Madero
City La Quinta zip 92253 Study Area 112
APN # Tract # Lot # Square Footage 11557
Type of Development I 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:
This certifies that school facility fees imposed pursuant to Government Code 53080
in the amount of 1.58 X 11.557 or $ 2,460.06 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 Expectations Construction
Name on the check
By James E. Lively
Assistant Superintendent, Business Services
Telephone 564-0793
Fee collected /exempted by `1iC ie J. Durrett43
Payment Recei edf ^'°
Signature f, '
C60, 6 x`00 .:C7J i
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
CALVIN. C. KAMINSKAS T ! r s DAN RILEY
Asslslonl Cominlssloner, 0 Sealer. Welghls & Measured
(714) 275-3000 (7141275-3 1 030 .
41
OFFICE OF
AGRICULTURAL COMMISSIONER
JAMES O. WALLACE, Commissloner. i
83-612 Avenue 45 Suite 7
Indio, CA 92201
(619) 342-8291 -
DATE Q p CASE N17. G• R a 9
DEVELOPER''S NAME: GYM Sx. L Mzv/ AL 41 12
ADDRESS:
GA-C; L; n1i GA5
TELEPHONE (16*) .S C-- D
Lof 9 L oJe Kee p . lef 11 19,pek3r Glkl &-1.20 &eele/SY 6WavA0. .
Lo-l.2t 6pd. es. 9uaoo td-S— aQ_ l Ma, i&o Lof,3 Ooals7 earn,Nua
LailB 9/ork,3/ M&Aw Ld l7 6"Y juma td-l( Wu"alo
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.
Agricultural Commissio is Office
cc: Indio and Riverside
_ 4080 LEMON" STREET, ROOM 19, RIVERSIDE, CALIFORNIA 92501 - FAX (714) •275-3012