RPL (11945),r
B&I-d, i n_g +
Address 53—.200 Mendoza
Owner, .
M13mbi l , Inc.
Mailing
Address .P.O. aox 1555
f•
City Zip Tel. Y r
La Quihta, � . 92253 56'4-2338
Contractor
Address - .
Same • ..
City. r�., Zip Tel.:
State L'C'e.`;u 'B-53733.3. City +. .2,526
& Classif. Lic. #
Arch:, Engr.,:"- _
Designer ,
Address- 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 Divii�sioo/n 3 of the Business and Professions Code, and my license is in full force and
effe Vi. _SIGNATURE 'DATE
s- 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 ort 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) oe.,
Division 3 of the Business and,Professions Code, of'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-
. orimprovement 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 t -Owner
t 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 '
3;�Copy is filed with the city. ❑ Certified copy is hereby furnished. `
r CERTIFICATE OF EXEMPTION FROM
WORKERS'COMPENSATIONINSURANCE
(This section -,need not be completed if the permit is for one hundred dollars ($100) valuation
or less.)_.'
I certify that in the performance of thg work for which this permit is issued, I shall not
employ any person in any manner so as to become subject to the Workers' Compensation
,Laws of California.
Date Owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor ,_Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
/
• CONSTRUCTION LENDING AGENCY '
Ihereby. affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3 97, 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
TA*ty of
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
No.9
{
11LDING: TYPE CONST. OCC: GRP.
A.P. Number
Legal Description
Project Description Pool s
3s setback adjustment appeoved by
planning.
Size Stories
No. Dw,
Units
New ❑ Add'[-] Alter ❑ Repair ❑
Estimated Valuation 000. QD u.
PERMIT
AMOUNT' -
Plan Chk. Dep.
Plan Chk. Bal:
i64.35
4.35
Const.
`Mech.
J 99. Citi
Electrical
1 45.00
Plumbing
27.00 ,..
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
I&bu . 15
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:
A
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
UNITS
SLAB GRADE
r
2ND FL. SQ. FT. @
BONDING
YARD SPKLR SYSTEM `
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK a
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
FOUND. REINF.
GAS (ROUGH)
DRAINAGE PIPING
CAR P. SQ. FT.
OTHER APP./EOUIP.
REINF. STEEL
WALL SQ. FT.
TEMP. POLE
DRINKING FOUNTAIN.
SQ. FT. ®
GROUT
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
WATER SYSTEM
FLOOR DRAIN
MECHANICAL FEES
=$
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEMIPERM
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 ® 1Va c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
MESH
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 PLUMBING32
UNDERGROUND 3_2
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
�v�✓ u� 3 �Z� _5 3 c,o
'
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION F-(3
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
I
T H E C I T Y O F
AL
IA Qulnta
1992 Ten Carat Decade
March 8, 1993
Mr. Bill Howard
PO Box 1555
La Quinta, CA 92253
Subject:
Setback Adjustment: 93-164
Location: 53-200 Ave. Mendota
Dear Mr. Howard:
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,
adjustmenthas been approved subject to conditions and in accordance
with attached Exhibit A.
SETBACK ADJUSTMENT:
Reduction of side yard setback from 5 feet to 3 feet
FOR: Swimming pool
CONDITIONS:
1. Obtain a building permit.'
2. Pool equipment shall comply with required setbacks (five -feet
from property line).
3. The fencing requirements of the SR Zoning Code shall be met.
After review itwas determined that:
1. This adjustment is consistent with the -intent and purpose of
the zoning ordinance.
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: the odd shape of the rear yard.
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 w�hkghh- the
adjustment is requested. n
City of La Quints IVIj°t'� U 91993 1993
Post Office Box 1504 • 78-105 Calle Estado BUILDING
La Quinta, California 92253 & SAFETY DEPT.
Phone (619) 564-2246. Fax (619) 564-5617
SBASHELL/CS DecT i °-oductw: Ma,k Pa mJen,..a!9.3a6-@C7?
If you have any questions, please contact the undersigned.
Very truly yours,
J RY
NNI & DEVELOPMENT DIRECTOR
G e sdell
e Planner
GT:ccs
Attachment: Exhibit A
cc: -Building 6 Safety Department
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