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BLCK (11-1169)78745 Maracas Ct 11-1169 P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 c&ty/ 4 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 11-00001169 Property Address: 78745 MARACAS CT APN: 646 -050 -018 - Application description: WALL/FENCE Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 550 Applicant: Architect or Engineer: p la -------------------------------------------------- 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. 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 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, 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 contractor(s) licensed pursuant to the Contractors' State License Law.). (_ ) I am exempt under Sec. , B.&P.C. for this reason Date:. Owner: QONSTRUCTION1POING AGENCY I hereby affirm under penalty of perjury that there is a construc on lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPERMIT Owner: MILLAN ERNESTO R 78745 UNKNOWN, CA 99999 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/25/11 ' ------------------- —--- OCT 2 7 o/ y1 Contractor: 2u l t Owner CITY pI -,.._ PL Ohm ----------------------------------------------- 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 Policy Number certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 37!00 of the Labor Code, I shal hwith comply with th a provisions. ate:/ / A icant: WARNING: FAILURE TO SECURE WO ERS' COMPENSA OVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND IVIL 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 building construction, and hereby authorize representatives of this county to enterupon t above-mentioned property for i ection purposes. -" Q,itA_a'7 / 1 S' ature (Applicant or Agent): Application Number . . . . . 1.1-00001169 Permit . . . WALL/FENCE PERMIT Additional desc . Permit Fee . . . 17.00 Plan Check Fee-. .00 Issue Date . . . . Valuation . . . . 550 Expiration Date 4/22/12 Qty Unit Charge Per Extension BASE FEE 15.00 .1.00 2.0000 HND BLDG 501-2,.000 2.00 ------------------------= Special Notes and -----------------=--------------------------------- Comments. 22 L.F. 6' GARDEN WALL @ SIDE P/L. CITY STANDARD: 2010 CODES ---------------------------------------------------------------------------- Other Fees . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited Due ----------------- Permit Fee Total ------------------------------ 17.00 .00 ---------- .00 17.00 Plan Check Total .00 .00 .00 .00 Other Fee Total 1.00 .00 .00 1.00 Grand Total 18.00 .00 .00 18.00 LQPERMIT 71 L -4- N I moo® am P.O. Box 1504 LA QUINTA, CALIFORNIA 92247-1504 78-495 CALLS TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT PROPERTY OWNEW S PACKAGE (760) 777-7012 FAX (760) 777-7011 Disclosures & Forms for Owner -Builders Applying for Construction Permits - NO EXCE ermits INOTICF TO PRUM MyOVMR Dear Property Owner. Aix. application for a building permit has been submitted in your name listing yourself as the builder of the property imPV0vements specified at We are providing you with an Owner -Builder A.Cknowledgment and Information Verification Form to make you awacu of your respensibilities andpossible risk you may incur by hsving this.permit.issued in your name as the Owner -Builder. We will sot issue a building permit until you.h&ve read, initialed your•undei r -standing of eadt'provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute tlmis notice unless You, the property owner, obtain the prior approval of the permitting authority. OZ'S AeKNOWLEDG AM-VERNWATLON OF POWUMN D?lRE070AT Read and mittd earls statement befaw— to signify you acrd erstand or oa* this KomutEion. L I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material personaft- i. I, as an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those 'Aiurtes. 1 am willfully acting as an Owner -Builder and am aware of the limits of my insurancecoverage for injuries to workers on my. propeay. 2. 1 understand building permits are not required to be signed by property owners unless they are responsible for the constriction and are not hiring a licensed Contractor to assume this responsibility. 3. I understand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that I may protect myseIf from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. 5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. 6. 1 understand if I am considered an "empioYee, under state and federal law, I must register with the state and federa government, withhold payroll taxes, provide workers' compensation disability inmmwce, and contribute to unemp[oymen compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financia risk. 7. I understand under California Contractors' State License Law, an Owner -Builder who builds single-family residenti; structures cannot legally build them with the .intent to offer them for sale, unless all work is performed by .licenst subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performs under contract with a licensed general building Contractor. 8. 1 understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal. 4uries sustained by any subsequent owners) that result from any latent construction defects in the workmanship or materials. 9. I understand I may obtainmore information regarding my obligations as an "employer" from the Interval ROWEL= Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1- 800-321-CSLB (2752) or www.cstb.ca.gov for more information about licensed contractors. 10. I am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the party legally and financially responsible for proposed construction activity at the following address: 11. [ agree that, as the party legally and fmamially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner -Builders as well as employes. . 12.1 agree to notify the issuer of this form immediately of any additions; deletions, or chages to any of the in€ormaEt l 1 have provided on this form.. Licensed contractors are regulated by laws designed to protect the public- If you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any finawW loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be inVi`+il court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while wOddng on your Property, you may be lucid Battle for damages. If you obtain a permit as Owner -Builder and wish to hire Contractors, you will be responsible for v v4wher or not those Comtra:ctors are Properly licensed and the staters of thm woFlcers' compensation insurance covemp. Before a building permit can be issued, this form must be completed and signed by the property owner sad returned to the agency responsible for issufug,&e.permit. NOW A copy, of tiro pmperiW owner's diver!rAlwtsei f"M n6tadcadrfi or other verification acceptable to the agency is required to be presented when tiro p"mdt is issued to verify the property owner's signature. Signature of property owner FV Mi Note: The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner -Builder. AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BE l Excluding.the Notice to Property Owner, the exmption of which I understand is my persomal responsibility, I hereby authorize the following person(s} to act as my agents) to apply for, sign, and file the documents necessary to obtain an Owner -Builder Permit for my project. Scope of Construction Project (or DescriptionofWork): oZ L• ' " ii t L Q/'L e/t (,.N Project Location or Address: 7 % 5 MaiAu e - Name of Authorized Agent: k1 a , kc-- 7Z, Tel No L16 9- 60 7 P7 Address of Authorized Agent: 'M O If—/ a_ Cou" La- t%`.i,, 2 1 zr3 I declare wider penalty of perjury that I am the property owner for the address listed above and I personally filled out the abo- information and certify its accuracy. Note: A copy of the owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature.. Property Owner's Signature: Date: View !. 1t wG• CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YY) PRODUCER Agape Financial Services 10/27/11 9437 Heil Avenue THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Fountain Valley, CA 92708 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ORDED BY THE POLICIES BELOW. Phone (714)531-7037 ALTER THE COVERAGE AFF Fax (714)531-7067 INSURERS INSURED AFFORDING COVERAGE VELASQUEZ MASONRY INSURER A: TOWER SELECT INSURANCE NAIC INSURER s: HARTFORD 443000 30266 MUIRFIELD WAY INSURER C: 20605 CATHEDRAL CITY, CA 92234 INSURER D: COVERAGES INSURER E: INSURER THE POLICIES OF INSURANCE LISTED HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE'FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERMOR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L LTR INSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION GENERAL LIABILITY DATE MID DATE MM/DD/YY LIMITS Q COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 100DAMAGE TO REN ED 0000 A ❑ CLAIMS MADE OCCUR LD 4500042810 02/25/11 02/25/12 PREM SES Ea occure ce 100000 ❑ ❑ ❑ MED EXP (Any one person) 5000 ❑ PERSONAL &ADV INJURY 1000000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 2000000 ❑ POLICY ❑ PROJECT ❑ LOC PRODUCTS - COMP/OP AGG 2000000 AUTOMOBILE LIABILITY ❑ ANY AUTO COMBINED SINGLE LIMIT ❑ ALL OWNED AUTOS (Ea accident) ❑ ❑ SCHEDULED AUTOS BODILY INJURY ❑ HIRED AUTOS (Per person) ❑ NON OWNED AUTOS BODILY INJURY ❑ (Per accident) PROPERTY DAMAGE GARAGE LIABILITY (Per accident) ❑ ❑ ANY AUTO AUTO ONLY - EA ACCIDENT ❑ OTHER THAN EA ACC EXCESS/UMBRELLA LIABILITY AUTO ONLY: AGG ❑ OCCUR ❑ CLAIMS MADE EACH OCCURRENCE ❑ AGGREGATE ❑ DEDUCTIBLE ❑ RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 46WECAB4645 02/25/11 02/25/12 OCP TA U- E]OTH- B ANY PROPRIETOR / PARTNER / EXECUTIVE T OFFICER / MEMBER EXCLUDED? YES E.L. EACH ACCIDENT 1000000 SPECIAL PROVISIONS below If yes, describe under E.L. DISEASE - EA EMPLOYEE 1000000 S OTHER E.L. DISEASE POLICY LIMIT 1000000 DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES Concrete Contractor. / EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE CITY OF LA QUINTA EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO 78-494 CALLE TAMPICO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY LA QUINTA, CA 92253 OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Q 25 (2001/08) QF © ACORD CORPORATION 1988 CITY OF LA QUINTA SUB -CONTRACTOR LIST JOB ADDRESS PERMIT NUMBER OWNER BUILDER This form shall be posted on the job with the Building Inspection Card at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to work on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to.comply will result in a stoppage of work and/or the voidance of building permit. For each. applicable trade, all information requested below must be completed by applicant. "On File" isnot an acceptable response. Trade / Classification Contractor State Contractor's License Workers Compensation Insurance City Business License Company Name Classification (e.g. A, B, C-8) License Number (xxxxxx) Exp. Date pix/xx/xx) Carrier Name (e.g. State Fund, CalComp) Policy Number (Format Varies) Exp. Date (xx/xx/xx) License Number (xxxx) Exp. Date (xx/xx/xx) EARTHWORK (C-12) CONCRETE (C-8) FRAMING (C-5) STRUCT. STEEL (CG51) MASONRY (C-29) PLUMBING (C-36) LATH, PLASTER (C-35) DRYWALL (C-9) HVAC (C-20► ELECTRICAL (C-10) ROOFING (C-39) SHEET METAL (C-43) FLOORING (C-15) GLAZING (C-17) INSULATION (C-2) SEWAGE DISP. (C-42) PAINTING (C-33) CERAMIC TILE (C-54) CABINETS (C-6) FENCING (C-13) LANDSCAPING (C-27) POOL (C-53) Bin # City Of. La Qu(n tQ . Building 8r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # nn Project Address: 7 ys a G µ-,f Owner's Name: OR s a A. P. Number: Address: Legal Description: City, ST, Zip: ,,/. , Contractor: :.;qty :>.>::> ::>•':2a,:: >.:>.i:.?:': ':t `> Telephone: "76 O —5-6 417 3/7 Address: Project Description: City, ST, Zip: Telephone:<><Y:::.:. . State Lic. # : City Lic. #: Arch., Engr., Designer: Address: City, ST, Zip: Telephone: State Lic. #: Construction Type: Occupancy: 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 N Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cales. Called Contact Person Plan Check Balance Tide 24 Cales. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan god Review, ready for correctionstiissue 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 correctionslssue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees f 4 P.O. BOX 1504 No. 13983 Bdd Addreressig 79-74,5 Maracus Ct LA QUINTA, CALIFORNIA 92253 Owner Ernesto Millan MailingBUILDING: TYPE CONST. OCC. GRP. Address Sc' rae A.P. Number City Zip Tel. yp $ 21555-3 La Quinta 92253 564-73.7 Legal Description Contractor Project Description Gunn$ Pool 13 Unique Pols By Camino Pere La Quinta Address 74--818 Velia Way # 1 City Zip Tela Palm Desert 92260 346-6335 State Lic. City & Classif. C53 680794 Lic. # 1366 Sq. Ft. No. No. Dw. Arch., Engr., Size Stories Units Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Divisiorr3 of the Business and (Profes(sions Code, and my license is/in fullforceand effect. SIGNATURE i % / DATE OWNER -BUILDER DECLARATION r Estimated Valuation $85{fl Oil 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 AMOUNT requires the applicant for such permit to file a signed statement that he is licensed pursuant to PERMIT the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit Plan Chk. Dep. subjects the applicant to a 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 Plan Chk. Bal. • do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. } • Professions Code: The Contractor's License Law does not apply to an owner of property who ou 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 • Q 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- Plumbing • struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for S. M. 1. such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading O I am exempt under Sec. B. & P.C. for this reason Driveway Enc. Date owner Infrastructure WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of 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. 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.) I certify that in the performance of Ing work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT. If, after making this Certificate of Exemption you should become ZONE: BY: subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Minimum Setback Distances: comply with such provisions or this permit shall be deemed revoked. Front Setback from Center Line Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line' I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Side Setback from Property Lie / — Lender's Name Lender's Address This is a buildingFINAL DATE INSPECTOR permit when properly filled out, signed and validated, and is subject l0 / expiration if work thereunder is suspended for 180 days. I certify that I have read this application and stale that the above information is correct. Issued by: Date +Pe mit 0.7 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 Validated by: ,9A mentioned property for inspection purposes. Signature of applicant —Date— Mailing ateMailing Address Validation: City, State, Zip \ `i CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS COLL. AREA „ 2ND FL. SO. FT. YARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. SO. FT. DUCT WORK DRAINAGE PIPING WALL SO. FT. DRINKING FOUNTAIN. SO. FT. ® HEATING (FINAL) URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation 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 GRADING cu. yd. $ plus x$ 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. SO. FT. ® c BATH TUB FIRE ZONE ROOFING SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR ® 3/4c HOUSE SEWER GAR. FIREWALL GAS PIPING PERMIT FEE LATHING PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE HPL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING .Z_2 UNDERGROUND 9 Z Jc A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM FINAL INSP. _ GRADING cu. yd. $ plus x$ =$ LUMBER GR. FRAMING FINAL INSP. _zo. iC ROOFING y %J Kiri/ /Z ZAeet REMARKS: O fJ Arrt rr VENTILATION CQ J ad FIRE ZONE ROOFING p ., per FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION q4Q—CjC1 CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL Parc la quinta PARC LA QUINTA HOMEOWNERS ASSOCIATION AVAIL PROPERTY MANAGEMENT P.O. BOX 1032 PALM DESERT, CA 92261 (619) 568-2717 City of La Quinta a Quinta, Calif,Drnia _ RE: 'f ?-744S" X91 -4f:7 -e -v& C7- M. iM. WHOM IT MAY CONCERN: Unique Pools has been hired to install a pool at the above reference location. The Homeowners Association approves of this installation with the understanding the side Nall/gate will be re -constructed in the exact location from which it was removed and with the same or similar materials. Further, Unique Pools will clean the debris :`.rom sight each night before leaving, and no heavy equipment will be left visible to the street. Should you have any questions, please contact this office. Sincerely, 0-'M aaLL4,,' Cam Anderson Project Mgr. Building 78-745 M=,aA Ct. Address Bal; am Dov. T-itif 4 4 Q" P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Mailing Address 68-713 Perez Rd. #1 City Cat City Zip 92234 Tel. 773-9024 Contractor I 8&IIE Address State Lic. City & Classif. 337077 Lic. # 1219 Arch., Engr., Designer Address I 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 70pp) of Divisions 3 of tL)1 h Business and Professions Code, and my license is in fu 1 -force and effect C ! _ ! i t yt 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,Busi7ess and Professions Code: Any city or county which requires a permit to construct, atter, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to rile a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 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 rive hundred dollars fS500). ❑ 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 knprovements are not intended or offered for sale. If, however, the building orrnprovement is soil within one year of completion, the owner-bulider will have the burden of proving that he did not bueld 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 contractorfs) 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 \ 1 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: H, 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 1 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 certity 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. 45945 LDING: TYPE CONST. OCC: GRP. P. Number Description Pt8" III Lot 8 Project Description Plan 2222 Faze La QSinta 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 6-16-89 Permit Validated Validati Sq. Ft. 2222 Size No. Stories No. Dw. Units New IX Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation 112,161.00 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal..571.10 Const. f3b5 . V Mech. Electrical . 79 Plumbing 14 U S.M.I. 7#91 Grading Driveway Enc. Infrastructure l Z 3.b3 a TOTAL 4IL2.9J 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 6-16-89 Permit Validated Validati CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS / B GRADE ( 2ND FL SQ. FT. YARD SPKLR SYSTEM STORAGE TANK MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® DUCT WORK ROCK STORAGE GAR. SO. FT. ® POWER OUTLET ROOF DRAINS HEATING (FINAL) OTHER APPIEOUIP. DRAINAGE PIPING CAR P. I SO. FT. ® WALL SQ. FT. GROUT DRINKING FOUNTAIN. SOFT ® FINAL INSP. URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER SYSTEM WATER PIPING NOTE: Not to be used as property tax valuation -$ FLOOR DRAIN MECHANICAL FEES FRAMING / WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED VENTILATION LAUNDRYTRAY AIR HANDLING UNIT CFM FIRE ZONE ROOFING= 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 THING ( 7` SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/. c SEWAGE DISPOSAL SO.FT.GAR ® 3/4c 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 S BACK RN&PLUMBIUNDERGROUND ay A.C. UNIT COLL. AREA / B GRADE ( ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK F S SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE VO/D- REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPIEOUIP. V11REINF. STEELS (FINAL) l TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM $ GRADING cu. yd. plus x$ -$ LUMBER GR. AL INSP.' FRAMING / AL INSP. -(/1CU/-- 1 q_ l ROOFING y7 n %1 ] I — / /Gr REMARKS. VENTILATION FIRE ZONE ROOFING= FIREPLACE SPARK ARRESTOR GAR. FIREWALL THING ( 7` MESH NSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL t