PAT (12287)P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address 53--770 Mendoza LA QUINTA, CALIFORNIA 92253
Owner
11ein
Mailing
Address Same
City Zip Tel.
La Quinta, CA 92253 554-2730
Contractor
Cali:arnia Construction - Ccnsrultant
,Jddires� Camino Castillo
City Zi Tel
Morena Valley, C% 92593 1909) 243-5876
State Lic. I City
& Classif. 9 552305 Lic. #
Arch., Engr.,
Designer
Address Tel.
City I Zip I State
Lic. #
� LICENSED CONTRACTOR'S DECLARATION
I hereby�afff rm that I am licensed ui'der,provisions of Chapter 9 (commencing with Section
7000)•of Division 3 of the Busin ss and Professions Code, and my license is in full force and
`effect. r ...gig'' + r
�.
_SIGNATURE V 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) 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).
D 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 or completion, the owner -builder will have the burden
or proving that he did not build or improve for the purpose of sale.)
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property who builds or improves thereon, and who contracts for
such projects with a 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 C mpensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Pol'c o. 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 youshould 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. 1228T '
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number
Legal Description
Project Description Patio Cove r
Sq. Ft.
Size
New ❑
r
No. No. Dw.
Stories Units
Add ❑ Alter ❑ Repair ❑ Demolition ❑
N
Estimated Valuation $3,325.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
40.95
Const.
63.00
Mech.
Distances:
Electrical ,r
Front Setback from Center Line
Plumbing
Rear Setback from Rear Prop. Line
S.M.I.
.40
Grading
Side Setback from Property Line
Driveway Enc.
FINAL DATE
Infrastructure
TOR
Issued by:
Date
Permit
e
TOTAL
IU4.35
REMARKS
SEP 15 19933
a1 1
t'
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
IN
TOR
Issued by:
Date
Permit
Validated by:
SEP 15 19933
Validation:
it j j
% th
a1 1
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. S0. FT.
FORMS
SEWER OR SEPTIC TANK
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT. ®
OTHER APPJEQUIP.
DRAINAGE PIPING
WALL SQ. FT. ®
TEMP. POLE
DRINKING FOUNTAIN
SO. FT. a
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.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. ® c
BATH TUB
SPARK ARRESTOR
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
LATHING
SQ.FT.GAR ® 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
ERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FrPL.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 L
u
40
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION Jib 4 -q
1 31-
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
')CALE. I* - 13'
30' oll
APP 10' x 17' ENGL-b5LJF
'n 5FD Of M/M HffKN
ADD 6' X 10' F*T10
&0J._..Q'jj L-A QUINTA, GA
MTFUMM11111111 (0q) 564-2730
WA15F
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CITY OF L (MINI 0 m
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3- OUTLETS, I- J -t
CMAA COte)TRLX
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25567 CAMINO CA5%
Ir
RENO /ALLEY, CA
A -ABLE C ES $AL
DATE�/� By 22
& X I PATIO COVER
CONSULTANT
5' 0"
(C) 1992 DAMAR Real Estate Information Service
(213) 380-7105 Outside 213/818 (800) 873-2627
I.
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7) Situs:53770 AVENIDA MENDOZA , LA QUINTA CA 92253-3576
Legal :L23 B249/LOT 23 BLK 249 MB 020/025 SANTA
DAMAR (c) 1991 Real Estate Information Systems 213/380-7105
------------------------------------------------------------
------------------------------------------------------------
>> Reported data believed to be reliable but accuracy is not guaranteed <<
Use: SFR
APN :774-173-002
Tax Rate Area:20-015
Assd Land:$8,280
County: Riverside CA
Property Tax :$1,247
Assd Imp :$75,769
Census:
Total Val:$84,049
Map Pg:224-D3
Exemption
Assd Year:92
$Improved:90%
Owner :HERN JOSEPH A & GERALDINE
Mail :53770 AVENIDA MENDOZA;LA
QUINTA CA 92253-3576
Last Sale
Prior Sale
Transfer Date:09/88
06/23/88
Bldg/Lvarea:1,402
Document # :258078
173234
Yrblt/Eff :87
Document Type:INDIV. GRANT
DEED INDIV. GRANT DEED
# Stories :1
Price :$82,000F
$32,000U
First TD :$82,500F
Total Rooms:
Bedrooms :3
Junior TD
Bathrooms :2
Lender
Fireplace :1
Seller :PIO MICHAEL
A
Pool
Title Company:GATEWAY TITLE
CO.
Other Rooms:
Other Impr
Amenities
Equipment
Remodeled
County Use:R01
Lot Size :A0.11
Construct
Bldg Class:
Lot Area :4,791
Quality
Zoning :R1
Condition
Heat :YES
Park Type :DETACHED
Type Improv:
Air-Cond :CENTRAL
Park Spaces:2
Style
Site Inf
Water :YES
Sewer
Roof Type
Roof Cover :TILE
Frame
Legal :L23 B249/LOT 23 BLK 249 MB 020/025 SANTA
DAMAR (c) 1991 Real Estate Information Systems 213/380-7105
------------------------------------------------------------
------------------------------------------------------------
>> Reported data believed to be reliable but accuracy is not guaranteed <<