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SPIN (08-489)52835 Avenida Martinez 08-489 11853 9884 9801 04582 `..=POSVON JOB IN CONSPICUOUS PLACE INSPECTOR MUST SIGN ALL APPLICABLE SPACES JOB ADDRESS 52-835 AVENIDA MARTINEZ 440 SQUARE FEET SOLID COVERED PATIO COVER PER CITY STANDARS & APPROVVED PLANS. PER AJ TYPE OF INSPECTION DATE INSP. TEMPORARY POWER SETBACKS U/G PLUMBING / WASTE U/G ELECTRICAL / GROUNDING FOOTINGS / STEEL CONCRETE SLAB DO NOT POUR CONCRETE UNTIL ABOVE SIGNED ROOF NAIL / PRE -ROOF OKAY TO WRAP FRAMING COMBINATION ROUGH ELECTRIC ROUGH PLUMBING ROUGH MECHANICAL COVER NO WORK UNTIL ABOVE SIGNED INTERIOR GYP. BD. DRYWALL EXTERIOR LATH GAS TEST SEPTIC ABANDONMENT SEWER CONNECTION SEPTIC / GREASE INTERCEPTOR MASONRY INSPECTIONS FOOTINGS / STEEL BOND BEAM POOL / SPA / WATER FEATURE INSPECTIONS PRE-GUNITE / SETBACKS U/G PLUMBING U/G GAS U/G ELECTRICAL PRE -PLASTER (ALARMS/ BARRIERS FINAL INSPECTIONS TEMP. USE OF PERMANENT POWER PLUMBING MECHANICAL PUBLIC WORKS DEPARTMENT COMMUNITY DEVELOPMENT DEPT. FINAL / JOB COMPLETED ABOVE APPROVALS DO NOT INCLUDE RIGHT TO TURN ON UTILITIES OR OCCUPY BUILDING I J _ W 1 v Ur LA UUINTA BUILDING & SAFETY DEPARTMENT y'' INSPECTION REQUEST LI NE `} „ _• 777-7153 . . imc Ia•---Owiier MARTINEZ RESIDENCE J.-4 KCorit actor OWNER / WILDER I =!. I `..=POSVON JOB IN CONSPICUOUS PLACE INSPECTOR MUST SIGN ALL APPLICABLE SPACES JOB ADDRESS 52-835 AVENIDA MARTINEZ 440 SQUARE FEET SOLID COVERED PATIO COVER PER CITY STANDARS & APPROVVED PLANS. PER AJ TYPE OF INSPECTION DATE INSP. TEMPORARY POWER SETBACKS U/G PLUMBING / WASTE U/G ELECTRICAL / GROUNDING FOOTINGS / STEEL CONCRETE SLAB DO NOT POUR CONCRETE UNTIL ABOVE SIGNED ROOF NAIL / PRE -ROOF OKAY TO WRAP FRAMING COMBINATION ROUGH ELECTRIC ROUGH PLUMBING ROUGH MECHANICAL COVER NO WORK UNTIL ABOVE SIGNED INTERIOR GYP. BD. DRYWALL EXTERIOR LATH GAS TEST SEPTIC ABANDONMENT SEWER CONNECTION SEPTIC / GREASE INTERCEPTOR MASONRY INSPECTIONS FOOTINGS / STEEL BOND BEAM POOL / SPA / WATER FEATURE INSPECTIONS PRE-GUNITE / SETBACKS U/G PLUMBING U/G GAS U/G ELECTRICAL PRE -PLASTER (ALARMS/ BARRIERS FINAL INSPECTIONS TEMP. USE OF PERMANENT POWER PLUMBING MECHANICAL PUBLIC WORKS DEPARTMENT COMMUNITY DEVELOPMENT DEPT. FINAL / JOB COMPLETED ABOVE APPROVALS DO NOT INCLUDE RIGHT TO TURN ON UTILITIES OR OCCUPY BUILDING I J 4 4 Qum& P.O. BOX 1504 Building 52-835 MARTINEZ 78-105 CALLE ESTADO Address LA QUINTA, CALIFORNIA 92253 Owner DAVID LUTES Mailing Address P. 0. BOX 1544 City Zip Tel. LA QUINTA 192253 Contractor VALLEY PLUMBIRG Address P 0 Boa 665 Zip Tela 92202 1 347-362 State Lic. City & Classif. 2730£8 Lic. # 101 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. {s 1 ! -! 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 or 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 or proving that he did not build or improve for the purpose or 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 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. 38_0 0, L.abor Code.) Policy No. Company `% y ' • 1...;,+f C py 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 or 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 No. 11883 BUILDING: TYPE CONST. OCC: GRP. A.P. Number I Description Project Description SEWER UOOKUP REMARKS X`u---T,;A.Vh V- 1JIOr !-. . - -.W,Qt/ - 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: Sq. Ft. Size No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ 'Demolition ❑ Estimated Valuation $2,Qo© PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing $430.00 S.M.I. Grading Driveway Enc. Infrastructure TOTAL nS31?.«o.ti, canx eK ^ •,,_.n < REMARKS X`u---T,;A.Vh V- 1JIOr !-. . - -.W,Qt/ - 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. SO. FT. ® $ UNITS SLAB GRADE ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL. S0. FT. FORMS LP SEWER ORSEPH63JW1( OUGH WIRING. As MOBILEHOME SVC. BAR SINK POR. SO. FT. ® GAS (ROUGH) METER LOOP HEATING (FINAL) POWER OUTLET ROOF DRAINS GAR. SO. FT. ® TEMP. POLE GROUT DRAINAGE PIPING CARP. SO. FT. ® FINAL INSP. WALL SO. FT. ® WATER SYSTEM DRINKING FOUNTAIN, GRADING _Cu. yd. $ -Plus-X$-=$ URINAL SO. FT. ® FINAL INSP. FRAMING 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 WASH ER(AUTO)(DISH) APPLIANCE DRYER FIRE ZONE ROOFING GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FIREPLACE 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 SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR ® 3/ac HOUSE SEWER FINAL INSPECTION 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 LP SEWER ORSEPH63JW1( OUGH WIRING. As DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP./EQUIP. 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 . b!°'+„ '• ,pg •K vm K.r _, ... .., A.:.. - ..... h ?S.i .'a= .h:ATi+. 7 . .. '..,} ' "w"u',or 7ii. w.j> n": 'rt +sf+,t i.Yf-k .JS=•tj.i.•":i ;rT:. r p..t"1:'1ii i.yRf COACHELLA VALLEY WATER DISTRICT . q j CASH RECEIPT DETAIL 11► 5' Received From: Address: Account No. Lots Service Address .- ❑ Meter(s) ❑ Service(s) © Backflow(e) ❑ House Lateral(s) LI DeteclorChack(s) ❑ Meter Surcharge , Sanitatlon Capacity Charge ❑ W.S.B.F.C. ❑ Temporary Construction Meter ❑ Turn on Charge ❑ Uncollected Account - Name ❑ Inspection Fee - Tract - Fee - ❑ Plan Check Fees Water I Sewer -, Tract - ❑ Bond Payment - A.D. - Bond Assmt. ❑ Customer Deposit ❑ Other Remarks: ❑Copy to: Cash Cec heck Money Order idry a:. ;;. G.A. Code c. TOTAL '•z!';a ._.... Water Service . , Cashier CVWD-4 111 8 .,y ?I. 1 4 y P.O- BOX 1504 No. 9884 Building 52—i 36 kiARTIREZ 78-105 CALLE ESTADO { C Address LA QUINTA, CALIFORNIA 92253 Owner Mailing DAVID LUTES GAS PIPpp BUILDING: TYPE CONST. OCC: GRP. Address F 0 Bog 1544 A.P. Number CityZip Tel. LA QUINTA, CA 92253 1564-2913 Legal Description Contractor Project Description 75* GAS LINE OF 1 1/2" TO F & F CONSTRUCTION POOLS Address METER. 80-975 INDIO BLVD. :ity Zip Tel.: INDIO. CA 92.201 State Lic. City & Classif. 476807 1 Lic. # 130 Arch., Engr., Designer Address 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 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 Contractors 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 rite 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). ❑ 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 9 as owner of the property, am exclusively contracting with licensed contractors to con - sXtruct 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 1 ` + f Owner A / +171,;1fr1l4- A..% /v,/, .;,7 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 i1 the permit is for one hundred dollars (5100) 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 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 Sq. Ft. Size No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $asn.©o PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. $15.00 Mech. Electrical Plumbing 15.00 S.M.L. Grading Driveway Enc. Infrastructure TOTAL $30.00 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 Property Line FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS SLAB GRADE 2ND FL SO. FT. BONDING YARD SPKLR SYSTEM ' POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. SO. FT. GAS (ROUGH) DRAINAGE PIPING WALL SO. FT. OTHER APP./EOUIP. DRINKING FOUNTAIN. SO Fr. ® 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 FINAL INSP. GARBAGE DISPOSAL I FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM I 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 @ 1 V. c SEWAGE DISPOSAL GAR. FIREWALL SO.FT.GAR ® V4c HOUSE SEWER LATHING GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PLCK.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 APP./EOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ -Plus-x$-=$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING: FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INfT1ALS GARDEN WALL FINAL 4 P.O. BOX 1504 , No. 9801 Building 52-835 MARTINEZ 78-105CALLEESTADO h Address LA QUINTA, CALIFORNIA 92253 Owner DAVE LUTES P OL/SP BUILDING: TYPE CONST. CC-. GRP. Mailing Address SAME City Zip Tel. LA QUINTA, CA 92253 554-2913 Contractor P & P POOLS 80-975 INDIO BLVD. STB. C7 INDIA 92201 345-5070 State Lic. City &O„4lasvfv'07 Const. Lic. 130 Arch., Engr., 24.00 Designer 45.00 Address Z 1 1 Vi! 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 Division_ C 3 oGthe Business and Professions Code, and my license -is in with force and effect. ;.{✓` r I.% J _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,Susiness 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 penalty of not more than five hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees, provided 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 Contractors 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 taw.), ❑ 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,Compensalion Insurance, ora ceraffiedaop%itherYBlelyc.3800, Labor Code.) P,,00rl&.Vo.'' Company dopy is filed with the city. O Certified copy is hereby furnished. J 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 thip work for which this permit is issued, I shall not =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 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 A.P. Number Legal Description Project Description POOL AND SPA Sq. Ft. No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ >timated Valuation $110000 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. * 81.90 Const. 126.00 Mech. 24.00 Electrical 45.00 Plumbing Z 1 1 Vi! S.M.I. 1110 Grading Driveway Enc. Infrastructure TOTAL $305.00 REMARKS rtn , o•s JA —)n,k A7 _;')_Q4 i {i 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. SO. FT. ® $ UNITS A.C. UNIT COLL. AREA SLAB GRADE 'i 2ND FL. SO. FT. BONDING YARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. I SQ. Ff. DUCT WORK DRAINAGE PIPING WALL SD. FT. GAS (ROUGH) DRINKING FOUNTAIN. SO FT ® URINAL ESTIMATED CONSTRUCTION VALUATION $ REINF. STEEL WATER PIPING NOTE: Not to be used as property tax valuation TEMP. POLE FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED WATER SYSTEM 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+/4 c SEWAGE DISPOSAL SO.FT.GAR ® 3/ac HOUSE SEWER LATHING 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 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 ^ o / / __ 7/`! //* y /(,/5/ / 71-231 / O 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 4Qu KI 0458 P.O. BOX 1504 Building 52-835 Martina-. 78-105 CALLS CALIFORNIA9 Address LA QUINTA, ORNIA 92253 /yrG Owner —2— ?avid J* Lutea Mailing .. BUILDING:'TYPE CONST. OCC. GRP. Address P. 0, Box 1544 A.P. Number 773-331-029 Cit y >9t Quinta zlp'92253 Contractor owner / su i ldt•31i Address City lZip State Lic. 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 penaky 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.) 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 contractors) licensed pursuant to the Contractor's License Law.) O 1 am exempt under Sec. -B. & P.C. for this reason 'e,Date 2//°//t * Owner S/ 1."\: 1/ 11i ✓''' 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. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars (8100) 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 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 Legal Description Project Description 50' of 64 high block wall WHITE - FINANCE, PINK -APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE Sq. Ft. Size No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation M.250 PERMIT a AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. *;22.0 . Mech. Electrical Plumbing 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 DATEINSPECTOR 9114768 Issued by: Date Permit Validated by: Validation: WHITE - FINANCE, PINK -APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES tST FL SO FT (p $ UNITS SLAB GRADE ROUGH PLUMB BONDING YARD SPKLR SYSTEM 2ND FL SO FT. r$ FORMS SEWER OR SEPTIC TANK ROUGH WIRING • MOBILEHOME SVC. BAR SINK POR SO FT. a GAS (ROUGH) METER LOOP HEATING (FINAL) POWER OUTLET ROOF DRAINS GAR SO. FT. kr TEMP. POLE GROUT DRAINAGE PIPING CAR P. SO FT. Q FINAL INSP. BOND BEAM WATER SYSTEM DRINKING FOUNTAIN WALL SO. FT. (d =$ LUMBER GR. FINAL INSP. FRAMING SO. FT. (aURINAL ROOFING ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES VENTILATION WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTOYDISHI APPLIANCE DRYER ' FIREPLACE 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, 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 (g tv. c SEWAGE DISPOSAL SO.FT.GAR @ 'i c HOUSE SEWER CERT. OCC. 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 8 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 APP.IEOUIF. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. y0. $ plu5 x$ =$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL E M Z O H U W Receipt No District: Riverside ❑ DISTRIBUTION: WHITE - Office File DOH SAN 122 (Rev 10/82) Indio ®'- Hemet ❑ YELLOW - Applicant Issued By Date "2 2 9 - 9 ' PINK - Building Dept. GOLDENROD - Pending File RIVERSIDE COUNTY DEPARTMENT OF HEALTH— PERMIT APPLICATION FOR A SUBSURFACE DISPOSAL SYSTEM Applicant: Submit this form with three copies of a scaled plot plan drawn to county specifications required on the attached check list. A non refundable filing fee of $15 is required when the application is submitted. Check must be made payable to County of Riverside. Name Mailing Addresses 7 City State Zip Code Phone i1 vy rrri ('` j LGft ,v, A- 'Property Address 'City or Community 'Legal Description of Property (Lot, Parcel Map, Tract) S iq r fit. 3 4 17Gcc— ! v"l c a• 'Assessors Parcel No. Water Serving Property From Lot size ' 77 z --33 azo l ' wa say/ .U' ✓ lw , ti l ` ► Is f' 3 Signature of Applicant / / y Date ! 'The above information must be verified from Building Application Staff Use — Do Not Write Below This Line Initial Date WQCB Clearance required Yes ❑ No ❑ 'jS Soils feasibility report required Yes ❑ Nob Detailed boring report required Yes ❑ No 0 Detailed contour plot required Yes ❑ Nob Comments: Soils or boring report by Date Approved by Date Soils Map Page Soil Type Tract File No.c'^ Other Number of Bedrooms Septic Tank Size (gallons) Rate Required Type of System r 1'" Y i SD S r., / J New Addition Replacement ❑ ❑• Leach line sq. ft. of bottom area trench Leach bed (sq. ft. of bottom area bed) Seepage Pit Diameter Number of Pits Seepage.Pit Depth B.I. Total Depth of Pit 5' ❑ 6' r Location of System LJf yti Y, Additional Requirements n.) A permit is approved/denied for the design of a subsurface disposal system as indicated on the accompanied plot plan using the requirements set forth in Section B above. A building permit is necessary for the installation of the above designed system. .r) S A'7 Signature of Health Official Date Receipt No District: Riverside ❑ DISTRIBUTION: WHITE - Office File DOH SAN 122 (Rev 10/82) Indio ®'- Hemet ❑ YELLOW - Applicant Issued By Date "2 2 9 - 9 ' PINK - Building Dept. GOLDENROD - Pending File