BLCK (07-2406) + PLGB (10471) + PAT (001700) + SFD (001649)53405 Avenida Madero
07-2406
10471
001700
001649
P.O. BOX 1504.
78-495 CALLE. TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 07-00002406
Property Address: 53405 AVENIDA MADERO '
APN: 774-033-018-10 -000000-
Application description: WALL/FENCE
Property Zoning: COVE- RESIDENTIAL
Application valuation: 320
T4t!t . 4 4-Q"
Applicant: \. Architect or Engineer:
- - --LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 Professionals Code, and my License is in full force and effect.
License Class: License No.:
Date: Contractor:
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 kits 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 70001.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 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.). -
(_) 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.).
(_) I am exempt under Sec. , B.&P.C. for this reason
Date: ,90% U7 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
Owner:
LINCOLN ROBERT W
53405'AVENIDA MADERO
LA QUINTA, CA 92253
(760)564-2801 ,
rrf _)
Contractor:Owner .
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
AUG 2 7 2001
u' of La Ot n.., _
Date: 8/27/07
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:
_ 1 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 - - - - - - - - - - - - - - - - .-- - - - -- Policy Number
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 shat ith comply with those provisions.
Date Applicant: 7
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 ($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 oromission 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 constru tion, and hereby authorize representatives
of this count to enter upon the above-mentioned property for ins pur
Date: Signature (Applicant or Agent):
Application Number . . . . 07-00002406
Permit WALL/FENCE PERMIT
Additional de_s_c
Permit Fee 15.00 Plan Check Fee .00
Issue.Date• . . .. Valuation 320
Expiration Date 2/23/08
Qty Unit Charge Per Extension '
BASE FEE 15.00
----- -.----------- ----------- -------
Special Notes and Comments
20 LN FT X 4 HT RETAINING WALL PER CITY
f STANDARDS
Fee summary Charged Paid Credited Due
-7 -------- ----------
Permit Fee Total 15.00 00 .00 15.00
Plan Check Total .00 .00 .00 .00
Grand Total 15.00 .00 ..00 15.00
LQPERMIT
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City of La Quinta
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit # j _
�j lD
u
Project Address:'
Owner's Name:
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor:"t
��✓ d(/-
Telephone: 162 p
Address:
Project Description:
City, ST, Zip:
//
Telephone:
�z-7e—e,00
a
State Lie. # :
City Lie. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lie. #:
Name of Contact Person:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Stories: # Units:
Telephone # of Contact Person:
P
B�
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE ~
N
Submittal
Req'd
Recd
TRACKING.
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"d Review, ready for corrections/issue
Electrical
Subcontac tor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
"d 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
OWNERBUILDER INFORMATION
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of the property
improvements specified.
For your protection you should be aware that as "Owner/Budder" you are the responsible party of record on such a
permit. Building permits are not required to be signed by property owners unless they are personally performing their
own work. If your work is being performed by someone other than yourself, you may protect yourself from possible°
liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license
from the City or County. They are also required by law to put their license number on all permits for which they
apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be
aware of the following information for your benefit and protection.' „
If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is $200.00 or more for the entire project, and such persons are not licensed as contractors or
subcontractors, then you may be an employer.
If you are an employer, you must register with the State and'Federal Government as an employer and you are subject
to several obligations include State and Federal income tax withholding, federal social security taxes, worker's
compensation insurance, disability insurance costs and unemployment compensation contributions.
There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with
respect to worker's compensation insurance.
For more specific information about your obligations under Federal Law, contact the Internal Revenue Service (and, if
you wish, the U.S. Small Business Administration). For more specific information about your obligations under State
Law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions'.
A frequent practice of unlicensed persons professing to be contractors is to secure an "Owner/Builder" building
permit, erroneously implying that the property owner is providing his or her own labor and material personally.
Building permits are not required to be signed by property owners unless they are performing their own work
personally..
Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your
community or at 1020 N. Street, Sacramento, California 95814.
Please complete and return the enclosed owner -builder verification form so that we can confirm that you are aware of
these matters. The building permit will not be issued until the verification is returned.
Very truly yours,
-10471.
k,'78-105 CALLE ESTADO,
P.O.. BOX 1504
Building t
Address 53-405 Madero' -
;,LA QUINTA, CALIFORNIA 92253
Owner
Mr. And mrs..,Robert Lincoln
Mailing BUILDING: TYPE CONST. OCC: GRP.
Address ' same - 774 -633 -018 -
City Zip . .
La Quint 92253
i a
Contractor—
Econo Sewer' Service
Address
68415 Perez Road
City Zip
. Cat. f_:_i ty
State Lic.
& Classif. 1480961
Arch., Engr.,.
• Designer
Address
92234
Tel.Number
Legal Description
Project Description Se,wer Hook Up'
I ei.:
346--.2793
City
Lic. # .342.
no
Sq. Ft.
Size
NO
Stories
New 0 Add 0 'Alter- d
No: Dw.
Units v,
Repair 0., 'Demolition 0'
City
Zip.
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
Ihereby affirm.that I am licensed under provisions of Chapter (commencing with Section..
.7000) of Division 3 of the Business drProfessions Code, and my'license,is in full force -
and
effect...
SIGNATURE- f DATE
OWNER -BUILDER DECLARATION,'
the followin g
Estimated.Valuation.
r reason: (Sec. 7031.S,Buslnessand ProlesslonsCode: 'Any city -or county which , ,
requiresa
'°peimlt to construct, alter, Improve, demolish, or repair any structure, prior .to its Issuance also
licensedr r f'.requlres the applicant/or such permit lo./!le a signed statement fhathe.is pursuant to
PERMIT AMOUNT
..the provisfons o/ the Contractor's LlcenseLaw, Chapter 9.(commencing with Section 7000) of
-' Division 3 0l the Business and Pio/esslons Code; or that. he fs exempt therelrom,-. and the basis
for a• permit.
Plan Chk.'Dep:
subjects the applicant to a civil penalty of not more than /ive hundred dollars.($500). " '
or
Plan Chk. Bal.'
my employees with; wages as their sole ensatiorf, will
.
t structure is not intended oroffered for sale. (Sac: 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,
'Me,ch"
provided that'such impiovements 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 Irnprove for the purpose of sale.)
0 1, as owner of the property, am,exclusively contracting with licensed contractors to con-
Plumbing:-- 30.,00-
struct the project. (Sec. 7044. Business and Professions Code: The' Contractor's License Law
does not apply to an owner. of,property -who builds. or improves thereon, and who contracts for
S. M. I.
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
0 1 am exempt under Sec. B. & P.C.-for this reason
Driveway Eric,
Date -Owner
Infrastructure
WORKERS' COMPENSATION DECLARATION' .
I hereby affirm that I have a certificate of consent to self-ihsure, ora certificate of
Worker's Compensation Insurance, ora certified -copy thereof- (Sec. 3800; Labor Code.)Policy
No. . company.
0 Copy is filed with the city.. 0 Certified copy is.hereby furnished.
TOTAL $u•UU
CERTIFICATE OF EXEMPTION FROM
REMARKS
WORKERS' COMPENSATION INSURANCE
be
.7 V
(This section need not completed.!/ the permit is for one hundred dollars ($100) valuation
or,less.)
I certify that in the performance of thp 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 i of 'Exemption you should r 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.
MinimumSetback.Distances :--
-Front Setback from Center Line
r.
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 isissued. (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 INS•
PECTOR.
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.
Issued by: Date Permit--'
I agree to comply with all -city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter the -above-.
mentioned property for inspection purposes.
Validated by:
Signature of applicant Date'
Mailing Address
Validation:
City, State, Zip
J
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT, ®
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. SQ. 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
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L 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, 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
SO.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
SEWERS
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- D
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
. • Y y
Building
Address 53-405 *9 t3
Owner a
Mailing
Address
City SAME .Zip
LA OIITNTA 922°
Contractor
-t1T;if<2}71? 9'% T:£tirdf2 -
Address
City Zrp
. • tIG1 GrCV' •.
P.O. BOX 1504 N o. r .05371.
3.
78-105 CALLE ESTADO-
LA QUINTA, CALIFORNIA 92253
BUILDING: TYPE CONST. - OCC: GRP.
A.P. Number
Tel—
Legal Description
Project Description-- 2AffT AT.Of-7 TATJ. til t3Tt'R
Tel.:
u
State Lic.
City
& Classif.
Lic. #
Sq. Ft.
No. No. Dw.
' Arch., Engr.,
Size
'•Stories Units
Designer.-
New Add ❑•;, Alter ❑ 'Repair ❑ Demolition,❑
Address ,...:,•
Tel.
City
Zip
State
'
Lic. #
,. LICENSED CONTRACTOR'S DECLARATION -•
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
• 700lp of Division 3 of the Business and Professions Code,'and my license is in full force and
effect. r' ft
•%DATE
a T
SIGNATURE X•,- -" '`+
" -
' ;OWNER -BUILDER DECLARATION
Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following.
-4
6,500
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
- -'
permit to construct, after, ftnprove, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to !de a signed statement that he is. licensed 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 .
Plan Chk. Dep.
- • - '
' subjects the applicant to a sail penally of not more Man five hundred dollars ($500).,
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will
Plan Chk. Bal.
do the worts, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Const:
Professfons Code: The Contractor's License Law does not apply to an owner of property who.
.;
builds or, improves thereon and who does such work hanself or through his- own employees,
Mech.
provided that' such improvements are not intended or offered for sale. If, however, -the building
,
or improvement is sold within one year of completion, the owner -builder will, have the burden
Electrical
_
of proving that he did not build or improve for the purpose of sale.)-
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
-• Plumbing
L .
struct the project. (Sec. 7044, -Business and Professions Code: The Contractor's License Law.
,
does not apply to an owner of property who bua7ds or improves thereon, and who contracts for
S.M.I.
• ,
such projects with a contractor(s),8censed pursuant to the Contractor's.License Law.)
❑ 1 am exempt under Sec_- - R• a P.C. for this reason
Grading
<!• - *i
Driveway Enc.
Date") -`' "Owner 3 .' / f a# `n %'
Infrastructure
1• WORKERS' COMPENSATION DECLARATION
t' 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.)
PolicyNo .Company
r ,
❑ Copy is filed with the city. ❑ Certified copy is hereby fumished.
'
TOTAL
ri.49
CERTIFICATE OF EXEMPTION FROM
REMARKS
WORKERS' COMPENSATION INSURANCE
• .,'(This section need not be completed if the permit is for one hundred dollars ($100) .valuation
§ ♦ 1} n s
"'•31 w'1?" $'%t XMa-..
`., or less:) - .. -
I certify that in the performance of thg work for which this permit is issued; I shall not
A •a 4 rss.• r i A, Sa a n ce,. . r 4
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 orMfsPermit she(]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, CM Code.) - ; }.
Side Setback from Property Line '
Lender's Name
Y '
Lenders Address
This is a building permit when property filled out, signed and validated, and is subject to
•,FINAL DATE
INSPECTOR
expiration if work thereunder is suspended for 180 days. ••
I cern that I have read this
h application and
? r
a r /t 9
state that the above information is correct'
"I agree to
Issued by:'
Date permit
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.. , _ y
Validated by: -
`p fr.
Signature of applicant Date
3Validation:
) s
,,Mailing Addres
. . City„ State, Zip
`
w` -JI 1 +J t , M ] f ,. 1.4 i,r. a e 4 . 5 f.' y S r -f
9 .. _v . ?L .'f :;:.. .. r_... ,Y4:" 4- •l r: _ : _ e.4. ...
air.: t; N' ,, va - ..3 w . 4 t r. • i 4 ,.
< n. :r'.':4 +F. rvi .•t„ .:. ro_ '- -x. .Y.... . _'u . _ .. ,' f at'
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
SLAB GRADE
2ND FL SO. FT. @
BONDING
YARD SPKLR SYSTEM
STORAGE TANK
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. (off
DUCT WORK
ROCK STORAGE
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
OTHER APP.IEOUIP.
DRAINAGE PIPING
CAR P. I SO. FT. ®
TEMP. POLE
WALL SO. FT.
GROUT
DRINKING FOUNTAIN.
SO FT ®
FINAL INSP.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
WATER PIPING
NOTE: Not to be used as property tax valuation
_$
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
VENTILATION
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
GAR. FIREWALL
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® V4c
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.IEOUIP.
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
Building
Address 53-405 A
Mailing - ' -
Address g p
City Zip
X10 . 52202..
Contractor
• l ioftism owa .
Address
City . _ _ IZip ...
P.O. BOX 1504NO.
78-105 CALLE ESTADO
LA QUINTA; CALIFORNIA 92253
BUILDING: -TYPE CONST. OCC: GRP.
A.'P. Number •f -•Q3 =-SIAL
Tel.
lot 10
-- Legal Description
Project Description ratio
cbVew
Tel.. ..
State Lia
City
& Classif.
Lic. #202
Sq. Ft.
Size- 2
No. No. Dw.
Stories Units '
Arch.;-Engr.,
Designer
New Add ❑
. Alter ❑.. Repair ❑.: Demolition ❑
Address {
Tel.
r
City
Zip
State
Lic. #
LICENSED CONTRACTOR'S_DECLARATION ;.
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section.
7000) of Division 3 of the Business and, Professions Code, and my license is in full force and
effect: r,• i.... C r i
i / ' !zr I r' ,• l,r ; /
... .. ..
..... .. .. - .. .. ,
SIGNATURE P DATE
OWNER;BUILDER DECLARATION ' -' :
I hereby affirm that I am exempt from the Contractor's License Law for the following.
reason:.(Sec. 7031.5,Buslness and Professions Code: Any city or county 'which requires a
Estimated Valuation
ri .1wi
F al .00
-
.:..PERMIT
"' AMOUNT
permit to construct, alter, improve,. demolish, or repair any structure,''prior.- -to is 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 ol'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 iora'.permit
subjects the applicant to'a civil penalty of not more than five hundred' dollars (8500).. - .. ". . :
O 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: 7644, Buisness and
Professions Code: The Contractor's License Law does not apply to an owner of properly who
-.r •
Plan Chk..Dep.
-
'
-
Plan Chk. Bal.
lira'
COf1St.
q
- 313.W
Mech.. '
.
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 .'
EIQCtrICal
_
'
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.) _ _ _
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
S.M.I'.
-
- - -- -
•• 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
Grading
-
Driveway Enc. '
Date owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
' I hereby'affirm'that I have 'a certificate of consent to. self- insure; or'a certificate of
n
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
64.02
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
REMARKS
(This section need not be completed it 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.
ZONE: BY:
-
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear. Prop. Line
colusTRucrlotu 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 frOfTl Property Line
Lender's .Name
Lender's Address
FINAL: DATE
Issued by:
Validated by:
Validation:
A2501
INSPECTOR
Date Permit
9 4'. 64,02 R
' 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.
1 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. J-
Signature of applicant st' "'3,r4'• /." iF f Date -le lam` 1
Mailing Address
City, State, Zip e'
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEESNO.
PLUMBING FEES
IST FL. SQ. FT. ® $
2ND FL. SO. FT. ®
FOR. SQ. FT. ®
GAR. SO. FT. ®
CAR P. SQ. FT. ®
WALL SO. 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
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEOUIP.
LAUNDRY TRAY
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.
SQ. FT. RESID ® 11/e c
SEWAGE DISPOSAL
SQ.FT.GAR (off 3/ac
HOUSE SEWER
REMARKS:
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 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
INSULATION/SOUND
FINISH GRADING
INALINSPECTION ,O
CERT. OCC.
FENCE FINAL
TUK'5 blUNAIUXE5/1NITIAL5.
GARDEN WALL FINAL
QUM&
P.O. BOX 1504 No.. 0023.91.
Building 78-105 CALLE ESTADO
Address 53""4-05 AVeAda M&M.' LA QUINTA, CALIFORNIA 92253
Owner
Linl=Ln
Mailing
Address Sam
City Zip Tel.
Contractor
- Address _
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number
Legal Description f%
Project Description
City
Zip ..
Tel.. .
927.01
564-2228
State Lic.
& Classif. f [ %<
City
Lic. # -
Sq. -Ft.
Size
No. No. Dw.
Stories Units
Arch., Engr.,
Designer
''New CC -C - Add ❑ Alter ❑' Repair ❑ •" . -Demolition ❑
Address
TeL
City
_ .
Zip
State
#
50 " n.
Un.
f.. of 6'°' $ bti wood
_..
.. 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. ..N. . Fr` i\ - A/' .. ( . . . . . ..
..
.. -.. _ ..
SIGNATURE r %___ - :. . ... .r-. r;ti... DATE
OWNER -BUILDER DECLARATION
I hereby affirm.that I am exempt from the Contractor's. License Law for the following
p00
reason:. (Sec. 7031.5,Business and Professions Code: Any. city or which requires a
ermit. to construct, alter, improve, demolish, or repair any structure, prior to its issuance alsoAMOUNT
requires the applicant" forsuchpermit to file a signed statement.that be 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 toa 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
Estimated Valuation
. ,.
` '
'PERMIT- "
'
--
-.Klan ' Chk. Dep.
- - -
-
Plan Chk." Bal.
ConSt.
- •
yt
f .efv.;
.Meeh.
"
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 '
- 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 of sale.)
Plumbing
j D 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.)
" D I am exempt under Sec. B. & P.C., for this reason
S.M.I. •. ..
-
-
Grading
Driveway Enc.
Date owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
` I h"ereby affirm that I have a certificate of consent to self -insure, or a certificate of.
Worker's Compensation Insurance, ora certified copy thereof. (Sec..3800, Labor Code.)
' Policy No. Company
❑.Copy is filed with the city. .❑ Certified copy is hereby furnished.
TOTAL•
CERTIFICATE OF EXEMPTION FROM •
WORKERS' COMPENSATION INSURANCE
REMARKS"
(This section need not be completed if the permit is for -one -hundred dollars (5100) valuation
. , or less.) .. - .. ._ .. ..
I certify that in the performance of tha 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 Oviner
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 Disfarices: -
Front Setback from.Center. Line
Rear Setback from.Rear Prop. Line
CONSTRUCTION LENDING AGENCY
I hereby affirm that* there is a construction lending agency for tfie performance of the .
work for which this permit is issued. (Sec. 3097, Civil Code.)
a
Side Street Setback from Center Line
$Iris 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
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 agreeto 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 di--' `-- - 1 ' ;'L..
FINAL. DATE
Issued'by:
Validated by:
Validation:
INSPECTOR
r_ .
- - Date Permit
City, State, Zip
A 5 7 0 9
6 3 20.60 7
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. @ $
2ND FL. SQ. FT. @
POR. SQ. FT. @
GAR. SQ, FT. @
CAR P. I SQ. 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
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 APP.IEOUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
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
SQ. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 1//a c
SEWAGE DISPOSAL
SQ.FT.GAR @ 3/ac
HOUSE SEWER
REMARKS:
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 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
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
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
INSULATION/SOUND
FINISH GRADING
`
7 &INAL INSPECTION t
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
P.O. BOX 1504 NO. 002338
Building 53-405 AV LA QUINOTAC
Address CALIFORNIA 92253
•
Owner
LiTKxdn
Mailing
BUILDING: TYPE CONST. OCC: GRP:=
Address
SUM A.P. Number 774-0313-018
City Zip .Tel.
Quinti ..: 922S3 564 -:Ml, Legal Description
Contractor ,
`ieaU St: y _ Project' Description
Address .. •...
74-1.33 • E Paseo, Suite K
City' Zip ...... - . Tel...
State Lic.
City.
& Classif. A 359105
Lic. # 1 _
Sq. Ft. • ' No. No. Dw.
Size _ -Stories - Units
•
Arch. • Engr., -.... r .. ..
Designer
NeW'E Add ❑ 1, Alter ❑ -Repair ❑.• Demolition ❑ '
Address
Tel.
CityZip
State
20 X 40 "PWI.. _
_ ....... .. ......
Lic. #..
_ LICENSED CONTRACTOR'S DECLARATION_ M
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
-• 3-•. OWNER -BUILDER DECLARATION
''1 hereby affirm that'l am exempt from the Contractor's 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-Buslness and Professioris'Code, oi'that. he is exempt therefrom, and the basis' -
'. for the .alleged exemption. Any violation •o! Section 7031.5- by'any 'applicant '- for -a permit'
' subjects the applicant to a civil penalty of not more than rive"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_propertg who
Estimated. Valuation c
d
• • 7 s .-
-
-.PERMIT .: ".AMOUNT
.•r.• • ,.'
• •... '
•. PlanChk..Dep. -zz
-
Plan Chk. Bal. '"
- 2 -
, - COnSt. -, -
-
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
• . ..
Electrical it
_ •
.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-
Strutt the project. • (Sec. 70441 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.) ; , • -
_p.1 am exempt under Sec.. B. & P.C. for this reason -
Plumbing 12X0
a
S.M.I. .67 -' -
G rad i Q
Dri 5
Date + Owner
f r re
WORKERS' COMPENSATION DECLARATION
' I hereby 'affirm that I have a certificate of consent to selKinsure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec: 3800, Labor Coda.)
-
• ' Policy No. Company .
❑.Copy is filed with the city. .0 Certified copy is hereby furnished. "
TOTAL
._ ..
t CERTIFICATE OF EXEMPTION FROM `'
_ WORKERS' COMPENSATION INSURANCE. -
REMARKS
(This section need not be completed if ' the permit is dor-one hundred dollars '($100) valuation
or less.)- .. .._ .. .. .. ._ _.
certify that in the performance of the work for which this permit is issued,I shall not-
^• .=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 Laboi Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked. - - '
ZONE: - BY:'
.Minimum Setback Distances: - -
Front Setback from Center.Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
• I fiereby affirm that thele is a construction lending agency for the peiformarice 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
FINAL DATE Y INSPECTOR `
_ ". F
Issued by.. Date +Permit -
.
Validated by:
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. / /.i,r
.... .r
Signature.of applicant— %-' + Date
Mailing Address f` -'
Validation:
A(5}4'4181 ' 4. 219'. 1t615•4;9' Sl
' City, State, Zip
- HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMB1,NG FEES ,
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT. p
POR. SQ, FT, ®
GAR. SQ, FT, ®
CAR P. SQ. FT.
WALL SO. 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
ONDING t / 30 f
v
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 APP./EOUIP.
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
SO. 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
fjyROUGH PLUMB. L
ONDING t / 30 f
v
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./EOUIP.
REINF. STEEL Q
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
INSULATION/SOUND
FINISH GRADING
I'
y FINAL INSPECTION
r'
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES11NITIALS
GARDEN WALL FINAL
07-1
74.133 EL PASEO, SUITE.
PALM DESERT, CA 92260
"(619)345.5175
STATE LIC. IVO. A-359105
44
P.O. BOX 1504 No. ' 00164
Building 78-105 CALLE ESTADO
Address 53-405 ASFEr`d& Ya&m LA QUINTA, CALIFORNIA 92253
Owner Ri/ek oaM 0M
t.
Mailing BUILDING: TYPE CONST.- W OCC: GRP. R
Address P.O..B= 2288 A.P. Number 774333-019
City Zip FDXMD 92A '..;-4-2228Legal Description
Contractor Project Description Sizta3 P f0mila c a 13ayr
.Address ..y _
irR. V
CityZip'
Tel. "
ate'
State Lic.
City
& Classif.
Lic. #
Sq. Ft.
43
No. No. Dw.
Arch., Engr:;
Size,
-- Stories - Units
Designer
New Add ❑
Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
City
Zip
State
_ -
Lic. #-
_.
". LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions•of Chapter 9 (commencing with Section
7000) of Division -3 of the Business and Professions'Code, and my license is in full force and '
effect... ..'i
SIGNATURE y- DATE
OWNER -BUILDER DECLARATION
Estimated Valuation
I hereby affirm that 1 am exempt from the Contractor's -License Law for the following
e4 $ c•! .Cla'
d /
reason: (Sec. .703 1,5, Business and Professions Code: Any city or. county. which repuires ,a
permit to construct, alter, improve, demolish,+ or repair any structure, prior to its issuance also
f •€a3J
.y
requires the applicant for such permit to file a signed. statement that he is licensed pursuant to
•. PERMIT
c i•• 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 Any Section 7031.5 by 'any for
Plan Chk. Dep.
-
exemption. violation of applicant a•permit
subjects'the applicant'to,a civil penalty of not more than five hundred dollars (5500). ..'
❑ I, the
Plan Chk: Bal.
319.52
as owner of property, or my.employees with wages as their sole compensation; will
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Const.
Professions Code: The Contractor's License Law does not apply to an. owner of property .who379.(M
'
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
ElectricalQ
70.12
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-
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.I.5.71
such projects with a contractor(s) licensed pursuant to the Contractor's LicenseLaw.)-
Grading
❑ I amexempt under Sec. B. & P.C. for this reason -
Driveway Enc.
24.00
Date owner
Infrastructure
1.221.71
WORKERS' COMPENSATION DECLARATION
A 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. O Certified copy is hereby furnished.
TOTAL
2.135,.06
CERTIFICATE OF EXEMPTION FROM
REMARKS,
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars (S 100) valuation "
or less.) - -
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 aconstruction 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 it 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' cityr to -enter the above-.
mentioned property for inspectiiomparposes. / %
Validated by:
"
1,41" Xr rr l: `
Signature of applicant r ff' Date
Mailing Address t"
'Validation:
City, State, Zip
A21"L"1
7 30 2 6 CK
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINq FEES
1ST FL. SO. FT. ® $
2ND FL. SQ. FT. ®
POR. SQ. FT. ®
GAR. SQ, FT, ®
CAR P. SO. FT. ®
WALL SQ. FT. ®
SQ. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
'
w
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 /
3
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP./EQUIP.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. 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 TLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
r ROUGH PLUMB. Fi
BONDING
HEATING (ROUGH)
STORAGE TANK
—FORMS /
3
p
SEWER OR SEPTIC I
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
INAL INSP. f%
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ —Plus—X$—=$
LUMBER GR.
r7FlNAL INSP. Iv I 5
FRAMING IgeYA,
)'
NAL INSP. /v / (,
ROOFING
VENTILATION
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING Z V
MESH
INSULATION/SOUND
FINISH GRADING
TI INAL INSPECTION 10 84<;
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
%f1Ep s
o o
— —0
r
Desert Sands Unified Schgol. District
A BERMUDA DUNES
RANCHO MIRAGE
82-879 HIGHWAY 111 ®INDIO, CALIFORNIA 92201-5878® (6 19) 347-8631'
' INDIAN WELLS , `y
. PALM DESERT a .'
f LA OUINTA
INDIO y
Juiy 29,' 1985
City'of La Quinta
Department Of'Community
Development
• 78-105 Calle Estado
La `Qui-hta' .CA -92253
-
Re 534o5::Madero La:
Qu inta,... Ca..
Gentlemen:
The. developer of the
above referenced 53405 Madero; La Quinta
Ca.
has , mi,ti.gated ,ts. impacts,
on our. overcrowded sch.00l's by -payment
of--.th'e- amount, of'$628.p
er unit to be`-appl_i.ed' to the cost of
-di'str'ct educational
facil i:ti;:es' made' necessary' by such. new
development;
'Si ncerely.
John' D. Brooks
'Assistant.. Sp pbrintendent
Busi ness,.;Serv:ces
fJDIB /crm
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EBVIEF C3V, C—_dObfl_. fl L_ T I C)9VS Z —=p4E
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t` 'f, sass° L+'.. ' :' .}, te'^r+'i+yr: ♦ y. .^' .. a , e -fy
BY,:' `KSUECOs `ENTERPRISES'
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'PROGRAM BY"40k H `NACKER;TCIVII ENGINEER, PALM—SPRINGS—CALIFORNIA
:
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'LAT IT•UDE '3.. 841' t"WIiNTER, TEMP. :1, :SUMMER TEMP. 110. DEG'
OWNER'
t------------ . ---------
JOB SITE. LOCATI01\1_:_,-
' - ---- -_ - - ,--------- - - - - - - - - -
AREA -°BLDG- 1440 SC.: P.T. .,
PERIMETER 148 SQ.FT.
.INSULATION R -VALUES ---SLAB EDGE = 0 .-=-GE i L I NG = 38 ---WALL , = 1 1 ' '
AREA ; OF NORTH 'GLAZ ING,= .48 SQ. FT.'---% OF TOTAL AREA = 3. 3333-_,
AREA.'OF,.` EAST GLAZ ING ` - :1 . SQ. FT. ---%/ OF TOTAL AREA = 2':<1870 .• ,:. ,,
q.
AREA•uOF ,SOUTl+- GLA Z ING , 34-, SQ. FT. ---% OF .TOTAL AREA = 2, 3,61 1 i
Y
AREA.' OF 'WEST ,GL:AZ ING $ - . 49 SQ. FT. ---% OF. TOTAL AREA—.3.40278 a:
P;REA yOF - SKY'L,I GHTS ` ; : - 0 ESQ. FT o - ,-% OF TOTAL AREA = 0
TOTAL' GLAZ.INGi AREA '°'` 162.5` SQ. FT. -%-OF TOTAL AREA - ;i 1.2847
THE U-VALUE-`,OFGLAZ I NG' I'S'*', --- (.65 SINGLE/PANE
•,T.HEw
_
THIS 61BLDG"USES 'A FLAT ''SHADING DEVICE (*) ON GLAZING (S . C. =. 33)
mini-blinds'';oll'er: shads;.'venetian blinds,l'ver•tic l blinds)
TIiE"",TOTAL S„ C 'OF,,-THE;,GLAZING IS. 1. ^9
SOUTH'. OVERHANG `LENGTH -,` 3> - -
I INI E I OR THERMAL MA AREA = 433 SQ FT ,
• A
ATTIC AREA, _ 1440 ': SQ 'FT-
s
INFILTRATION 'CONTROL (STD. /.018, I IED. /.014, TIGHT/.012)= . 014
HEAT ,'LOSS
FOOTING L.:OSS--'-=. "6464 n 64' •BTU/H
CEILING ' LOSS --='--'1"42.1•. 77 BTU %H
GLAZING LOSS_ ,4119.._,7 BTU/H —
WALL;rLOSS=--- , —_ 3187.08- BTU/H
INFILTRATION LOSS x:6289..92 BTU/H
TOTAL`IaEAT' 1_OSS ;E{TU/H?=.- 21481„8
GAS 'FURNANCE. SI ZE >3.5884'.-1 ,,'B7'U/H OR 45,000 'BTU/H. (OUTPUT)
HEAT, GAIN. uw'r •' a f
FOOTING GAIN-.,;af b•_ O'.4MBTU/H
CEILING`GAIN-=—= =''+1t4..58 X2'3 'BTU/H.
GLAZING GA I IN -=—=-+,7002: 11- • BTU/H
WALL. ,GAIN-.- '.---_- 3268.8 BTU/H
I NFI LTRAT,.I ON—'GAIN—=- 6451.2 BTU /H E
.
NUMBER 'QF PEOPLE., `-== ' 5 - :HEAT GAIN=--= 2000 BTU/H
KI TCHEN ' GA I N-`:-== '1500 BTU/H '
DUCT'GAIN INCLUDED IN TOTAL_
'TOTAL_ HEAT 'GAIN—=- 28310.7 BTU/ H
1:OMF'L I ANCE;, CHECK L I ST PER D I S I GN DATA
d
SI AB ' ON GROUND,' UND ,,'
—4 f"'U I Rll TS)
,, y•.
r
WAL_.L` . I NSLJLAT-ION ',
F'Cl I NTS
CE I L. NG' I NSUL_ATI OILI, '- :; •
0 POINTS
AT "f I C,
4 POINTS
NORTH WINDOWS GLA ZI NG
0 PO 1 IT'S
EAST—WINDOWS GL.AZ I NG2
POINTS
S0L)T.H "W IN D 0 WS G1...AZ I NG
C:) PC) I IVT':,
.
.WINDOWSGLAZ I NG %. •.
WEST"
—^ POINTS
Sk,YLIGHT GLAL-IIVG-,`.
i) F=DINTS
F_AST•;SHADING,COEFFICIENT
—1 POINTS
SOUTH •°-SF-IAD I IVG COEFf=ICI ENT
—1 POINTS
WEST +::SHAD I NG n. COEFF`I C I ENT
—? POINTS
NORTH - SHAD I NG' 'COEFF I.0 I ENT `
3 POINTS
SKYL'IGH':%SHADING'''COCF=FICiEr1T
0 POINTS
s
5
IIVFTLTFIATIUr1 .` _," =
—1 F'OIr1T'S
ti
a.• r
,
THERMAL= -MASS ,4 3 ;f'SO.•FT.
10 POINTS
SOUTH OVERHANG'"
PO NTS
HEAT' PUMP'
THE SEER OF THE `COOLING SYSTEM :I CG. 3
COOLING ",
1 POINT ; S
THE- ALL OWABL_'C ;POI NTS PRE Alit 16:7, FOR ZOIVE•: 15
r'1RE —.4
T HE -TOTAL ' PCM NTS' FOR. TH IS Pf ;OJE CI- ARE ` 3
THE' FOL-L.OW I r1G IIAND I TORY- FE:ATLJRI:-S / DE:V I CIES ARE
REL:,1_) I RED PER CAL..
I F. ADMINISTRATIVE'
CODE TITLE 24
INSULATION ' AS;,SPEC I1= I ED y PSR. -MAIM-1F= ACTURE:S
LABEL
I NE" I LTI;AT I ONS CONTROL-. ` DOORS, `WINDOWS FULLY
WE ATHE•RS'TR I PPED
'
OF'EIV I EVGas".CAL.JLk rEDi ANDD `,SEAL:ED AROUND " JO I N f S .
I N W I NDOW AND WALL_
SOLE ' PLATES AND
EL_ECTR'I C'' OUTLEV`4' AS' KETS ON -ALL. EXTERIOR WALLS,
'
MANUFACTURED kDOORS '-SHALL' MEET, APDL I CABL_E4STAI\JI)ARDS
PACk ;DRAFT _ ;DAMPERS UN -EXHAUST FAN
. .
F I REPLACES `-MUS T v',HAVE ; T',I GHT -'F I TT I NG, " CLOSEABLE:
DOORS COVER I NLi
FIREBOX
1=;ROt'IDEr<COr1i U.STIOhJ='AIR'" IIVT.Ak.:E.`DUCTS-{S"'SO.
IN.:) WITH TIGHT FITTING.
DAMPEN`.
DUCTS q, "BU I LLT : PER,'=`CHAF,'TER ',I O • U. I-l. C.
GAS,-FURNACE`' SI7_ED :<-0. t.'•,' DESIGN LO1.=3S 10
BTI_J/H PER SCI. FT. OR
45, 000 BTU/H
SETBACk;' "THERMOSTATS ,'SHALL 'HAVE AUTOMATIC SETBACk,'
CAPABILITY
/2 PERIODS PER 24 HR
WATER,HEATER 'J*O ' HAVE,-R--1. 2 r,:E NSULA'T' I ON WRAPPING,
AND R-3 ON FIRST
5 ' OF, P I PE
r.)A'TUR L GAS' ANDS _5A_L HAVE I NTERrI Tf
ENT IGNITION )EtICE
,
L I GWT F%-:I1\11' KI TCHEN-AND' BATH -1-O DE AT LEAST' '.:_'S
LUMEIVS/ WATT • EXCEPTaPL-..0
I F I C• TASk:. l AS
,
CERTIFIED LAY s OAAR;
C=" __,_ ENTERPRISES LIC. # C20
471337
_SUECO
FOR: 'JOHN H., HACL;ER REGISTERED TML ENGINNEEk 414614
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a tk FEW,
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