SATT (13681)50760 Mango
13681
Buildi .0•-7GO tai ngo
Addres- r "N
Owner
P.O. BOX 1504
78-105 CALLE ESTADO
LA OUINTA, CALIFORNIA 92253
Mailing
Address 35101-Jambana Road;.
City Zip Tel.
i ewwl10: -,t Be& , CA 92653 ('110054-251
Contractor
S 21113 0
City ]Zip Tel.
State Lic. B-1 310863 City 1503
& Classif. Lic. #
Arch., Engr., i3erkus moll;:!
Designer
Ad( Ts Orj,or<te Way Tel 714) 251-'-321
City Zip State
C ;TZiiy, CA 92714 Lic.# 06385
LICENSED CONTRACTOR'S DECLARATION
I horegyy affirm that) atn licensed under provisions of Chapter 9 (commencing with Section
700M of ❑f "510" of, the tlusi and Professions Code, and my license is in full farce and
effect: }. i ✓V •
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
ref,1,lov7slon.tfie appficant for such permit to file a signed statement that he is licensed pursuant to
the s 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 (hat such improvemanis'are not fnfanded or offered for sale. If, however, the building
of Improverr+enf is sold w0in one year of completion, the owner -builder will have the burden
of proving lhei he did not bumld 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 Sea 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 thereol: (Sec. 3800, Labor Code.)
Policy No. Company
F-. . Copy is filed with the gl.ty, C] 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 Loss,)
I certify that in the performance of thV work for which this permit is issued, I shall not
empley anYperson in any manner so as to become subject to the Workers' Compensation
Ltiws oT California.
Date Owner
NOTICE TO APPLICANT., If, alter 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 a this permit shall be deamed revoked.
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 appilcalion and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to bulfding
construction, and hereby outhorize representatives of this city to enter the above.
mentioned properly for inspection purposes.
Signature of applicant Gate
Mailing Address
City, State, Zip.
No. 13631
T' "7
BUILDING: TYPE CONST. w OCC. GRP,
A ) 9.-4.91/.:.01 0
2
Legal Description ijot 33 I-ract 24890-2
Project Description -;FA flag 2
Citrus
Sq. Ft.
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
$2031203.00
PERMIT
AMOUNT
Plan Chk. Dep,
Plan Chk. Bal.
845.51
Const.
1,003.50
Mech.
6-3.50
Electrical
5 0
Plumbing
--165.
'7 4. O
S.M.I.
/10r io
Grading
"00
Driveway Enc.
t1 t`i
Infrastructure
i
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 DATE INSPECTOR
Issued by: Date Permit
Validated by:
Validation:
MAX. HEATER OUTPUT, B.T.U.
I PERMIT FEE
DBL TOTAL FEES
ESTIMATE
CONSTRUCTION
1ST FL.
$
SQ. FT.
2ND FL.
FRAMING
ROOFING
SQ. FT.
POR.
VENTILATION
SQ. FT.
GAR.
SPARK ARRESTOR
SQ. FT.
CARP.
MESH
SQ. FT.
WALL
FINAL INSPECTION
SQ. FT.
FENCE FINAL
DRINKING FOUNTAIN
SO. FT.
ESTIMATED CONSTRUCTION VALUATION
NOTE: Not to be used as property tax valua
URINAL
MECHANIC
VENT SYSTEM FAN
EVAP.COOI
APPLIANCE
FURNACE UNIT WALL FLOOR
AIR HANDLING UNIT
FLOOR DRAIN
ABSORPTION SYSTEM
ion
PRESSOR
HP
ING SYSTEM
r
FORCED
ER
B.T.U.
MAX. HEATER OUTPUT, B.T.U.
I PERMIT FEE
DBL TOTAL FEES
ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
$
UNITS
FINAL INSP.
FRAMING
ROOFING
FINAL INSP.
//✓� i/ V!/
YARD SPKLR SYSTEM
VENTILATION
IMOBILEHOME SVC,
BAR SINK
SPARK ARRESTOR
POWER OUTLET
ROOF DRAINS
MESH
INSULATIONISOUND
DRAINAGE PIPING I
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
DRINKING FOUNTAIN
URINAL
$
WATER PIPING
FLOOR DRAIN
ion
1L FEES
WATER SOFTENER
HOOD
SIGN
WASHER(AUTO)(DISH)
DRYER
GARBAGE DISPOSAL
SUSPENDED
LAUNDRY TRAY
KITCHEN SINK
CFM
B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
POLE, TEMIPERM
LAVATORY
3RAVITY
AMPERES SERV ENT
SHOWER
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
SQ. FT. RESID a 14/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/4C
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
MICRO FEE
MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE
SMI FEE
1
PLUMB. FEE1
1-
STRUCTURE
SETBACK
SLAB GRADE
FORMS
FOUND. REINF.
REINF. STEEL
GROUT
BOND BEAM
PLUMBING
ROUND PLUMBIN /
ROUGH PLUMB.
SEWER OR SEPTIC TANK
GAS (ROUGH)
GAS (FINAL)
WATER HEATER
WATER SYSTEM
ELECTRICAL
UNDERGROUND
BONDING
ROUGH WIRING
METER LOOP
TEMP. POLE
SERVICE
LUMBER GR.
HEATING (ROUGH)
FINAL INSP.
FRAMING
ROOFING
FINAL INSP.
//✓� i/ V!/
JJ
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESHNITIALS
GARDEN WALL FINAL
HEATING & AIR COND. SOLAR
FINAL INSP.
GRADING
cu. yd.
$ -Plus-X$-=$
REMARKS:
A.C. UNIT
COLL. AREA
HEATING (ROUGH)
STORAGE TANK
DUCT WORK
ROCK STORAGE
HEATING (FINAL)
OTHER APP./EQUIP.
FINAL INSP.
GRADING
cu. yd.
$ -Plus-X$-=$
REMARKS:
i 11 -.
07/08/1999 12:49 6195640297
CITY OF LA OUINTA
DEPARTMENT OF PLANNING & DEVELOPMENT
BUILDI ISION
24-HOUR NOTICE FOR INSPECTIONS
777-7153
CRY OF LA QUINTA
)vna J.M. Peters CO.
)6ntmctor Same V. 4.I
lwmR Nuff"r 13681 1 IVA Nr,E=bERT
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
108 ADDRESS 50-760 Mango
xplex Lot 33 .
4188
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
• 4
P.O. BOX 1504 No. €7793
Building 78-105 CALLE ESTADO
Address RAWO LA QUINTA, CALIFORNIA 92253
Owner
MailinEf BUILDING: TYPE CONST. OCC. GRP.
AddressCitrus Came
H' B1 Of Q!". Suite 2$4# A.P. Number
City Zip Tel.
431—CM Legal Description 'Tract 24990-24-2 Plan 2A
Sim Diea4 M30
Contractor lProject Description Lett 33
Aaaress
City
Zip
Tela
State Lic.
City
& Classif.
Lic. #
Sq. Ft.
Size 2%1
No. No. Dw.
Stories Units
Arch., Engr.,
Designer
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
City
Zip
State
Lic. #
L LICENSED CONTRACTOR'S DECLARATION
I hereby ffirm tf)at I m Iicen led under provisions of Chapter 9 (commencing with Section
effec of D vis' n 3 of t Busio. s and Professions Code, and m license is in full force and
effect. A it
SIGNATURE DATE
/J, OWNER -BUILDER DECLARATION
! I hereb affir, that I am exempt from the Contractor's License Law for the following
Estimated Valuation
}
$1871400
reason: (Se 703-.5,Bustness and Professions Code: Any city or county which requires a
permit to costruct, 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).
O 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
Code: The Contractor's License Law does not apply to an owner of property who
PERMIT
AMOUNT
Plan Chk. Dep.
,
Plan Chk. Bal.
7197 52
Const.
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
11
or improvement is sold within one year of completion, the owner -builder will have the burdenElectrical
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
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ I am exempt under Sec. B. 8 P.C. for this reason
S.M.I.
13,16
Grading
Driveway Enc.
Date Owner
Infrastructure
4216.51
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
bpy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL
t r :1_ 1 } • r
7•
CERTIFICATE OF EXEMPTION FROM
WORKERS'COMPENSATIONINSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.)
1 certify that in the performance of th? 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.
REMARKS
_
rt
4 n" 'Y'f1 t "(4 % . j {j{>; ;Rf{ lV
e
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
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.)
Side Street Setback from Center Line
Side Setback from Property Line
Lender's Name
FINAL DATE
-INSPECTOR
5l4IT O
0
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.
Issued by:
Validated by:
Date Permit
Signature of applicant Date
Mailing Address
Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SO. FT. ®
GAR. SQ, FT. ®
CAR P. SQ. FT.
WALL SQ. FT. ®
SQ FT ®
ESTIMATED CONSTRUCTION VALUATION $
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, 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 ® 1 Vac
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
REMARKS:
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING.
DUCT WORK
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