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BMCH2015-020978-495 CALLS TAMPICO LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BMCH2O15-0209 Property Address: 51518 AVENIDA MENDOZA APN: 773143001 Application Description: JONES RESIDENCE HVAC CHANG Property Zoning: Application Valuation: $16,737.00 Applicant: IE INC. 32115 LA BAYA WESTLAKE VILLAGE, CA 91362 1N3NJ8Vd301N3PId013A?f- . NW4 00 VINIRO Vl 3C 0Z S 1 Nnr LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that l 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. License Class: C20 License No.: 968141 Date: Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contract is State License Law for the following reason (Sec. 7031.5, Business and Professions ode: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: ( ) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ( ) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractors) 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: VOICE (760) 777-7125 FAX (760) 777-7011' INSPECTIONS (760) 777-7153 Date: 6/18/2015 Owner: RANDALJONES 51518 AVENIDA MENDOZA LA QUINTA, CA 92253 Contractor: HARRISON ENTERPRISES INC DBA D 31170 RESERVE DRIVE THOUSAND PALMS, CA 92276 (760)343-5562 Llc. No.: 968141 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 wor compensation insurance carrier and policy number are: Carrier: _ Policy Number: _ _ 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 Code, I shall forthwith comply with th se prov'sions. Date: Applicant: _k,, WARNING: FAILURE TO SECURE WORKERS' COMPENSATION Q9ERAGE IS UNLA FUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES U 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 Building Official 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 city to ent r upon the above mentioned property for, inspection purposes. Dat J Signature (Applicant o en : FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE. BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00 DESCRIPTION ACCOUNT QTY. AMOUNT PAID PAID DATE HVAC CHANGEOUT - SPLIT -SYSTEM 101-0000-42402 0 $72.52 $0.00 PAID BY METHOD RECEIPT # . CHECK # CLTD BY DESCRIPTION 'ACCOUNT. QTY AMOUNT PAID PAID'DATE HVAC CHANGEOUT - SPLIT -SYSTEM PC 101-0000-42600 0 $36.26 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forCHANGEOUT: $108.78 $0.00 DESCRIPTION ACCOUNT. QTY AMOUNT PAID PAID DATE PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forPERMIT ISSUANCE: $91.85 $0.00 TOTALS:•0 Description: JONES RESIDENCE HVAC CHANGE OUT Type: MECHANICAL Subtype:- Status: APPROVED Applied: 6/18/2015 MFA Approved: 6/18/2015 MFA . Parcel No: 773143001 Site Address: 51518 AVENIDA MENDOZALA QUINTA,CA 92253 Subdivision: SANTA CARMELITA AT VALE LA QUINTA Block: 112 Lot: 24 Issued: NO 12 WESTLAKE CA 91362 VILLAGE (760)574-6672 Lot Scl Ft: 0 Building Scl Ft: 0 Zoning: Finaled: Valuation: $16,737.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 OWNER RANDAL JONES Details: HVAC CHANGE OUT - 18 SEER/ SPLIT SYSTEM [2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES. (760)574-6672 Fnvtavc:iAl,,, INFORMATION 71 - Printed: Thursday, June 18, 2015 8:19:45 AM 1 of 2 srsTeMs CONTACTS CITY STATE ZIP PHONE FAX EMAIL NAME TYPE NAME ADDRESSI APPLICANT IE INC. 32115 LA BAYA WESTLAKE CA 91362 VILLAGE (760)574-6672 CONTRACTOR HARRISON ENTERPRISES INC DBA D 31170 RESERVE DRIVE THOUSAND CA 92276 PALMS (760)574-6672 OWNER RANDAL JONES 51518 AVENIDA MENDOZA LA QUINTA CA 92253 (760)574-6672 Fnvtavc:iAl,,, INFORMATION 71 - Printed: Thursday, June 18, 2015 8:19:45 AM 1 of 2 srsTeMs Permit Details PERMIT NUMBER dr City of La Quinta BMG H2O1�5-!0209 .. PARENT PROJECTS REVIEWS - REVIEW TYPE REVIEWERRETURNED STATUS REMARKS. SENT DATE DUE DATE DATE NOTES Printed: Thursday, June 18, 2015 8:19:45 AM 2 of 2 sysrrnns CLTD DESCRIPTION ACCOUNT. CITY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: HVAC CHANGEOUT - 101-0000-42402 0 $72.52 $0.00 SPLIT -SYSTEM HVAC CHANGEOUT - 101-0000-42600 0 $36.26 $0.00 SPLIT -SYSTEM PC Total Paid forCHANGEOUT: $108.78 $0.00 PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 Total Paid forPERM1T ISSUANCE: $91.85 $0.00 TOTALS:• • 0• .. PARENT PROJECTS REVIEWS - REVIEW TYPE REVIEWERRETURNED STATUS REMARKS. SENT DATE DUE DATE DATE NOTES Printed: Thursday, June 18, 2015 8:19:45 AM 2 of 2 sysrrnns ,.� Cky of La Quints DWw P.O. Box 1504,'78-49S Calle T=** La.Qti ra4 CA 92253 - (760) 777-7012 Building Permit Applicadon and Trac(dng Sheet Pem* # Project.Addtwts:51518 AVENIDA MEDOZA Ownw'sName:. RANDAL JONES A. P. A&tm s: 5.1518 AVENIDA MEDOZA Legal Desaipd on: Contractor: GENERAL A/C & HEATING city, sr, zip. LA QU I NTA, CA 92253 Tdephorx: 760-574-6672 Address: 31170 RESERVE DRIVE Pmjc4Dmdption: City, $r, Zip: THOUSAND PALMS, CA 92276 Tekphoae: 760-343-7488 CHANGE OUT A/C 4 TON & FURNACE 90,000 BTU Stec Lic. #: 686310. City Lia #c Arch , Eg•. Address aty. ST. Zip: TdcphIIe' Consiruc ion Type:. Occupancy: sten Lic. #: Project ripe (cirde one): New Add'n Altet Repair Dean Name of Conra+x Person: PATRICK . Sq. FL: # stories: 9 unitx TckPhoae i of Contact Person: 7.60-343-7488 Estimntod. Vatic of Project 16737.00 . APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Recd TRACMG PERMIT FEES. !flan Seb Pias Ckedr submitted Item Amoat stractual Cain. R-Uwed, ready for corteetioae Plan Chock Deposit. Trow Caret. Called Coapct Perm Plan Ckeek Balance TMe M Cates. Plana plelm sp Cosatrscdos nOw Plats plan Plass "submitted Mechanical Pram T! Rtriew, ready for correetioas w" Electrical Sabcostaetor Ust Called Contact Person Ploabing Gnat Deed Plast picked up SAL N O A Approval Plans rasbmitted Grading IN MOISB:. Renew, ready for wrrectioas/issac Developer Impact Fee Planning Approval Called Contact Perm A.LP.P. Pub. Wks. Appr ' Date of permit issue School Tea Total Permit Fees CERTIFICATE OF COMPLIANCE Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) Project Name: RANDAL JONES I Date Prepared: CF111-ALT-02-E (Page 1 of 3 ) 2015-06-12 A. General Information CF1R-ALT 02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented, use one CFIR-ALT 02 document for each dwelling unit. 01 Project Name RANDALJONES 02 Date Prepared 2015-06-12 03 Project Location 51518 AVENIDA MEDOZA 04 Building Type Single family 05 CA City La Quinta 06 Dwelling Unit Name RANDALJONES 07 Zip Code 92253 08 Dwelling Unit Conditioned 1800 Installling En fallin' g Installing Floor Area (ft2) Location or Area by this SC ducted containing system Number of space conditioning entirely new 09 Climate Zone 15 10 (SC) systems in this dwelling 1 component? components? feet of ducts? duct system? unit. Alteration Type B. Space Conditioning (SC) System Information /� f 01 02 ,03 04'x' 05 I r6 r\ 07 08 09 10 Cls the SC;, ' 3 .-: Installing a � SC System SC System CFA served "'.,systema re rf igen nt, 4, Zlnstalling new SC Installling En fallin' g Installing Identification or Location or Area by this SC ducted containing system more than 40 entirely new entirely new Name Served System (ft2) system? component? components? feet of ducts? duct system? SC system? Alteration Type System 1 Location 1 1800 Yes Yes Yes No No No Altered space conditioning system C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)1Diib) This section does not apply to this project. Registration Number: 215-Ao158295A-000000000-0000 Registration Date/Time: 2015-06-12 16:33:18 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-06-12 16:32:24 Schema Version: 0.555SDD CERTIFICATE OF COMPLIANCE CFlR-ALT 02-E Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 2 of 3 ) D. Altered Space Conditioning System (Sections 150.2(b)1E and F) 01 02 03 04 05 06 07 08 09 10 11 12 Heating Cooling System Heating Altered Heating Minimum Altered Cooling Minimum Required New or Identification System Heating Efficiency Efficiency Cooling Cooling Efficiency Efficiency Thermostat Replaced New Duct or Name Type Components Type Value System Type Components Type Value Type Duct Length R -Value Central gas All new Central split All new This field or This field or System 1 furnace heating AFUE 0.8 AC cooling SEER 18 Setback section is not section is not components components applicable applicable Required Documentation: CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans -Duct insulation requirement for new plenums: R6. MR -MCH -20-H & CF311-MCH-20-H — Duct Leakage testing required when heating or cooling components are installed in ducted systems, or when more than 40 ft of duct length is replaced. -Leakage rate compliance: 515%, or 5 10% leakage to outside, or seal all accessible leaks. CF2R-MCH-25-H & CF311-MCH-25-H Refrigerant Charge Verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15). CF2RCF3R-MCH-23 & CF311-11VICH-23 Air Flow 2 300 CFM/ton required when MCH -25 is required. Exceptions: �,... n.. C -Duct systems registered with HERS provider as previously sealed are exempt from MCH -20 Duct LeakagerTesting requirements. Heating Handler/Furnace do Air FI MCH 23,tor Refrigerant,Chafrge MECH 2 -only systems and Air changes not require verificaalon of :, Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH -20 DuetLeakage Testing requirements. E. Entirely New or Complete Replacement Duct System, with'or withoUVEquipment Changeout (Sections 150.2(b)1Diia�and, l,50.2(b)lE, F) This section does not apply to this project. F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C) This section does not apply to this project. Registration Number: 215-A0158295A-000000000-0000 Registration Date/Time: 2015-06-12 16:33:18 HERS Provider: CalCERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-06-12 16:32:24 Schema Version: 0.555SDD CERTIFICATE OF COMPLIANCE CFIR-ALT 02-E Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 3 of 3 ) Documentation Author's Declaration Statement 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Jan loco Jacoby, Ian Jr Company: Signature Date: Stratz Permit Service 2015-06-12 16:32:18 Address: CEA/ HERS Certification Identification (if applicable): 5858 Dovetail Drive City/State/Zip: Phone: Agoura Hills CA 91301 °S 818-735-7876 Responsible Person's Declaration statement`, I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. 1 am eligible under Division 3 of the.Business and Profe"ssions�Code to accept. responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer). 3. That the energy features and performance specifications, materials, components and manufactured devices for the building -design or system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part6 of the California Code ofd g lotions 4. The building design features or system design features identified on.this Certificate of Compliance are consistent with,the informat on,provided o qt r>ap l le compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval.with this building permit application. S. I will ensure that a registered copy of this Certificate of.Compliance shall be,;marJe,ayailable wlththe bmldmgpermit(s);issued for;the building, and, ade avahable to th enforcement agency for all applicable inspections. I understand that a registered copy of thisGert� Cate of Compliance is required to be included with the documegta.tionyt he.,builder provides too building owner at occupancy. -the Responsible Designer Name: Responsible De'sig er Signature: I-&-oO� Valdez, Dayana O Company: Date Signed: HARRISON ENTERPRISES INC dba GENERAL AIR CONDITIONING 2015-06-12 16:33:18 Address: License: 31-170 RESERVE DRIVE STE A 686310 City/State/Zip: Phone: THOUSAND PALMS CA 92276 (760) 343-7488 Digitally signed by CaiCERTS. This digital signature is provided in order to secure the content of this registered document and in noway implies Registration Provider responsibility for the accuracy of the information. Registration Number: 215-A0158295A-000000000-0000 Registration Date/Time: 2015-06-12 16:33:18 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-06-12 16:32:24 Schema Version: 0.555SDD Building Address 52528 Mendoza Mailing Address 54035 Martinez City Zip La Quinta 1 92253 Contractor owner/Builder Address T-iht 4 P.O. BOX 1504 , No. 10437 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 113 BUILDING: TYPE CONST. OCC. GRP. P. Number Tel. 564..-1236 Legal Description Zip I Tel. State Lic.I City & Classif. Lic. # 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) of Division 3 of the Business and Professions Code, and my license is in full force and effect. diGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Lawfor the following reason: (Sec. 7031.5,Suslness 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 Fubjects 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 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 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.) b 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 propertywhobuilds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to t�i8 mason Contractor's License Law.) ❑ I am exempt under Sec. B ;t¢� fdthason ,t'J,,AA AA/ ._ .. rx- Date Own ?"i 1 �� i W_ WORKERS' COMPENSATION DECLARATION I hereby affirm that.) 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 performanceofthe wo,{{k for which this permit is issued, I shall not employ any person in y manner so as to b&come subject to the Workers' Compensation Laws of Cali ornia. t li {� �� Date Owner N RS ti-.CL/fT� i.. NOTICE TO APPLICANT,: f, after making ith&CertlRctate 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 s6hall6e'deemed revoked. f I uJ CONSTRUCTION LENDING AGENCY Ihereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration 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 ateMailing Address City, State, Zip Project Description 1001 of 4' wo frame stucco wall Sq. Ft. No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation 3$32.00 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. 45.00 Mech. Electrical Plumbing S.M.I. .20 Grading Driveway Enc. Infrastructure TOTAL REMARKS ,. .. «!,zZ9n, ,-?. 1 A• ...�.�__ta� W # N` TKAU A i (I 41.:'0 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. ® $ 2ND FL. SQ. FT. POR. SQ. FT. ® GAR. SO. FT. ® CAR P. SQ. FT. WALL SQ. FT. ® Sp 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 SLAB GRADE FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER SEWER OR SEPTIC TANK GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED DUCT WORK 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. a c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1 Vi c SEWAGE DISPOSAL BOND BEAM SO.FT.GAR ® 3yc HOUSE SEWER 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 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 a FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING: FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING 79� MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION-? CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL 44a P.O. BOX 1504 a�L N Q . 08665 Building 78-105 CALLS Address 51-518 Ava. Mendoza LA QUINTA, CALIFORNIAORNIA 92253 Mailing I Address 17 Blue River City Zip Tel. Us%t Desert 92.264 773.3369 Contractor Jeff Hines Address Same Zip I Tel. State Lic. City & Classif. 436276 Lic. # Arch., Engr., Designer ` -Address Tel. CityI Zip I State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 70 OO) of Division 3 of the Business and Professions Code, and my license is in full force and effect. _SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to Its issuance also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ❑ 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 or sale.) O 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 ^ Y YY k WORKERS' COMPENSATION DECLARATION I hereby affirm that 1 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 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 BUILDING: TYPE CONST. OCC. GRP. A.P. Number 9?3..Ii3—iltil Legal Description Lot 76, Mark 112 Project Description AT— S -1-91a R=14! U=_ -G Sq. F1505 No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ r PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. 236.o Const. QG Mech. r -rt Electrical Plumbing S.M.I. • r n Grading S. A Driveway Enc. • W Infrastructure vs 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. ® $ 2ND FL.SQ. FT. POR. SQ. FT. ® GAR. SQ. FT. ® CAR P. SQ. FT. WALL SQ. 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 BONDING WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER TANK GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED ROCK STORAGE LAUNDRY TRAY AIR HANDLING UNIT CFM GAS (ROUGH) 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 WATER HEATER SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/. c SEWAGE DISPOSAL SO.FT.GAR ® 3/ac HOUSE SEWER FINAL INSP. ? �/ �! GRADING cu. yd. $ plus x$ GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE T SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK Aw GROUND PLUMBINVI /!//AtMNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. 090 4's BONDING HEATING (ROUGH) STORAGE TANK FORMS S PTI 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 FINAL INSP."') ! 4�- yh t FINAL INSP. ? �/ �! GRADING cu. yd. $ plus x$ _$ LUMBER GR. FRAMING ///9,( 014 ROOFING � I� 9 REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND 9/ FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURE INITIALS GARDEN WALL FINAL DESERT SANDS UNIFIED SCHOOL DISTRICT 82-879 Highway 111 NOTICE: Indio, CA 92201 Document Cannot Be Duplicated (619) 347-8631 Date 9/13/90 1 Type of Permit JLa Quinta No. 10148 Permit # - Owner Name Jeff Hines Log N No. street See Below City La Quinta Zip 92253 Study Area 112 APN N Tract ii Lot f Square Footage 131,% Type of Development Single Family Residence No. of units Comments X1_.9(1 nnrl Aua MPnflA7n At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under 500 square feet, detached accessory structures or replacement mobilehomes. It has been determined the above-named owner is exempt from paying school fees at this time due to the following reason: EXEMPTION NOT APPLICABLE 11& certifies. that school facility fees imposed pursuant to Government Code 53080 in the amount of 1.58 X 13.155 or $ 4,984.90 have been paid to D.S.U.S.D. for the property listed above and that building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued. Fees Paid By . Hines Development Telephone 773m13369 Name on the check By John D. Brooks Associate Superintendent, Business Services Fee collected /exempted by Shelley D. Bennett Signature �1/ Chack 44o. 129 Collector: Attach a copy of County or City plan check application form to Dist.zct copy. Embossed Original- Building DeptJApplicant ' Copy - ApplicanVReceipt Copy - Accounting 1 +. �'►,� OFFICE OF AGRICULTURAL COMMISSIONER .,• AND WEIGHTS &MEASURES CALVIN C. KAMINSKAS JAMES O. WALLACE 4080 LEMON STREET. ROOM 19 n+,atom comms„toner Ark^not Comma,tonnr RIVERSIDE. CALIFORNIA 92501 CLEMENT lef ISLE Oheolat o1 wetphti & Mealue► (714) 767.2561 Seater .. 49613 Highway 86, Suite B12 Coachella, Ca. 92236 (619) 342-8291 `. DATE — (O CASE ND. II DEVEWPER'S NAME: i ADDRESS t '� �• o �.�� 2'2. L V TELEPI :ONE t ( 4 Dear Developer: After reviewing your landscaping plans, all plant material listed is not in violation of quarantine laws governing the Coachella Valley. if substitutions do occur and they differ fran plant material listed, this office IIUSL be notified' Immediately. Tbank you for protecting and preserving the Coachella Valley's pest -free environment. EM 4sOW oo. NAND WHF,N RIK DFD MAIL TO Jeffrey C:,,Hines Me`s e/o 17 Slug River Daaertir._Cal. 92260 _ 96-12 1-3 7 '' '" a MAIL TAX 1TATFMFNTt TO an above uY}y. H !►ACF ARAVP. THIS I.M! FAR RP.CARbF.R'S USE COXA I-WIAar "AN., It TAX s 48.40 —XX__..cuMPv»e ON not. VALult o► nto►atrn cawerao. nR CnMPt "ft ON FULL VALUE LESS Luxe AIRI P►u'UMaaANUFS aPMA1NIN0 AT TIME OF SAI.E. -:ick-. � - — v� tt__� Naa.tirrr -1 n.atarow W ApWdl - M ap 1a r" Tlwat CORPORATION GRANT DEED "-i:. ^AOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, ;'BRANTFORD ASSOCIATES, Inc. R.,, California _ Corporation hereby GRANT(S) to •i . JEFF*EY C. HINES, a single man :�•'t?Ie followrind described real property in the a0 Z04 ;�onMy of Riverside , state of California: ;Cotta 23 and 24, Block 112, Santa Carmelita at Vale La Quinta Unit ":!`; ;No. 12, as per map recorded in Book 18, Pages 79 and 80 of Maps, ,,_,:;records of Riverside County, California. E; July 30, 1990 ?�;ETATF OF fARN1A (1t �t)L1N ` z "'`fht ni a NotAry Putilk M aeA fes+ wld fou y arr `a'?`�Iate. panntlally appeanrd � Ca. t/G�, mif! -i•ktterwn to me to he the ._ -`_. _._ I'mident. a ...__. n�:c• .........known to the 10 he 4S! iecretaty ed the corporation that executed fhe within Instrument, and acknawlydaed to me that uach corporation executed t .ithin struexnt COrpnr �'`/�" inpursuant 10 its hy- o ^ : law% or lution of its `-d di►ecton Name ITyped or Printed ? Notary Puhlk W and for said County and State : aAAer ..Y M.1l.IMV♦ �� A..lr?!w .�.�..� -_ _ .._ r-� .Brantford.�!s iates, c._ Y$04, SEAL Y Now woo c rr... woe-CAo" a Vi oamanrr Ar�a� • %Wfta4,- w rw tan a" or (Thu stat lar aartr astrtr Wd) .1