BLDG (0004-020)51505 Avenida Martinez
0004-020
14413
14658
12410
LICENSED CONTRACTOR 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 # Lic. Class Exp.. Date
6 2^3 C-39 1 09430/2(
Date i/ U X°-JSignature of Contractor % / ` ' ' ;Z
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 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 & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
() I am exempt under Section B&P.C. for this reason
Date Signature of Owner
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 & policy no. are:
CarrierSTATE FU14D Policy No. 235-00-0001707
(This section need not be completed if the permit valuation is for $100.00 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, and agree that if I should become
Subject to the workers' compensation provisions of Section 3700 of the Labor
Co6e, I shall forthwith comply with.those prove ions?
ffate: / ,%,, } rm Applicant 1462 Crr ' /i wn G / k0l,
/.....
Warning: Fa,ilure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $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.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to .the conditions and restrictions set forth on his
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 applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quints, its officers, agents and employees.
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 State laws relating to the building
construction, and hereby 'authorize representatives of this City to enter upon
the/above-mentioned property for inspection purposes.
Signature (Owner/Agent) / Date
U
BUILDING PERMIT PERMIT#
DATE VALUATION LOT 06. 4-020 TRACT
JOB SITE
APN
ADDRESS
OWNER
CONTRACTOR/DESIGNER/ENGINEER
PERFF7,
BAZUA ROOFD40
51-505 MART.NFZ
85990 M IDDMON
LA CSL%wv. CA 92253
THERMAL CA 92254
(7601776.7663 C}3LO 2600
USE OF PERMIT
GMQ_MW,.
>t
RE -ROOF OVER EXISTINCI SH MULZS WITH SAME KIND OF"SHlNGL E
rA
RYROOF :X500.00 LIQ APS 042009
2000
!,
IrSIMIAT D COST OF CON15TRUC-MON
34500.00
RER.00F MJ Z 101-000.418.000 X34.00
fi
A
MW r0TAL C014W t! UC`ixON AND PF,.W CHECK
$30.00
LESS PRE -PAID FMS
$0.00
I OTAL PKRMfT Fri ,S DUE NOW
MIMI,
RECEIPT
DATE
Y
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck(p
oc7
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.Q.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
'
T4&f 4 4--Q"
Building 51-505 Ave. Martinez
Address
Owner Danny Johnson
Mailing
Address Same
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
City Zip Tel.
La Quinta, CA 92253 771-0158
Contractor
Owner/Builder
Address
p
State Lic. City
& Classif. I Lic. #
micas., tngr., '
Designer
Address Tel.
City( Zip ( State I
Lic. #
LICENSED, CONTRACTOR'S DECLARATION .
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000)
t. of Division 3 of the Business and Professions Code, and my license is in full force and
effec
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,Bustness 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 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 cfvfl penally of not more than rive hundred dollars ($500).
l as owner of the property, or my employees with wages as their sole compensation, will
o 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 or 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.)
0 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 or property who builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pdrrsuant to the Contractor's License Law.)
0 1 am exempt under Sec. !B. & P.C. for this reason
ate .. / Owner
r
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, ora certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
0 Copy is filed with the city, 0 Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed Athe permit is for one hundred dollars ($100) valuation
or less.) J
1 certify that in the performange offthp work fortwhich this permit is issued, I shall not
employ any arson In any mann rsoJas to become, subject to the Workers' Compensation
ws qi Ali omta:-
Dat Owner
NOTICE TO APPLICANT. N, after making this Ceffifica a of Exemptlon you should become
subject to the Workers' Corrpensa0on •provisions o/ the Labor Code, you must forthwith
comply with such provisions or this permit shall be deems evoked. -
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 ($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.
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 160 days.
I car ify,that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this city to enter the above.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, ZIp
No. 14858
19
BUILDING: TYPE CONST
Number
OCC. GRP.
Legal Description
Project Description 40 1. f' of 61 high wood fence
Sq. Ft. No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation $340 00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
15.00
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
15.00
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 Prope VLme r__
FINAL DATE INSPECTOR
AV
Issued by: Date` Permip,4 f
A
Validated
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW\i FEES
1ST FL. SO. FT. ® $
2ND FL. SO. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. I 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
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L 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
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 ® 11/a c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
REMARKS:
VENTILATION
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 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
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
• Qum&
F
t P.O. BOX 1504
Building 51-505 Ave. Martinez 78-495 CALLE TAMPICO "
Address LA QUINTA, CALIFORNIA 92253
Owner Danny R. Johnson
'Mailing
Address Same
City Zip Tel.
La Quinta, CA 92253 771-0158
Coffit tL95.-.- /BLtf.lder
Address .
Tel.:
State Ljc. — I City
8 Classif. Lic. #
Arch., Engr., -
Designer
Address Tel.
City lZipState
(
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 1 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 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 penally of not more than rive hundred dollars ($500).
a
s owner of the property, or my employees with wages as their sole, compensation, will
l0 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 andProfessions 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.. 8 P.C. for this reason
Date f /_`'Owner !'f acrrl1 ` F
y
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. O Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed ifthe'permit is for one hundred dollars ($100) valuation
or less.) " ! • j
1 certify that in the performance,of thF work for which this permit is issued, I shall not
employ anyerson in any manner so as to becomesutiject to the Workers' Compensation
Laws gf ca 91pt
Date! Owner
NOTICE TO APPLICANT: d, 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.
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 '($100,000), IN ADDITION TOrTHE COST OF COMPENSATION,
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE', INTEREST, AND
ATTORNEY'S FEES.
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certify that I have.read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives 'of this city to enter the above-.
mentioned property for Inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
No. 14413
BUILDING: TYPE CONST. OCC. GRP.
A.P. Number
,Legal Description
Project Descriptiori Patio Cover
Sq. Ft. 360 • No. No. Dw.
Size Stories Units
New ❑ Add ❑ • Alter ❑ Repair ❑
'Demolition ❑
Estimated Valuation $4t788.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
46.80
Const.
72.00
Mech.
Electrical
Plumbing
S.M.I.
-50
Grading
Driveway Enc.
Infrastructure
119..34
TOTAL '
REMARKS
ZONE- BY:
Minimum Setback Distances:
Front Setback from Ce/moi
Rear Setback from Rear D. Lin
Side Street Setback: Cent
Side Setback from• opels,6ine
ff CC
FINAL DATE , IN PECTOR I o n
Issued by:.
Validated by:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW FEES
IST FL. SQ. FT. ® $
UNITS
A.C. UNIT
2ND FL. SQ. FT.
SLAB GRADE
YARD SPKLR SYSTEM
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO, FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. I SQ. FT.
DRAINAGE PIPING
WALL SQ. FT.
DUCT WORK
DRINKING FOUNTAIN
SO. FT. ®
GAS (ROUGH) '
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
REINF. STEEL
FLOOR DRAIN
MECHANICAL FEES
TEMP. POLE
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FINAL INSP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
WATER SYSTEM
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
�( �/
�A"�`�V • �/ �I
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1 I c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/.c
HOUSE SEWER
FIRE ZONE ROOFING '
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 APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
$
GRADING
cu. yd.
lus x$
-plus-x$-=$-
=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
/ / �//,I� I r/
,V/�//7K/
�( �/
�A"�`�V • �/ �I
REMARKS:
REMARKS:
VENTILATION
FIRE ZONE ROOFING '
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
51 -505
Avenido
Mortinez.
APPA
Y PLANNING & DEVELOPMENT DEPARTMENT
S
.BY
GATE
EXHIBIT
N
: - 4 X'8" Beam
CASE N0.
0
--- --- =-- ----
--- --- --- -- -- ---
--- --=
-- -- -- ---
o---
U-,
0
_
o
LL-
C>
CD -
36.000 FT
--Tl
0
0o
-- - ----_ P r o p e. r t y Line
CA
o .
•
•
0
Utter iia. S Spacing
soot htcA
Co'Dtiemout Sed11 rr
If I
ak.,er y X
Size.
• after ipso -
--_l?IAV.
See Holing Mot• Ulow
spa / sooling t SAeatAlwe ar qeo Lattice
' "d, ' ' i
JL
Y aat angle strap /
rus"al-mils- oStb J
4-14 s Bails or bolt
t
nt apacial_ frall IrLsth
11118. cm- posts
4 2000 0.9A. m - ate --.r_j .t'-j-
PAZ.
J
111x. IrX12"
3/8"m3- lag screws Sato at•ds At Ig- D.C. tooting 12"
lelov C:ads
Caotsb~ ledger
L_J
11 -strep or
Angle
Provide 1" i Ron-e.rosiwo.•
learanc plate
ost To 60 _ -
Joi.t man er • s. d Concrete . ••
S r Ii sloctiat
hail (after to SlodUs
M- al"s6><'fiw 4 - IS 4 angle or bolt
SDPIL CI ZMy 70
"I'= URUMi S1;TIIAM tubed AwcMrs s- L scat.
CME
so -M sots, "'L'z .0 0 •
cradiry (Fibr
(feet 20-70
iaNes)
bks• €tis yb• €
2X4 16' C.C. 11-2 10-6 7-li 6-3 6-4
24' 9-0 1-1 6-S 6-9 5-2
2x:S 12- c.c. 17-10 17-5 3-0 13-7 load
16• 16-3 15-1 1-3 11-9 H
24' 13-3 12-4 1-2 9`7 7-1
32 • ' 10-10 5-11 7-0 7.4 S -S
? e4 16• case 21-S n -lo 11-10 1S -a U-6
24- - 17-6 16-3 12-1 12-5 !.
32• - 11-5 13-0 10-0 104 7-0
4 4a QuIbAu
FC250 143 tee2,87, rR
• 1'' ` «4.
•
• •,tt trate
's
r T _
1 ADM IfeLJm. .
dmvlm tis 14.1
site am St7t • Ma
4m4. s' y•i 1'.
• Aacbor
rt►olto
4x10 .. -- U• .
AL2_....17' y'12 ta'
14'
. 4' baf fj
Wo.....11• '6100 1y
ldefiaq Sete
A' "30d mhakes 4/12 pitch (3/12.si-j. pitch •-11 301
felt trd`layl Class A
b• *Cd. C—m5itier. A` -noes 4/12 pitg!t 13/12 tri..
pitch v:tA 151 felt uldeflayl. Class A
e. hilt LP mlled roof slcpe to dra_..
d* kir k sa0f 3/12 minx y Fatch.
T PIML P-NTW CWZR
Building
Address 51--505 Martinez
Owner Danny Johnson
T4hf
"
P.O. BOX 1504 No. 12410
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Address Same
City Zip Tel.
to Quint a0 CA 92253 554-4708
Contractor
Owner/Builder
Address
City lZip I Tel.
State Lic. I City
& Classif. Lic. #
Arch., Engr.,
Designer
Address TTel.
CityI Zip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm th t 1 afn licensed uh`deVrovisions of Chapter 9 (commencing with Section
000) of Division f,the LBusiness ajid,PEf ,9kions Code, and my license is in full force and
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, after, 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).
❑ 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 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.)
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property who builds or improves thereon, and who contracts for
such projects with a contractors) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of 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
WING: TYPE CONST. OCC: GRP.
,A.P. Number_
(Legal Description
Project Description 100' of .h high wood frame
fence
ram' -
fence with stucco
Sq. Ft. No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
f µ
Estimated Valuation $683.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
tr 25.40
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
`r
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 i er" it
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
SLAB GRADE
r H
t
2ND FL. SO. FT.
BONDING
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
FOUND. REINF. ) 1
GAS (ROUGH)
DRAINAGE PIPING
CAR P. SQ. FT.
OTHER APP.IEQUIP.
REINF. STEEL
WALL SQ. FT.
TEMP. POLE
DRINKING FOUNTAIN.
SO. FT. ®
GROUT
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
WATER SYSTEM
FLOOR DRAIN
MECHANICAL FEES
_$
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
SPARK ARRESTOR
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
LATHING �' G
SO.FT.GAR ® 3/ac
HOUSE SEWER
MESH
GAS PIPING
PERMIT FEE
INSULATION/SOUND
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
+t
FORMS J\
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. ) 1
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEQUIP.
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
l
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING �' G
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
T
r ,
78-105 CALLE ESTADO - LA QUINTA, CALIFORNIA 92253 (619) 564-2246
March 13, 1991
To Whom It May Concern:
The structure located at 51-505 Avenida Martinez is located in a
"B" flood zone per the revised F.I.R.M. for La Quinta..
If you have any questions, feel free to contact me.
Sincerely,
BUILDING AND SAFETY DEPARTMENT.
Tom Hartung
Director of Building and Safety
TH:es
LTRTH12