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PAT (07525) + RPL (06706)79515 Marigold Lane 07525 06706 P.O. BOX 1504 N o . Building 78-105 CALLE ESTADO Address 79-515 Har3to2d Laud LA QUINTA, CALIFORNIA 92253 Owner Address Sam. City Zip Tel. La GuInta 92253 35-►8 . ress City lZip State Lic. I City & Classif. Lic. # 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 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). O I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec. 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 if /t_J 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 (s 100)' valuation or less.) I certify that in the performance of the work for which this permit is issued, 1 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 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 Address City, State, Zip BUILDING:,TYPE CONST. - OCC: GRP.- A.P. Number cact" $loiia1E Legal Description Project Description natio r 07525 REMARKS 3'1 ' 6r YYr! s . r .,r • s .., .m . ., 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 4/10/90Permit Validated by: Validation: Sq. Ft. Size No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. S29.25 Mech. Electrical Plumbing S.M.I. . AA Grading Driveway Enc. Infrastructure TOTAL REMARKS 3'1 ' 6r YYr! s . r .,r • s .., .m . ., 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 4/10/90Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ 2ND FL. SO. FT. POR. SO. FT. ® GAR. SO. FT. ® CAR P. SO. FT. WALL SO. FT. ® SO 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 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) LAUNDRYTRAY 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. SO. FT. ® c BATH TUB BOND BEAM SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1% c SEWAGE DISPOSAL LUMBER GR. SO.FT.GAR ® 3Ac HOUSE SEWER FRAMING 5 Q_ 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 APPIEOUIP. 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 5 Q_ FINAL INSP. ROOFING �✓ - / q// telhIr OJ 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 T4tit 4 P.O. BOX 1504 No. 06706 Building 78-105 CALLE ESTADO Address 79-515 ftrigold LuteLA QUIIVTA, CALIFORNIA 92253 Mortenson Mailing Address City Zip Tel. La Qainl a 92253 L{ 0 . Contractor Califo=' La Parols & Spas Address 41-910 Boardwalk A-3 City Zip Tel.: Pain Desert 92260 340-9000 State Lic. City & Classif- 185102 Lic. # Arch., Engr., Designer Address Tel. Ity "f Zip I State rf n A Lic. # r UC04SED CONTAAdTOR%S DECLARATION ✓ ,r I hereby affirm tiW 1 am licensed under prbvisions•of Chapter 9 (commenting w.kit¢=Sect DOD) of Dmvision;3'.iif the Business,and Professiony Code, and my license i"s°in fullPforce't ffr t.. 0 t I f,%. l ., .x I iii" f . I' r i r c ,. - OWNER -BUILDER DECLARATION 1 hereby affirm Unat 1 am exempt from the Contractors License law for the following reason: (Sec- 7031-5,8ushess and Professions Code: Any city or county which requires a permit to construct. after, improve, demolish, or repair any structure, prior to its issuance also requires the aPPI=d for such permit to Me a signed statement that he is licensed pursuant to the provisions of the Canbactor'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 tar the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit subjects the appica t to a c"penaffy of not more than five hundred dollars ($500). ❑ 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 professions Code: The Contactor'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 irprovemenls are not intended or offered for sale. If, however, the building or improvements sold wifhim arra year of completion, the owner -builder will have the burden Of Provxhg that he it'd not bkii or improve for the purpose of sale.) ❑ 1, as owner of the properly, am exclusively contracting with licensed contractors to con- struct the project (sec- 7044, Business and Professions Code: The Contractor's License Law does not appy to an owner of property who builds or improves thereon, and who contracts for such projects with a contrdctar(s) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec a_ & P.C. for this reason Date owner WORKERS' COMPENSATION DECLARATION WI hereby affirm that I have a certificate of consent to. self -insure, or a certificate of Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No Company ❑ Copy is filed wfth the qty- ❑ 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 fess-) . 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: f, after making this Certificate or Exemption you should become subject to the Mbrkas' C m petsatron provisions of the Labor Code, you must forthwith corrpy With such provsiors or Llys 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.) Lenders Name Lenders Address This is abuilding permit when "properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. ' I certify that 1 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 Plawar Legal Description Project Description Pool & Spa Sq. Ft. No. No. Dw. Size Stories . Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ PERMIT AMOUNT Plan Chk. Dep. Distances: Plan Chk. Bal. Front Setback from Center Line Const. L{ 0 . Mech. 30.00 Electrical 27.00 Plumbing 24.00 S.M.I. 1.1 Grading Validated by: Driveway Enc. Infrastructure TOTAL REMARKS _ ,z*i `?t" riff:: t,; "179.i9 tri 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 32%5/859 Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SQ. FT. ® $ UNITS SLAB GRADE 2ND FL SQ. FT. ROUGH PLUMB. BONDING YARD SPKLR SYSTEM STORAGE TANK MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® DUCT WORK ROCK STORAGE GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS HEATING (FINAL) OTHER APPJEQUIP. DRAINAGE PIPING CAR P. I SQ. FT. GAS (FINAL) TEMP. POLE WALL SQ. FT. GROUT DRINKING FOUNTAIN. SQ FT ® FINAL INSP. URINAL ESTIMATED CONSTRUCTION VALUATION $ 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 REMARKS: 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. SQ. FT. RESID ® 11/. c SEWAGE DISPOSAL MESH SQ.FT.GAR ® 3/ac HOUSE SEWER INSULATION/SOUND 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, 4,, / r"3 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 4 -J- U REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION Sat L CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL ' - P.O. BOX 1504 N o . 05,904 Building 78-105 CALLE ESTADO Address 79-515 Mar3.ROl4ani LA QUINTA, CALIFORNIA 92253. Owner ... , ... _ v La Quinta Associates "' .... .'... Mailing BUILDING. rTYPE CONST. OCC: GRP. Address 43-875 Washington Sts w A.P. Number. City Zip Tel. P.D. . 92260 - w. Legal Descriptio fliaai ZI Lot 34 E Address - ... Project Description Plan 481 Cactus Floes e t. €iil lts i1 .,• o ,_,.., ; .a ,.. ...... , f . - :. I , Ity up Ie1.. State Lic: & Classif- 49919• City 12 - -Arch-, Engr., Designer Address- Tel: Lic. # ' .City Zip State i„ Lic. # LICENSED CONTRACTOR'S DECLARATION `I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section '-7- 7000) of Division 3 of the Business and Professions Cade, and my license is in full force and effect: - i SIGNATURE •DATE - OWNEWBUILDER DECLARATION 1 hereby affirm that 1 am exempt from the Contractors License Law for the following reason: (Sec. 7031-5,Bsiress and RWessions Code: Any city or county which requires a permit to .construct, after. improve. denn4sh, or repair any structure, prior to its issuance also •,;•,requires the, applicant for such permit to fife a signed statement that he is licensed -pursuant to the•; provisions"'of the ConhactorS 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 +:fob, -the aged iexarptiorn. Any violation of Sermon 7031.5 by -any applicant for a permit subjects the applicant to a avd penalty of not more than five hundred dollars.($500). O I, as owner of the property, or my employees with wages ai 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 reproves thereon and who does such work himself or through his own employees, provided that such erprovemems are not Wended or offered for safe- d, however, the building.. or improvement is 'sold within' one year of completion, the owner -budder will have the burden of . proving that he did not tndd or frrprove for the purpose of sale ) i ,:a Sq. Ft. Size 1$$7 Stories ; New © Add ❑ ' Alter ❑ No. Dw. Units Repair ❑ ``Demolition ❑ Estimated Valuation $$1509.0 ` rt } PERMIT , AMOUNT Plan Chk. Dep. Plan Chk. Bal. • , .. , , 39 4.ZW ' Const. {} Mech. • Electrical' • t - ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumblfig 3. • struct the -project. (Sec -.7044. lAtimess and Prolessions Code: The Contractor's License Law ' does'not apply to an owner of property who bolds or improves thereon, and who contracts for S.M.I. • ' . • such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading ❑ I am exempt under Sec_ R, & P.C. for this reason Driveway Enc. Date owner Infrastructure 222.1.98'' WORKERS' COMPENSATION DECLARATION' ' I hereby affirm that 1 have a certificate of consent to self -insure, or a certificate of - Workers 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 civ c•Ls•;(, .- CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE (This section need not be eonpleted If the permT is for one hundred dollars (S100) valuation [)'• i"tf`.,f pa ,L tf 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: B after malting this Certificate' of Exemption you should become `subject ZONE:, -- , BY: ' to the 1Morkers' CarrpensalkIn provisions of the Labor Code, you must forthwith • - comply with such wovImons or Orispermd shailbe deemed revoked. - - • - Minimum Setback__Distances:, • ,, Front Setback from Center Line Rear Setback from Rear Prop. Line - CONSTRUCTION LENDING AGENCY. Side Street Setback from Center Line I hereby affirm that there is a construction lending agency for the performance of the ' work for which this permit is issued. (Sea 3097, Ciel Code.) Side Setback from Property Line .Lenders Name Lenders Address FINAL DATE INSPECTOR ' This is a building permit when property filled out' signed and validated, and is subject to expiration'if work thereunder is suspended for 180 days.., • . f. I certify that I have read this application and state -tht the above information is correct.: ' Issued by: Date - Permit' ' I agree to comply with all city and county ordinances and state laws relating to building ' ^ " construction, and hereby authorize representatives -of this city to enter the:above-... ` mentioned property for inspection .. .. ­ - wtrPoses'Validated by: -+ Signature of applicant Date " • Mailing Address Validation:' City, : State. Zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS SLAB GRADE f1(a ROUGH PLUMB. BONDING YARD SPKLR SYSTEM F 2ND FL S0. FT. FORMS SEWER OR SEPTIC TANK ROUGH WIRING. MOBILEHOME SVC. BAR SINK POR. SO. FT. ® AS (ROUGH) ( 2 rf METER LOOP GAR SO. FT. ® POWER OUTLET ROOF DRAINS GAS (FINAL) ( //z -.r POLE DRAINAGE PIPING CAR P. I SO. FT. GROUT WATER HEATER WALL SO. FT. FINAL INSP. DRINKING FOUNTAIN. BOND BEAM • WATER SYSTEM URINAL SO FT ® =$ LUMBER GR. ESTIMATED CONSTRUCTION VALUATION $ FRAMING 10 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 LAUNDRY TRAY 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 SO. FT. ® c WATER HEATER MAX HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1% c SEWAGE DISPOSAL SO.FT.GAR ® V4c HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE fL.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 f1(a ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING. DUCT WORK ROCK STORAGE FOUND. RE NF. L 2 / FJ AS (ROUGH) ( 2 rf METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) ( //z -.r POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM • WATER SYSTEM GRADING ;1 4-cu. yd. $ plus x$ =$ LUMBER GR. FINAL INSP. FRAMING 10 FINAL INSP. ROOFING VENTILATION (/ REMARKS: FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR FIREWALL LATHING .7(V/ MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS ' GARDEN WALL FINAL 1