BLCK (07-0444) + RPL (08986) + PLBG (08356) + BLCK (07880)54680 Avenida Madero
07-0444
08986
08356
07880
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Ta!t 4 4-Qm&&
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 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
ar licant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
( 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the
improvements are 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 1, 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 contractorls) licensed
pursuant to the Contractors' State License Law.).
(_) I am Daexempt under Sec. , B.&P.C. for this reason
te: RJ wner:
40E 4ou
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
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/23/07
Owner:
RAMOS NICKY
54-680 AVENIDA MADERO
LA QUINTA, CA.92253
---------------------------------
Contractor:
Owner
----------------- --- --- /
ay
t (J_ _ _ _ _ _
WORKER'S COMPENSATION DECLARATI/
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, fort he performance of the work for which this permit is issued. My workers' compensation
insurance arrier and policy number are:
Carrier Policy Number
I c=at, 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 th r o e, I sha orthwith cly with those provisions.
/[7 n
Date:0/ - a pplicait: f
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 1$100,0001. 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 building construction, and hereby authorize representatives
of this county to enter upon thy -above-mentioned pr perty for inspect n purposes.
Date% d ature (Applicant or Agent): /7
r
`07-00000444
Application Number:
Property Address:
54680 AVENIDA MADERO
APN:
774-262-009-16 -000000-
Application description:
WALL/FENCE
Property Zoning:
COVE RESIDENTIAL
Application valuation:
4088
Ta!t 4 4-Qm&&
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 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
ar licant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
( 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the
improvements are 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 1, 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 contractorls) licensed
pursuant to the Contractors' State License Law.).
(_) I am Daexempt under Sec. , B.&P.C. for this reason
te: RJ wner:
40E 4ou
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
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/23/07
Owner:
RAMOS NICKY
54-680 AVENIDA MADERO
LA QUINTA, CA.92253
---------------------------------
Contractor:
Owner
----------------- --- --- /
ay
t (J_ _ _ _ _ _
WORKER'S COMPENSATION DECLARATI/
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, fort he performance of the work for which this permit is issued. My workers' compensation
insurance arrier and policy number are:
Carrier Policy Number
I c=at, 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 th r o e, I sha orthwith cly with those provisions.
/[7 n
Date:0/ - a pplicait: f
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 1$100,0001. 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 building construction, and hereby authorize representatives
of this county to enter upon thy -above-mentioned pr perty for inspect n purposes.
Date% d ature (Applicant or Agent): /7
r
Application Number . . . . . 07-00000444
Permit WALL/FENCE PERMIT
Additional desc .
Permit Fee 72.00 Plan Check
Fee..
.00
Issue Date . . . . Valuation
. . .
. 4088
Expiration Date . . 10/20/07
Qty Unit Charge Per
Extension
BASE FEE
45.00
3.00 9.0000 THOU BLDG 2,001-25,000
=------------------------------------
27.00
----------------------------------------
Special Notes and Comments
53 SQ. FT. REAR, 75 SIDE @ 6 FT. AND 41
5 FT.PER STRUC CALLS. SEE PLANS.April
23, 2007 2:03:43 PM JJOHNSON
Fee summary Charged Paid Credited
---------------------------------------------------------
Due
Permit Fee.Total 72.00. .00
.00
72.00
Plan Check Total .00 .00
.00
.00
Grand Total 72.00 .00
.00
72.00
LQPERAIIT
Bin #
FC
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 #
`(��
o- "
Project Address:5 4 SO vEN 4b
Owner's Name: �(
A. P. Number:
Address: 8
Legal Description:
Contractor:
City,'ST, Zip. ix 915
-C Telephone -,W_ 0
Address:
Project Description: C L`
City, ST, Zip:
r
Telephone:
State Lic. #: City Lic. #:
Arch., Engr., Designer:
j
;•'` _. �� L L .
N16� 10
Address: '
cj �— 9
City, ST, Zip:
Telephone:
State Lic. #:
Construction Type: , Occupancy:
Project type (circle one): New dd'n Alter Repair Demo
Name of Contact Person: 4D
Sq. Ft.:.
#Stories:
#Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd :.
Rec'd
TRACKING .•
PERMIT FEES
Z
Plan Sets
Plan Check submi5 =-_) ...,_,�� 0710 Item Amo
Structural Calcs.
Reviewed, ready or (recti ns Plan Check Deposit.
Truss Calcs.
Called Contact.Person Plan Check Balance
Energy Calcs.
Plans picked up -L C Construction
Flood plain plan
Plans resubmitted Mechanical
Grading.pisn"
2'' Review, ready fo corrections/is a :S 2D Electrical AkY
Subcoutactor List
Called Contact Person
A.Plumb
Grant Deed
Plans picked up S.M.I.
II.O.A. Approval
Plans resubmitted Grading
IN HOUSE:-
"Review, ready for.correctionsrssue Developer Impact
Planning Approval
Called Contact Person p p.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
�7 I/,../ , &T%_vrv4_, L�/��iJ/ f ulo). 3/ T9%44,'2- tJv,,
d114' &1e
�� �3�0� �� �PP�-��,��lr✓ 3 ZS�U� STR- �ZFG
0%.
CITY OF LA QUINTA
BUILDING & SAFE: fY DEPT.
APPROVED
FOR CONSTRUCTION
OFirict 5, 14„
CONSTRUCTION IO
October lst - April 30
Monday - Friday: 7:00 a. .t
Saturday: 8:00 am.(
Sunday: None
Government Code ROB
May 1st - September 30
Monday - Friday: 60:00 aa.to 5
Saturday R8:0 am.
Sunday:q ........a�.one .... aA...__
ooe Holidays:
Governnp
PEs°
io v I
BLOCK WALL EXHIBIT
OWNER/APPLICANT:
P/L :OPTIONAL NIKKI RAMOS
ROUND/FLAT CAP 54-680 AVENIDA MADERO
LA QUINTA CA, 92253
#4 CONT @ PH: (760)564-
24" O.C. TYP
0 P.M. 32"
�� °el #4 REBAR (DOWEL -IN) ss
ENGINEER:
EXISTING 5'--'
S- n • •
or DWOR
WOOD FENCE
I
#4 CONT W & W DESIGN DEVELOPMENT INC.
79-440 CORPORATE CNTR DR.
SUITE -107 LA QUINTA CA, 92253
ROPOSED 5'-4"
I
Dec.F)cmT P. eoidry
LOCK WALL
°', -�: �,�:�HL°.s e
° , �, , F L i/,�,
° 12 �,,� ,�\,!���� d
1(tv-)45 .9(0'71
#6 STD. DURO-WALL
`
VARIES
5' TYP.
VARIES
#4 CONT
Rs 5' TYP.
DROP-IN BAR
5.30 p.m. 7
(32" OVERLAP) Construction is NOTPERM
0 P.M. 32"
�� °el #4 REBAR (DOWEL -IN) ss
2' TYP. 3' TYP. FF
on the following Code Holidays:
S- n • •
or DWOR
_ 1 EXISTING 2'
RETAINING WALL
RQhd*§JSDJY SET
EPDXY.
None
New Year's Day
o
° Dr. Marin Luther long lr. Day
7:00 P.
)o m.
°
°', -�: �,�:�HL°.s e
° , �, , F L i/,�,
° 12 �,,� ,�\,!���� d
President's Day
° Memorial Day
_bone_
Independence Day
�x/x
,.
�� °el #4 REBAR (DOWEL -IN) ss
Labor Day
'
NNOPsD �
12" DEEP Q 32" O.C.
°=1 EPDXY FILLED
S- n • •
or DWOR
_ 1 EXISTING 2'
RETAINING WALL
RQhd*§JSDJY SET
EPDXY.
8" BLOCK(S)
"AN ADEQUATELY SIZED DEBRIS CONTAINER L ° _' 1
IS REQUIRED ON THE JOB SITE DURING ALkOCK WALL ADDITION DETAI
PF CONSTRUCTION AND MUST BE NTS
' p
U ECESSARY, FAILURE TO DO SO SECTION "A -All d �
M�AY� EEM TAINER INING STEEL.
DUMPED AT MW
000%TOJECTINGS SHALL BE POURED ON UNDISTURBED NATURAL
OUND OR COMPACTED FILL.
3. WALL SHALL BE PLUMB.
4. REBAR SHALL BE ASTM A-615 GRADE 40.
5. BLOCK SHALL BE GRADE A PER ASTM C-90 AND CEMENT SHALL
BE PORTLAND CEMENT PER ASTM C-150.
6. MORTAR SHALL CONSIST OF 1 PART CEMENT, a PART HYDRATED
LIME AND 31 PARTS OF SAND PER ASTM C-270.
7. GROUT SHALL CONSIST OF 1 PART CEMENT AND 3 PARTS SAND.
8. ALL CONSTRUCTION SHALL COMPLY WITH 2001 CALIFORNIA
BUILDING, PLUMBING, MECHANICAL, 2004 ELECTRICAL, AND 2005
ENERGY CODES AND ALL OTHER LOCAL ORDINANCES.
t °.I
riYti eseii�� W3
jraL{rl.y • r
r
Cr9
F�? �61j I.Ojill
Its si;ta�tiE
bJh f. SaY �✓il4
YJ,
T•lx
RAJ^^?•^��n...,,� �'�.,,, ��,
� A
P'�ov •.
iJ n,..,
OZOG OT qV ;:Al ,YF,. _ J',' , C.I.. .
�f c�- n
.Iii: (,... .„
Porti w?a bla 4uo e�
VM i�-p�e V,=�aPti�
. To? covkc. e t.►zi w4dt
" L'a d
3' &4:, r 4 4,
Ay ,00.5(0
p p (2-
o0�.,
M �ror� ►a K 4z rtl; la 9y:8 ov,
.4:
�S rKL r r'ls � =.0;61 2a� � ,�92j � : 5352 �43bg �,0�
-
-� 4 Cea�T
SzOe .
L�C�ST �4; Lori T ;
E�Xt6t 4&
-" Ex iST d 4 COI.�T
C ��yl 1
�� !o" .a Inca., . �.U���-� �ZY,`�e� � • 3" � �,, ` �'� d t�`���. �'2�tl��—ZgSd`�
n
)ciM,co�-�. ►-���,� ror�;9.��;���_�go.t;.�.
mcc,7Aa 6A
5e►tict VvA ��•. 9"`' • ! = Z .��.4. 14 oe-; oQ air
�,.�.�.,.,�,.• �; � � s d ;�° ( R.C. E
186
79 3 ExF"ES t
`!q — 4.40 CorporA CAV D
(,.a Q�iwq.
'-q -7 --
SUEPLAN
I
N.T.S.
73'±
OWNER/APPLICANT:
NIKKI RAMOS
54-680 AVENIDA MADERO
PROPOSED
MA
LA QUINTA CA, 92253 -- El
EXISTING PH: (760)564- PER CITY Sftc'
WOOD FENCE
ENGINEER: NoupnHISNOO j
W & W DESIGN DEVELOPMENT INC. (13AOtJHo,
,/j
79-440 CORPORATE CN TR DR.
J-d3G A13 -AVS V E)Nia-iine
SUITE -107 LA QUINTA CA, 92253 Jo --ulo
?cn/ v imm v
Ln
L4
F+-
LEGEND:
31C=M= PROPOSED GARDEN WALL
-tw*- EXISTING RETAINING WALL
EXISTING WOOD FENCE
CONSTRUCTION NOTES:
EXISTING 6'
(DCONSTRUCT BLOCK WALL PER CITY SPECS
173± LF
WOOD FENCE
LTJ
Y
t=
EXISTING
NH
DRIVEWAY
APPROACH
cn C17
cn
FESS
n
DELBERT D.
m
BOYER
3'
t9 R.C. E 1354 m
13'± S
EXPIRES3?
Civi
30'
12'
.0 No
PROPOSED 5'
PUE BLOCK WALL
PROPOSED
PROPOSED 5'
BLOCK WALL
40' BLOCK WALL
6' MAX---",
-
PER CITY SPECS.
PER CITY SPECS.
oci
-J
PROPOSED 4'-4"
BLOCK WALL
EXISTING 6'
EXISTING j
PER STRUCTURAL
WOOD FENCE ------
WOOD FENCE i
CALCS
GATE
SPECIAL INSPECTOR
"A?)
REQUIRED
EXISTING 5' i.
EXISTING 2'
EXISTING 2'
BLOCK WALL I
RETAINING WALL
RETAINING WALL
73T
'A
Ln
L4
F+-
44 V8986
P.O. BOX 1504 ilding 78-105 CALLE ESTADO coI 1
Address 54.680 AVMMA iADERO LA QUINTA, CALIFORNIA 92253 {
Owner .
Mailing
Address S
City - lZip ITel.
—3115
Contractor
Address
ty lZip I Tel
State Lic.
City
& Classif.
C53-476807
Lic. # 1303
Arch., Engr.,
No. Dw.
Units
Designer
Repair ❑ Demolition 0
'Address
Tel
City
Zip
State
Lic. #
LICENSED CONTRACT,OR'S DECLARATION
I herebyaffirm that 1 am license der provisions of Chap er 9 (commencing wit on
7000 of i ision,3.of=t a°Bds ness and Professions Code nd my license is in uII-- oo- nd
effect. D / . r - A.ii'i//
_ OWNER BUILDER DECLARATION
I heieby-affirm that I am exempt from the Contractor's License Law for the following
i ,!reason:: -(Sec. 7031.5,Business and Professions Code: Any city or county which requires a
eimit 1o: 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 iprovisions 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 improvementsare 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 coniractor(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, ora 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 ($100) valuation
or less.)
I certify that in the performance of thg work for which this permit is issued, I shall not
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California.
Date Owner
NOTICE TO APPLICANT., If, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this city to enter the above-.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
LDING: TYPE CONST. POOL OCC: GRP.
A.P. Number
Legal Description
Project Description POOL (ONLY)
TOTAL 220.91
REMARKS
,7, / i$/3i'e i V 4 Y4' ._ x •, n: S s 1 P:
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:
.. ...,z f. K , - .i-a•Y .. - • M- 0. -, .r , • . I Y. y .:.i - (. ,L tt • i 2. ...r -
Sq. Ft. No.
Size . Stories
No. Dw.
Units
New ❑ Add 0 Alter ❑
Repair ❑ Demolition 0
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
64.35
Const.
99.00
Mech.
1S,00
Electrical
30,00
Plumbing
21.00
S.M.I.
5
Grading
Driveway Enc.
Infrastructure
TOTAL 220.91
REMARKS
,7, / i$/3i'e i V 4 Y4' ._ x •, n: S s 1 P:
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:
.. ...,z f. K , - .i-a•Y .. - • M- 0. -, .r , • . I Y. y .:.i - (. ,L tt • i 2. ...r -
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SO. FT. ®
GAR. SO. FT, ®
CAR P. SO. FT.
WALL SQ. FT. ®
SQ FT ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN.
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
SLAB GRADE
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
ROUGH WIRING
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
DUCT WORK
LAUNDRY TRAY
AIR HANDLING UNIT CFM
GAS (ROUGH)
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
WATER HEATER
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
BOND BEAM
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 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
312 [ / /(/Y`
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
Building
Address 54-'680 HADMID
T a
4hf 4
P.O. BOX 1504 No.
V
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
PINSON BROTHERS & ARROYO UBi/,
Mailing
Address 4.5_250 SMiifiR ST.
City lZip ITel.
ntractor
P
Ad
IZip
State Lic. City
& Classif. 549897 Lic. #
Arch., Engr.,
Designer R
Address I Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that 1 am licensed under piovisions of Chapter 9 (commencing with Section
70(nof DivisiigliZ of the Business and Pror}es ions Code, and my license is in full force and
. OWNER-ByfLDER DECLARATION
I hereby affirm that I am exempt from the Contractors License law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
permit to construct, 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 (8500).
❑ 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.)
O 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
O 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 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 Date
Mailing Address
City, State, Zip
BUILDING: TYPE CONST. OCC. GRP.-
A.P. Number
Legal Description
Project Description SEIVER BOOK—UP
Sq. Ft. No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑.
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
11.00
S.M.I.
Date Permit
Grading
Driveway Enc.
Validation:
Infrastructure
TOTAL
$ t3 A
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 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. SO. FT. ®
GAR. SQ, FT, ®
CAR P. I SQ. FT.
WALL SO. FT. ®
SQ FT ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
r—
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN.
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEOUIP.
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
JAMPERESSERVENT
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 ® 3V4c
IHOUSE SEWER
REMARKS:
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR'
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING.
DUCT WORK
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES(INITIALS
GARDEN WALL FINAL
COACHELLA VALLEY WATER DISTRICT
*
CASH RECEIPT DETAIL
Received Fro'm: l osor,) S• ` f v
Address: L- '5 -QSb 1111'' 1
Account No. (Oem \ a ) J`tJ • J v Lot(s)
- Service Address 5 10 0 i`Yia
4
r
-Meter(s) `
`-314
Gl Servlce(s) 1•
❑ Backflow(s)
❑ House Lateral (s)
❑ DetectorCheck(s)
r
❑ Meter Surcharge
Sanitation Capacity Charge
-
' ❑ W.S.B.F.C.
' ❑ Temporary Construction Meter
❑ Turn on Charge
❑ Uncollected Account - Name
❑ Inspection Fee - Tract -
Fee -
❑ Plan Check Fees Water I Sewer -
Tract -
Q Bond Payment - A.D. -,—Bond
Assmt.
❑ Customer Deposit
'. n 0thAr
Remarks:
❑Copy to:
Cash
Check
Money
Order
rT< % ,, F'.` Ai,a "•:4yb"....:F.'.....1 iity _7A ',r.. -.
a),d5(
Tr
G.A. Code
. s o)
TOTAL o . o U
t
Water Service
Cashier -
438(11189)
`F,i- tit 4 4 Q"
P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address 54-6W Macro LA QUINTA, CALIFORNIA 92253
Owner
Mailing
Address
Zip Tel.
"Indio 92201 347-3115
Contractor
OlKI@>r
Address
Zip
State Lic. City
& Classif. I Lic. #
Arch., Engr.,
Designer
Address Tel.
CityI Zip I State I
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 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) or
Division 3 or 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`yiner i / ,/ . ..,
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
. O Copy is filed with the city. O 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 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.
Signature of
Mailing Add
City, State,
BUILDING: TYPE CONST
A.P. Number
I Description
N o . 07880
OCC. GRP.
LOU 15, if , 17
Project Description 2' X 3001 retainlne wall
Sq. Ft. No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const. 72.00
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL 72.35
REMARKS
,fir.-, f r a t7 a
2ti aAJ#i.I C IAL.I
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 5/20,9Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST 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
j DRAINAGE PIPING
DRINKING FOUNTAIN.
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
ROUGH PLUMB.
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GAS (ROUGH)
LAUNDRY TRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER. B.T.U.
SQ. FT. ® c
BATH TUB
BOND BEAM
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1+/a c
SEWAGE DISPOSAL
LUMBER GR.
SQ.FT.GAR ® 3/ic
HOUSE SEWER ;
FRAMING
FINAL INSP.
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING 401�1—
���
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