PLBG (13-0855) + PLBG (11081) + RPL (13181) + BLCK (11028)51995 Avenida Martinez
13-0855
13181
11081
11028
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 13-00000855
Property Address: 51995 AVENIDA MARTINEZ
APN: 773-175-024-12 -000000-
Application description: PLUMBING
Property Zoning: COVE RESIDENTIAL
Application valuation: 1040
C&hf 4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Applicant: Architect or Engineer:
-----------------
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 CI ss/: SB, to
C10 , 166 cense No.: 811114
Date: (0 3 Contracr:/
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).:
1 _ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the .
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
one year of completion, the owner -builder will have the burden of proving that he or she did not build or
improve for the purpose of sale.l.
(_) 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 whocontracts 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:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name: -
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/11/13
Owner:
BARBARA JORDAN
51995 AVENIDA MARTINEZ D n a
LA QUINTA, CA 92253
(760)564-0756
JUL 16 2013
Contractor:
CALIFORNIA DELTA MECHNICAL IN CITY OF LAQUINTA
6056 E. BASELINE RD, #155 F44ANCFpEPT. I
MESA, AZ 85206
(866)692-5273
Lic. No.: 811114
-----------------------------------------------
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.
YJ%1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
V Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier STATE FUND Policy Number 1697823-11
_ 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
37700 of the Labor Code, Is hw' comply with those provisions.
Date: ' 3 Applicant:`
WARNING: FAILURE TO SEIC!/U/RE 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.
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 c ntV enter upon the above-mentioned property fo ctio pur os
i
Dater Signature (Applicant or Age/
VV
Application Number . . . . 13-00000855
Permit PLUMBING
Additional desc . .
Permit Fee . . . . 18.00
Plan Check Fee
4.50
Issue Date . . . .
Valuation . . .
. 0
Expiration Date 1/07/14
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 3.0000 EA PLB WATER
INST/ALT/REP
3.00
----------------------------------------------------------------------------
Special Notes and Comments
WATER HEATER CHANGE OUT - 50GALLON/GAS
[2008 ENERGYI.CARBON MONOXIDE ALARM(S)
TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2010 CALI.FORNIA.BUILDING
CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
PERMIT
ISSUANCE M/P/E
90.57
Fee summary Charged Paid
----------
Credited
--------------------
Due
---------------------------
Permit Fee Total 18.00
.00 .00
18.00
Plan Check Total 4.50
.00 .00
4.50
Other Fee Total 91.57
.00 .00
91.57
Grand Total 114.07
.00 .00
114.07
LQPERMIT
JUL/09/2013/TUE 08:11 AM DELTA MECHANICAL -NU
FAX N :, 702-369-9578
P. 002
gin #
QtY of La Quin to
Building a Safety D.ivlslort
P.O. Box 1504,'78-495 Calle Tampico
ta,Quinta, CA 92253 -:(760) 777-7012 Budding Permit Application and Tracking Sheet
Permit # Q
Proj.tAddms: Sl99S tletlib C1. ,n
OwnWsNamc:. r
Address: FJ) S
Ciiy, ST, Zip: L&OwnjAa
A. P. N.umbLx
Legal Description_
Contractor: at } 1
Telephone: 5&44 - 07SILO
Address: t D
ProjectDesoription: 10
City, ST, ZiP: JAma Ai
Telephone. 1844. (r92, 5.7-73.
gas Lialtr b,= -,6r
City Uc, *-. Iot4
Arch., Bggr., Design r:
Address:
City., ST, Zip:
Telephone: Construction Type:. C5& Qc=p--y-
State Lie- 1f: Projoct type (chde one): New Add'n Alter Repair Demo
Name of Contact Person: O h n Sq. h: # Storits: fF Units:
Telephone # of Contact Pc=n: 3
Estimated Value of Project 16
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Pian Seit
ReWd
Recd
TRACKING
Plan Check submitted
VJERrdry MS.
Item .Atnouut
StructuPal Coles.
Reviewed, ready for carmetions
Plan Check Deposit
Truss Cates.
. Called Coultact Person
Platt check Ralapce•
Title 24 Cates.
Plane picked up
Canstmrdan
Flaod plain plan
Plans resubulltted '
Meahaniml
G'rading plait
2"RcvlCw. ready for correclionafisbvc
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Decd
Plans picked up
S.M.L
IMM Approval
Plans resubmitted
Grading
IN HOUSE:.
Review; ready ibr correctionsflssue
Developer Impact Fee
Planning Approval.
Called Contact Person
Pub. Wks. Appr
Date of permit Issue
School Fees
Total Permit Fees
JUL/09/20-13/TUE 08.11 nM DELTA MECHANICAL—NU
FAii Nr'. 702-369-957 T. 003
ct•iative Certificate of Compliance: Residential Nbater pleating CF- IR-ALTAVI.I
General Information
Site :\ddre.":
9 Av Climate !'Itre; j Date. 7 8'
%OTE: This fim-ur i; ,/n/6 ulferuriun nr ul/Jhiun tl/•Nater hearbIgIf it tet t.;.
WATER I1 EATING
l,(l , r l7' , / r , I f F G6; ,I:'c(/•n'C ttih( /1='(h-c//lh;' ; IU[:c' lt':'cUUtS %llt!it i[ltfUl !(;l+_'/(ills ((If
+ (j I '
twafc'1•j aul.if be <ti op. pl'rrlllute.1b,ed. tin:( 17101; lir/( _f c'•:t'(i 51) Ul(lll7.i. 11V1 tiWe1' PIPe 1P,jl(Ictri'm fiwnl (,'?L'hearer trl ((It'
l;ttc hen!;/ and in cI// I rtic'l-,l'Uund hot :I'tfte).PiPL.i i.S eet !.(ll'ec( )n, tt!l c'UMP'Inc, t pctC!iclSl.S bt ulI l(LIl1<tr rlHt.'S•
Energy FaccQr ur
i'V,irer
--lank
Standard)
E icien•v
Insulation R-` alike
Foe( Tvot
50
0'
60-T
GAS
STp
1. 110i';ufe r.pa f.S/urcf
Gus. /t!,/( Ptr'+rp. lr1S('11R01le'rn.;. _:c.1
r•1ylUl` m,01IS .)I i JUntl.
Tile Prest:riprive reyui!'t;nle/t(y tit) not
), R cN'Cf(/(I(jnr.; t-.i(Nnf,; ia'1 .111'yr
nrullip/ t(''rllinS lutits autl! nt /L/t llle +'c't:u-.'ItictUOn
I rel/u it, theinstyllatinno
a— pi or;ingledrve/lliff 'Mix.,.
... (,( .1•..tet:l li(..il .•/.l— ..c rv'.1(Il_,.l, t.l . 'r ..
`
Contractor (Documentation Author's!Respoasibte Designer's Declaration Statement)
1 ccrrir (hat thk Certificate of Con)pliancz do%:UIrlcntluon is ac,:urate.and compleEz.
• 1 am eli-ible under DiviAori : Jt the California Business and Professions L bdC tti aii2pf `-jppr1ilhil(C: h?C the t,Ullcli0{ dasl';n 1tiCntt6cd Un
(hii Certifica(, of Compliance.
( cNlzil w that the cner2v t.:ac'•tres :ani! perfu(-mance ;pecificacions iter the uildi.n_ gest_=n idcncnetl ,7n flit; C-ltiriwte Of Compliance , nn:u(-11
• to the re-quircmcnEs of Titic ?-1. Parts 1 and 6 of the California Cotte of Re{'i(a ions.
The bUdding ; csign (Cat.&fS Id,;o(; lcd on this Certificate a[ C,)ri:pll111cC aC::on6isrent •t ith die information pro•: itkd :a Jocumc,t this
`xoVUheeEs. calculations, lalti;lntl spet:(ticati i iUbmittcd to rhe
nuildin>_; .lcii•,ti On dte t'thcr applicable compliance Ppr-iu. P
CCC,,I•.... enr _t•r,-.. •: r.,rtt^"rn•:•]I -.t•itlt:h - n P!(hr?Y li*nl!'::u'on.
Nalllc: _ Ji• :11(ltrc:
T Sant(— Daie: -7
Cvmpony':
elt cch_l is- l Inc
License S l l l 14
A,Jdreis:
6056 E .Baseline Rd = 155
SC1CCZi
Mesa AZ, X5206
.i •
4
P.O. BOX 1504
Building
Address 51-995 Martinez LA QUINTA, CALIFORNIA 92253
Zeke Coronal.
Mailing
Address P.Q. Box .1238
City Zip Tel.
La Quintal, CA 92253 564-1403
Contractor
Coronel Constuuction
Address
P.O. Box 1238
City Quinta, CA ZIp92253 Tel. 564-1403
State Lic. City
& Classif. 634981 B Lic. # 2261
Arch., Engr.,
Designer
Address I Tel.
City I
Zip ,-IState I
Lic. #
CENSED CONTRACTOR'S DECLARATION
licensed under provisions of Chapter 9 (commencing with Section
iusigef ss and, Professions Codetend 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, atter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) or
Division 3 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 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.)
PolicyeN Company
Zpy is filed with the city. 0 Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of the work for which this permit is issued, I shall not
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California.
Date Owner
NOTICE TO APPLICANT: If, after making this Certificate or 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
No.
LDING: TYPE CONST. OCC. GRP.
A.P. Number
Legal Description_
Project Description
Pool
13181
ZONE:
BY:
Minimum Setback Distances:
Sq. Ft. No.
Size Stories
No. Dw.
Units
New ❑ Add ❑ Alter ❑
Repair ❑ Demolition ❑
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE
INSPECTOR
Issued by:
Date Permit
Validated by:
Estimated Valuation8:'jrjQ,
Validation:
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
64.35
Const. 'V
09f.OU
Mech. (
.00
Electrical
Plumbing
.00
S.M.I. `
Grading
Driveway Enc.
Infrastructure
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:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
SLAB GRADE
2ND FL. SQ. FT.
BONDING
YARD SPKLR SYSTEM
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. I SQ. FT. ®
GAS (ROUGH)
DRAINAGE PIPING
WALL SD. FT.
OTHER APPJEOUIP.
DRINKING FOUNTAIN.
SQ FT ®
TEMP. -POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FRAMING
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
l��'eS✓� (Tr 7 -7- if -5 3
p
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.
SQ. FT. ® c
BATH TUB
SPARK ARRESTOR
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
LATHING
SQ.FT.GAR ® 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING 7'
NDERGROUND7-& j
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. , y
$
GRADING
CU. yd.
plus x$
=$
LUMBER GR.
FRAMING
FINAL INSP. es'
v
ROOFING
l��'eS✓� (Tr 7 -7- if -5 3
p
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION / �93
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESlINITIALS
GARDEN WALL FINAL
Ct
78-495 CALLE TAMPICO — LA QUINTA, CALIFORNIA 92253 - (619) 777-7000
FAX (619) 777-7101
July 16, 1993
Coronel Construction
P.O. Box 1238
La Quinta, CA 92253
Dear Coronel Construction:
SETBACK ADJUSTMENT: 93-191
LOCATION: 51-995 Avenida Martinez
APN: 773-175-022
This letter is to report approval of your recent application for a setback adjustment,
pursuant to Chapter 9.188 of the City of La Quinta Planning & Zoning Regulations.
The following setback adjustment has been approved subject to conditions and in
accordance with attached Exhibit A .
SETBACK ADJUSTMENT:
Reduction of street side yard setback from five feet to three feet and a reduction of
the pool distance to the existing house from 5 feet to 3 feet.
FOR: Swimming Pool
CONDITIONS:
1. Obtain a building permit; provide additional'reinforcing as required by code.
2. The S -R fencing requirements shall be met.
3. Pool equipment shall comply with required setbacks and maintain a minimum of
five feet from property line.
After review it was determined that:
1. This adjustment is consistent with the intent and purpose of the Zoning
Ordinance.
1
2. There are special circumstances applicable to the property, including such
factors as size, shape, topography, location or surroundings that justify
approval of the adjustment.. These special circumstances are: small size of
corner lot .
3. 'This adjustment will not be detrimental to the health, safety, and general
welfare of the community or be detrimental to property in the vicinity of "the
parcel for which the adjustment is requested.
_ MAILING ADDRESS - P.O. BOX 15041 -'LA OUINTA, CALIFORNIA 92253
.If you have any questions, please contact the undersigned.
Very truly yours,
JE Y ER N -
P NNI G 'DEVELOPMENT DIRECTOR
i
y t ---
re Tr�usdell
crate Planner
GT: ccs
Attachment: Exhibit A
cc: Building & Safety Department
2
.•`•r_ - '^FC c ii '; L .-•-•x.+,17. ;,.(.y ,( (Z' 9311
pla
\! >' ' 1 .-f,.'!'L'[.ii, __. ,t SW r b• } ( •`. y: f-r L. i.
4 MN
r ,
W PI Lo ed • P P 31- 99S pA MEli
E5ptA
c<
DEP
`1
h- Pp1NG$ E
• W' `l A / Op E
.N ,..:-.:.•- _ 181
to
• io=oma - - S, ,t . '
L Bw t 77
S"&J GATT.
®o _
-root- eqAtImr-at.
-
. aCOCK .WALt:-!"
• ' ' -•tit • .. 'i>• '- e
/1./PAAll"
P.O. BOX 15041
Building 78-105 S1-995 MARTINEZ LA QUINTACCALIFORNIA 92253
AL E EST DO
Address,
Owner
TSH CORONEL BUILDING: TYPE CONST.
Mailing
Address SAME A.P. Number
City Zip Tel.
LA QUINTA 192253 566-0174
Contractor
CORONEL CONSTRUCTION
Address
P O BOX 1238
City Zip Tel.:
LA QUINTA 92253 564-4604
State Lic. City
& Classif. B 634981 Lic. # 2261
Arch., Engr.,
Designer
Address Tel.
City IZip I State I
Lic. #
LICENSED CONTRACTOR'S DECLARATION
e ^^
I hereby affirm that I am licensed under provisions of Chapter 9 ( o6 mmencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect. i
/ ,70 ' DATE
e
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 Processions 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 or not more than rive hundred dollars ($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Professions Code: The Contractor's License Law does not apply to an owner of property who
builds or improves thereon and who does such work himself or through his own employees,
provided that such improvements are not intended or offered for sale. If, however, the building
or improvement is sold within one year of completion, the owner -builder will have the burden
of proving that he did not build or improve for the purpose of sale.)
O 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 contractor(s) licensed pursuant to the Contractor's License Law.)
,,XI 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. -,
o. Company
Copy Is filed with the city. O Certified copy is hereby furnished.
i
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of the. work for which this permit is issued, I shall not
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California.
Date Owner
NOTICE TO APPLICANT: ff, after making this Certificate of Exemption you should become
subject to' the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this city to enter the above-.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
Description
No. 11081
OCC: GRP.
Project Description SEWER HOOKUP
Sq. Ft. No., No. Dw.
Size Stories, Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing $30.00
S.M.I.
Grading Y s
Driveway Enc.
Infrastructure
1100
.IiOSfS?'1 _in JIW T At
TOTAL x30.ff0t r+fit Y. 1. rtt.tl !
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued by: Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SQ, FT. ®
CARP. SQ. FT.
WALL SO. 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
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCTWORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVCWATER
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1% c
SEWAGE DISPOSAL
LUMBER GR.
SQ.FT.GAR ® V4c
HOUSE SEWER
FRAMING
FINAL INSP.
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE TLUMB. 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
71
ROUGH WIRING.
DUCTWORK
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
INSULATION/SOUND
FINISH GRADING
v
• FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
ct-
'
'o.'
.«=•r'•'
_,.; F.r• I -';.
... ..ii .. ..r:+ f
,fit y''i
t
COACHELLA VALLEY WATER DISTRICT
CASH RECEIPT DETAIL
Received From:
Address: _
Account No. t /el , •
Lots)
Service Address
❑ Meter(s)
❑ Service(s)
❑ Backflow(s)
❑ House Laterals)
❑ DetectorCheck(s)
❑ Meter Surcharge s
Sanitation Capacity Charge
❑ W.S.B.F.C.
❑ Temporary Construction Meter
❑ Turn on Charge
❑ Uncollected Account - Name
❑ Inspection Fee - Tract -
Fee -
❑ Plan Check Fees Water / Sewer -
Tract -
❑ Bond Payment - A.D. - Bond
Assmt.
❑ Customer Deposit
❑ Other
46666
P.O. BOX 1504 i 'No.
N o . 11028
Building 7&105 CALLE ESTADO \
Address 51-995 Martinez LA QUINTA, CALIFORNIA 92253 1
Owner ttt
Ish Co>:onel
Mailing
BUILDING: TYPE CONST. OCC: GRP.
Address same
A.P. Number
City La Quinas zipTel.
92253 5v4 -V114
Contractor
Co;ouel Construction
Address
P. €1. Boit 1238
City
Zip
Tel.:
La Guinta
92253
564-4604
State Lic.
City
& Classif. B 534981
Lic. # 2261
Arch., Engr.,
Designer
Address
Tel.
City
Zip
State
Lic. #
LICENSED C NTRACTOR'S DECLARATION
I hereby affirinIthat I am,ljcensed nder provisions of Chap et r 9 (commencing with Section
7000) of DiJis:on 3 of the Business and( Professions Cob and my license is in full force and
ILA
*SIGNATURE r 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).
❑ 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.)
❑ 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.)
O.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
CEJ Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of the work for which this permit is issued, I shall not
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California.
Date Owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you' should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter the above-.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
Legal Description
Project Description
49' of 4' block wall
161 of 211 block Waif.
Sq. Ft. No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation 897.68
PERMIT AMOUNT
Plan Chk. Dep. -
Plan Chk. Bal.
Const. 25.00
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL 25.10
REMARKS Wrf$ti . ?0 It, f '1*1D_VJS'
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued by: Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEE,$
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT.
FOR. SQ. FT. ®
GAR. SQ. FT. ®
CAR P. SQ. FT.
WALL SO. 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
MW
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® V4c
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 IA
q
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
rlv
SLAB GRADE1411z
ROUGH PLUMB.
BONDING
-
HEATING (ROUGH)
STORAGE TANK
MW
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 --I v V`✓
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 —Z 3
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL