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RR (06-0930) + BLCK (13306) + PLBG (12651) + RPL (12650) + AR (12613) + BLCK (003821)54455 Avenida Madero 06-0930 13306 12651 12650 12613 003821 P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: Q3 APN: Application description: Property Zoning: Application valuation: Applicant: 06-00000930 54455 AVENIDA MADERO 774-231-009-9 -000000- RE-ROOF COVE RESIDENTIAL 7989 Tiht 4 XP Q" Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT LICENSED CONTRACTOR'S DECLARATION 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. LicenseClass: C3[9 Lice se No.: 828478 Date: ,5 O ss_045rContra" ctor ^11Ar 5 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: 1 _ 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 not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). (_ 1 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 contractors) licensed pursuant to the Contractors' State License Law.). 1—) 1 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 ISec. 3097, Civ. C.). Lender's Name: _ Lender's Address: LQPERMIT Owner: M/M DAVID SALVATIERRA 54455 AVENIDA MADERO k QUINTA, CA 92253 C S p PFHO aA L i c tO ROOFING ©X 122 D PALMS, 343-0042 No.: 82847 INC CA 92276 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3/08/06 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier STATE FUND Policy Number 285000245205 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 shout become subject to the orkers' comp ensation provisions of Section 3700 of the Labor Cod „ shall forthwith comwwith thocarovisions. WARNING: FAILURE TO SECURE WeRKERS' COMPENSATION'COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMI AL 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 or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to bu*Idinp con truction, an eby orize representatives of this county to enter upon the above-mentioned property r inspection pur s. 2-R- 06 _ l LQPERMIT Application Number . . . . . 06-00000930 Permit . . . RE -ROOF Additional desc . Permit Fee . . . . 30.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date 9/04/06 Qty Unit Charge Per Extension BASE FEE 30.00 ---------------------------------------------------------------------------- Special Notes and Comments REROOF COMPOSITION SHINGLES. ALL MATERIALS MUST BE CLASS "A" MATERIALS. Fee summary Charged Paid --------------------------- Credited Due ---------- Permit Fee Total 30.00 -------------------- .00 .00 30.00 Plan Check Total .00 .00 .00 .00 Grand Total 30.00 .00 .00 30.00 Bin # City of La Quinta Building 8z Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address:' Owner's Name. pig A C A. P. Number: Address:j%O%l0 Legal Description: City, ST, Zip: Contractor: L162-110 Telephone: Address: Boy Project Description: Lo woof City, ST, Zip: Telephone: 7Gp 3 S-00yZ State Lic. # : eW City Lic. #: Arch., Engr., Designer: Address: City, ST, Zip: Telephone: Construction Type: Occupancy: State Lic. #: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd 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 Energy. Cates. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading, plan 2"d Review, ready for correctionsfissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees FEB -27-2006 13:21 .From: 7603426247 To:7603432097 ��� P.2/2 P.O. Box 122, 71touand Patna, CA 92276 (760) 343-0042 * Fax (760) 343-2097 License #828478 David and Nancy Salvatierra 34-4$5 Avenida Madre I.a Quints, GA 92253 Re: Re -roof Estimate Completely remove and discard_ existing roof. Substrate to be .inspected for dry rot or defective plywood panels, any found to be in need of replacement will be replaced at a rate of $45.00 per sheet (4 X 8 X V2), upon approval of owner or agents. Substrate to be inspected for loosened or non -flush to dAck.sheathiD"&UkAo)r,buad, wW-be Axivea.Aush,-or,complete y...puled-,out,-,ar4.re-naiaed-using-a new nail at a new location. Substrate to be cleaned and frce of all debris, prior to new roof installation. Over prepared sheathing at perimeter install new (2X2) drip edge inial. Over entire roof install 14aycr of #15 felt nailed to hold in place. Over felt install new Pro. 30 -year self-sealing shingles with pipe and vent flashings nailed to manufactures specification. Install new hip and ridge trim to enhance roof. appearance. All pipe and vent flashings to be painted with rust proof paint to match new roof. Total Amount: $7,989.00 Price does not include disconnecting and rye -connecting A/C unit. LW2ENDING ON THICKNESS OF EJQSTING PLYWOOD NA1LZ MAY PENt:I'RATE. THROU(TH THF. PLYWOOD AN OTTMIPR OVRRHANG. 'IUW: 100% UPON COMP=ON, UNLESS OTHERWISE SPECWIED IN 1112 ()XWI'RACr FIVE (S) YV.AR CRIARANTEB AGA[NST LEAKS WILL DE Ih'l'L`7IVE UPON f ULL PAY MEMr. Al J. nEBItIS CAUSED FROM ABOVE WORK TO ITE DISCARDF-D AND ARVA TO 11R LEFT CLEAN. JOB TO BE STARTED IN A TIMELY MANNER ACCORDING To sc11EDTnLF AND WEATHER PERA nIM. WE PROPOSE TO FURNISH AND APPLY I.AROR, MATFETAT,S, PERMITS. TRANSPORTATION, &TOOLS NECESSARY FOR (X)MPI KnON OF ROOFING WORK. THIS PROPOSAL WLI..L, BR NTJTJ, AND VOIDAFTER 13 DAYS FROM DATE SuamrrrED. DURING TIM ROOFING PR()JM.C'I' CAgMO ROOFING WLLL MAKE ALL ATT[MPTS TO MWIMrY,E, FUR' WIIJ. N(Yr BE RESPONSIBLE FOR DIRT. ROCK. OR DEBRIS THAT MAY FALL INTO 1JVrN0 AREAS, DAMAGES TO VENTS CONDUrf PIPES, OR MIJNG M()T wrRI1 CONTRACTOR DOES N(Yr ASHUMR ANY RESPONSUMM FOR CORRECTION OF EXtsr1N(I (:()DM, VI K ATIONS OR FOR TLE REPAIR . OF ANY FAIMING gMILIC URAL DEFEM, UNLILU sPPV11FIRI) IN THIS PROPOSAL DOES NOT INCLUDE ARiC1IITWIVRAL, F,NGINEERINO OR EXTRA WORK IF K9Q11IRED BY CITY. IN TK9 RVEn SUIT 18 DROUOLI'1' 1r) ENFORCE THR TERMS OF 71M CONTRACT, THE PREVAILING PARTY BHAIJ., RECOVER A.LL COSTS EXPENDED, DiCLUDINGATTORNEY FEES AS AN FJ.EM.MT OF COST. CONTRA(.'1'ORS ARE RF,Q1JIRFI) BY LAW TO BE LICENSED AND Rl:(,WLArED 13Y THE CONTRACTOR'S STATE LICENSE BOARD. ANY QUESTIONS RF,FER 'r(Y. ccwm Acrows STATE LICENSLD WARD, 1020 -W $ IRRRT, QACRAMF,NPO. CA 95814. IF TIiHS ESTIMATE MVM WITH YOUR APPROVAL, PLEASr: 1NOICATY YOUR ACCEPTANCE BY SIGNING THIS COPY AND RE-11URNING IT TO OUR OMCE DY MAILOLL VAX WE LOOK FORWARD TO WORKING WIT1l YOU. Mw EWER Submittal Date: Februmy 14. 2006 Acceptance Date: Z 2-Z o T4'ht 4 4 Q*& P.O. BOX 1504 Building 78-105 CALLE ESTADO Address 54-455 AVR4, IDA MADERO LA QUINTA, CALIFORNIA 92253 Owner Address 54-455 AVENIDA MADERO City Zip Tel. LA QUINTA 92253 Contractor TOM STONE RMONRY Address City Zip Tela LA QUINTA 1 92253 564-2128 State Lic. City & Classif. 494257 C-29 Lic. # 1228 Arch., Engr., Designer Address Tel. CityI Zip I State I Lic. # LICENSED CONTRACTOR'S DECLARATION I herebyy affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000,0 f.Division 3 of the Business and Professions Code, and my license is in full force and effect. SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the 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 Business and Professions Code, or that. he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit subjects the applicant to a civil penalty of not more than 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 builds or improves thereon and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale.) ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company ql_ 93 Copy 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: If, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives -of this city to enter the above- mentioned property for inspection purposes. Signature of applicant Dale Mailing Address City, State, Zip BUILDING: TYPE CONST A.P. Number I Description No. OCC. GRP. 13306 Project Description 90 If of 5 • garden block wall and 20 if of 6' garden block wall Sq. Ft. Size No. Stories No. Dw. New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ REMARKS ZONE: BY: Minimum Setback Distances: Front Setback Rear Setback:: Center l Sid t from Property Li FINAL DATE {1 pzc1a4 Issued by: =iDate P1 Validated by: " gy -- Validation: stimated Valuation PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. $54.00 Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL $54.00 REMARKS ZONE: BY: Minimum Setback Distances: Front Setback Rear Setback:: Center l Sid t from Property Li FINAL DATE {1 pzc1a4 Issued by: =iDate P1 Validated by: " gy -- Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS SLAB GRADE `+ BONDING HEATING (ROUGH) 2ND FL. SQ. FT. ® FORMS YARD SPKLR SYSTEM POR. SQ. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. I SQ. FT. ® OTHER APPJEQUIP. DRAINAGE PIPING WALL SQ. FT. TEMP. POLE DRINKING FOUNTAIN SQ FT ® GROUT URINAL ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP. WATER PIPING NOTE: Not to be used as property tax valuation WATER SYSTEM FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM 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 SPARK ARRESTOR SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL LATHING SQ.FT.GAR ® 3/ac 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 ROCKSTORAGE 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 SIGNATURES/INITIALS GARDEN WALL FINAL ~, 4 4 " P.O. BOX 1504 Building Sr45r3t!(ieroLA QUINOTACCAL FORNALLE pDO IA 92253 Address Owner Nancy Obrehaus Mailing Same CitIya Qt2i.fttay CA ZIp92253 Tel 564-4496 Co itractor arbler Construction Address .74653 Yucca Trail Drive 9yaim Desert, J_.Z111p 92260 Tel.341r-3023 State Lic. & Classif. B 452696 City Lic. # 2459 Arch., Engr., Designer Address Tel. City I Zip I 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 ect. SIGNATURE DATE OWNER -BUILDER DECLARATION —1 hereby affirm that I 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 Business and Professions Code, or that. he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit subjects the applicant to a civil penalty of not more than 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 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 Of 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.) ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. ,Company ❑ Copy 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 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 — % -e Owner NOTICE TO APPLICANT: If, alter making this Certificate of Exemption you 'should become bject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter the above- mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip No. 12651 BUILDING: TYPE CONST. A.P. Number Legal Description Description OCC. GRP. Sewer ConnectProject Sq. Ft. Size No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $10000.00 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing 3U.00 S.M.I. Grading Driveway Enc. Infrastructure TOTAL Ju ti REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback om ee mine: Side Setback fro p f per FINAL DA1 Issued by:_ Validated t Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS COLL. AREA l 2ND FL. SQ. FT. YARD SPKLR SYSTEM POR. SQ. FT. ® MOBILEHOME SVC. BAR SINK GAR. SQ, FT. ® POWER OUTLET ROOF DRAINS ROUGH WIRING DUCT WORK DRAINAGE PIPING CAR P. SQ. FT. GAS (ROUGH) WALL SQ. FT. HEATING (FINAL) DRINKING FOUNTAIN. SO. FT. ® URINAL ESTIMATED CONSTRUCTION VALUATION $ 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 GRADING cu. yd. $ plus x$ GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM FINAL INSP. 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 FIRE ZONE ROOFING SQ. 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 GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE7 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 eR--feFTrC-TA"K ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP./EQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ 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 FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL r I P.O. BOX 1504 Building 54-455 Madero78-105 CALLE ESTADO Address LA QUINTA, CALIFORNIA 92253 Owner Nancy Oberhaus Mailing BUILDING: TYPE CONST._ Address Sa' to A.P. Number C'ty Zip Tel. ' "La Quinta, CA 92253 564-4496 Legal Description sarbier Construction .Address 74653 Yucca Tran Drive Clt-yalm Desert,fz,? 92263 . State Lic. & Classif. 452696 Arch., Engr., Designer Address 341-3023 No. OCC: GRP. Project Description Pool and Spa Lic. If 2459 Sq. Ft. Size New ❑ 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. SIGNATURE DATE OWNER -BUILDER DECLARATION I.heieby affirm that I 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 Business and Professions Code, or that. he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit subjects the applicant to a civil penalty of not more than 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 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 orimprovement 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.) O 1, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company ❑ Copy is filed with the city. _ ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM r WORKERS' COM PENSATI ON 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 manne_r,so as to become subject to the Workers' Compensation Laws of California., + Date '--- wCOwner NOTICE To;APPLICANT: If, aftet'•making thiseCertificate;ofExemption'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. jr CONSTRUCTION LENDING AGENCY Ihereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter the above- mentioned property for inspection purposes. Signature of applicant -Date- Mailing ateMailing Address City, State, Zip No. . Stories 12650 No. Dw. Units Demolition O Add O Alter 0 Repair ❑ ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line 1't + +F FINAL DATE IN ECT _ Issued by: Date Permit ' Validated by: JAN04 + .. V Validation: Z;3- Estimated Valuation $16,000.00 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. 115, U5 Const. 111 • O Mech. L. U Electrical U Plumbing L I . U0 S.M.I. Grading Driveway Enc. Infrastructure TOTAL LY5 • t%=> rREMARKS mt ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line 1't + +F FINAL DATE IN ECT _ Issued by: Date Permit ' Validated by: JAN04 + .. V Validation: Z;3- CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEE i, IST FL. SQ. FT. ® $ UNITS ROUGH PLUMB. BONDING 2ND FL. SQ. FT. p STORAGE TANK Y ARD SPKLR SYSTEM POR. SQ. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. SO. FT. REINF. STEEL DRAINAGE PIPING WALL SQ. FT. DRINKING FOUNTAIN SQ. FT. ® FINAL INSP. URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER SYSTEM WATER PIPING NOTE: Not to be used as property tax valuation LUMBER GR. FLOOR DRAIN MECHANICAL FEES FINAL INSP. WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER VENTILATION GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP POLE, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. 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 FINISH GRADING 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-7—,3GJ ERGROUND— 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. ROOFINGM REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION. w 62 C FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL 78-495 CALLE TAMPICO — LA QUINTA, CALIFORNIA 92253 (619) 777-7000 FAX (619) 777-7101 July 19, 1.993 SETBACK ADJUSTMENT: 93-193 Ms. Nancy Oberhaus LOCATION: 54-455 Madero 54f' -4-55-Madero La Quinta, CA 92253 Dear Ms. Oberhaus : This letter is to report approval of your recent application fora setback adjustment, pursuant to Chapter 9.188 of the City of La Quinta Planning & Zoning Regulations. The following setback adjustment has been approved subject to conditions and in accordance with attached Exhibit A. SETBACK ADJUSTMENT: Reduction of 5 -feet to 3 -feet of the side property line FOR: Swimming Pool CONDITIONS: 1. Obtain a building permit; provide additional reinforcing as required by code. 2. The S -R fencing requirements shall be met. 3. Pool equipment shall comply with required setbacks and maintain a minimum of five feet from property line. After review it was determined that: 1. This adjustment is consistent with the intent and purpose of .the Zoning Ordinance. 2. There are special circumstances applicable to the property, including such factors as size, shape, topography, location or surroundings that justify approval of the adjustment. These special circumstances are: small size of lot. 3. This ' adjustment will not be detrimental to the health, safety, and general welfare of the community or be detrimental to property in the vicinity of the parcel for which the adjustment is requested. MAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253, 1 If you have any questions, please contact the undersigned. Very truly yours, JERRY HERMAN PLANNING & DEVELOPMENT DIRECTOR eslie Mouriquand-Cherry Associate Planner LC: ccs Attachment: Exhibit A cc: Building & Safety Department 2 C I TY O F LA QUI NTA 75;/6J' ? "Vo C_ Contractor _ s .e /5, „f EiZ Address/' MLI- _ ('meg, 922-2 Owner if/ij,UC'y C ?FlLt i¢r f Job Address S5'j!fS /Yf}c E,QpQyicrng This form shall be posted on the job with the Building Inspection Card at all times in a R. conspicuous place. It is the responsibility of the General Contractor or the Owner/Builder to monitor the sub -contractors that are on this list are the same persons performing the work. Any changes of this list must be approved by the City of La Quinta Department of Building and Safety prior to work being performed by a changed sub -contractor. Failure to comply will result in a stoppage of work and/or the voidance of building permit. TRADE SUB -CONTRACTOR NAME CONTRACTOR'S LICENSE NO. WORKMAN COMP. NO. ON FILE CITY BUSINESS LICENSE NO. GRADE/ EXCAVATE vac 6 • PIPELINES CEMENT/ FOUNDATIONS CDA-.&- , 6 /7017.e CEMENT/WALKS & DRIVES /! ASPHALT FRAMING STEEL/ STRUCTURAL MASONRY PLUMBING / / j / S/2 p $%• L LATHINGJ -77 DRYWALL J 19-C'OC) d T/GJ PLASTERING HVAC / ELECTRICAL x, -_r _ JS" L, ROOFING SHEET METAL FLOORS Tib 1®Z $; '✓ J Z-6 6 GLASS/ GLAZING , j rjz CD.vSJ y.J'L INSULATION i2(ZCiGv— 8si d SEWAGE DISP PAINTING/ DECORATING O TILE CABINETS/ INSTALLATION p ORNAMENTAL METAL FENCES/ BLOCK WALLS Sv LANDSCAPING OTHERS 7 2 2To Budding 54-455 11ADnW.0 rs Owner AIMCY OSERBAQS 1 wQ rw P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Mailing Address SAME City Zip Tel. LA QUINTA 192253 564--4496 Contractor EARDIER CONSTRUCTION Address 74653 EUCCA TRAIL DRIVE CjtTel. VAM, DESERT YiP92260 341-3023 State Lic. & Classif. j } tlrf ,,J City Lic. # 2459 Arch., Engr., Designer BARRIER CONSTRUCTION Address SASE Tel. SAM City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section A7000) of Division 3 of the Business and Professions Code, and my license is in fulljorce and ffact. SIGNATURE r DATE OWNER -BUILDER DECLARATION I hereby affirm that I 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 Business and Professions Code, or that. he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit subjects the applicant to a civil penalty of not more than 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 builds or improves thereon and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year or completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale.) ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company ❑ Copy 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 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. IDate.-/. ' owner QIOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter the above- mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip 11LDING: TYPE CONST P. Number gal Description Project Description No. 126313 OCC. GRP. ROOM ADDITION ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DA1 Issued by:_ Validated t Validation: Sq. Ft. 298 Size No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $16,181.40 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. $117.00 Const. $0.00 Mech. 27.00 Electrical 25.43 Plumbing 33.00 S.M.I. 1.62 Grading Driveway Enc. Infrastructure TOTAL + REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DA1 Issued by:_ Validated t Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. pXIUMBINC�;EES, 1ST FL. SO. FT. ® $ UNITS COLL. AREA 2ND FL. S0. FT. PLUMB. YARD SPKLR SYSTEM MOBILEHOME SVC. BAR SINK POR. SO. FT. ® SEWER OR SEPTIC TANK ROUGH WIRING GAR. SO. FT. ® POWER OUTLET ROOF DRAINS FOUND. REINF. DRAINAGE PIPING CAR P. SO. FT. ® I WALL S0. FT. REINF. STEEL DRINKING FOUNTAIN SO. FT. ® URINAL ESTIMATED CONSTRUCTION VALUATION $ bp GROUT WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES BOND BEAM WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER LUMBER GR. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FRAMING 3 G L LAUNDRY TRAY AIR HANDLING UNIT CFM ROOFING 3^0 _GL ql(/ 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 SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. S0. FT. RESID ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR ® 3/ac HOUSE SEWER LATHING 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 DERGROUND YMP A.C. UNIT COLL. AREA SLAB GRADE 01YROUGH 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./EOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE bp GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM $ GRADING cu. yd. plus x$ =$ LUMBER GR. FINAL INSP. FRAMING 3 G L FINAL INSP. ROOFING 3^0 _GL ql(/ `, -3��Z �/� ✓��—j��J����'✓ I�SC+�� fit x'19 REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL 3 LATHING MESH INSULATIONISOUND .,,ge t FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL t 27A 5 .; 78-495 CALLE TAMPICO — LA GIUINTA, CALIFORNIA 92253 - (619) 777-7000 FAX (619) 777-7101 July 19, 1993 Ms. Nancy Oberhaus 54-455 Madero , La Quinta, CA 92253 Dear Ms. Oberhaus : . SETBACK ADJUSTMENT: 93-193 LOCATION: 54-455 Madero e This letter is to report approval of your recent application for a setback adjustment, pursuant to Chapter 9.188 of the City of La Quinta Planning & Zoning Regulations. The following. setback adjustment has been approved subject to conditions and in accordance with attached Exhibit A. SETBACK ADJUSTMENT: Reduction of 5 -feet to 3 -feet of the side property line FOR: Swimming Pool CONDITIONS: 1. Obtain a building permit; provide additional reinforcing as required by code. 2. The S -R. fencing requirements shall be' met. 3. Pool equipment shall comply with required setbacks and maintain a minimum of five feet from property line. After review it was determined that: 1. This adjustment is consistent with the intent and purpose of the Zoning Ordinance. 2. There are special circumstances applicable to the property, including.)such factors as size, shape, topography, location or surroundings that justify approval of the adjustment. These special circumstances are: small size of lot. 3. This adjustment will not be detrimental to the health, safety, and general welfare of the community or be detrimental to property in the vicinity of the parcel for which the adjustment is requested. MAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253 1 If you have any questions, please contact the undersigned. Very truly yours, JERRY HERMAN PLANNING & DEVELOPMENT DIRECTOR eslie Mouriquand -Cherry Associate Planner LC: ccs Attachment: Exhibit A cc: ;Building-& Safety -Department`' 2 (619) 564-2246 C} CASE NO: CITY OF LA QUINTA FEE: $100.00 PLANNING & DEVELOPMENT DEPARTMENT APPLICATION FOR SETBACK ADJUSTMENT APPLICANT: Submit this form with two copies of a scaled site plan, drawn to adequately depict the nature of the request. A nonrefundable fee of $100 is required when the Application is submitted. Check must be make payable to the "City of La Quinta'. If the Applicant is not the owner of the property, submitted by the owner authorizing the Applicant to in his behalf. PLEASE PRINT OR TYPE APPLICANT/ CONTRACTOR: CONTACT PERSON (IF DIFFERENT) MAILING ADDRESS: (Address) (City OWNER'S NAME: MAILING ADDRESS: 1-5-1-1iyE (Address) (City) a letter must. be ent 1 *J u t l*. *1 *: J * * * PHONE State) (Zip) PHONE " /- (State) (Zip STREET ADDRESS OF PROPERTY: LEGAL DESCRIPTION OF PROPERTY: LOT # 9 TRACT ASSESSOR'S PARCEL NUMBER: % %f2 3 /6O q - c,: , ADJUSTMENT REQUESTED: /' S"j e _i -7:p . ISQN FOR REQUEST: r ale/ 6 tf 601 loll .1 JUSTIFICATION: No request for a Setback Adjustment shall be granted unless it is determined that it is consistent with the intend and purpose of this Ordinance; that there are special circumstances applicable to the property, including such factors as size, shape, topography, location or surroundings that justify the approval of the adjustment of the setback requirement, and that the adjustment will. not be detrimental to the health, safety, and general welfare of the community or. be detrimental to property in the area of the parcel for which the adjustment is requested. FORM.013/CS 0 Building Address 545— Owner mailing Address P. n. BOX 111 CityZip :Jn5 L. tklinta- 92253 Contractor I'irtast y-.IAiii I-A.or Address.. . _. .. City Zip Tela P.O. BOX 1504 NQ, UU415ZI 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 BUILDING: TYPE CONST. - OCC: GRP. A.P..Number _774-231-0059 ,,,4496 Legal Description Project Description 67 wood fence 261 Of chain State Lic. City Minimum Setback Distances: & Classif. Lic. # Sq. Ft. No. No. Dw. Side Street Setback from Center Line Size Stories Units Arch:, Engr., - -- - FINAL DATE INSPECTOR Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. Validation: 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 ofkthe Business and Professions Code, and my license is in full force and effect.. _SIGNATURE DATE OWNER -BUILDER DECLARATION Estimated Valuation I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. .703 1.5, Business and Professions Code: Any city or county which requires a' permit to construct, alter, improve, demolish, or iepair any structure, prior to its issuance also requires the applicanf for such permit to file 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 r Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis for the alleged exemption. Any Section 7031.5 by for Plan-Chk. Dep. violation of any applicant a permit • subjects the applicant to a civil penalty of not more than five Hundred dollars ($500). ._ ' Plan Chk. Bal. . . 11 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, Buisness and Const. . Professions Code: The Contractor's License Law does not apply to an owner or. property who Brit 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 roving that he did not build or improve for the purpose of sale.) l, as owner of the property, am exclusively contracting with licensed contractors to con- V, Plumbing ' siruct 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.1. such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) I Grading ❑ Lam exempt under Sec. B: 8 P.C. for.fhis reason 1 Af Driveway Enc. Date -- -' — - >r.m l s fi`1 R r,a = SZ, owner Infrastructure <x s•k • 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. I Company ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. TOTAL CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less.) _ k'r - 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: If, after making this Certificate or Exemptionyou should become subject to the Workeis' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY . . I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) ' Lender's Name Lender's Address This is's 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 stale 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, Slate, Zip HARD COPY ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date/Permit Validated by: Validation: 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. ® 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 APPJEQUIP. 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 ® 1% 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. FEEELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING d 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 I N SU LATIONISOUN D FINISH GRADING KFINAL INSPECTION I CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL