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12089 (RPL)Building Address 54-035 Mendoza Dane Awry T a 4,Yl 4 �`U P.O. BOX 1504 N o . 12089 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Mailing Address same City Zip Tel. La Quints, 92253 564-'4$15 Contractor Owner Address City ,_ Izip I Tel. State Lic.I City & Classif. Lic. # Arcn., tngr., 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. _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 sub'ects the applicant to a civil penalty of not more than five hundred dollars ($500). , as owner of the property, or my employees with wages as their sole compensation, will ilo 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 _J 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. 3900, 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 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., It, 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. 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 LDING: TYPE CONST. OCC. GRP... P. Number Description Project Description Sq. Ft. Size No. Stories Pool No. Dw. New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $10,000.00 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. 117.00 Const. 76.05 Mech. 24.00 Electrical 45.00 Plumbing 27.00 .S.M.I. 1.00 Grading Driveway Eno. Infrastructure TOTAL 290.05 REMARKS Y"v e.-MuiYY 1 fkYl tip �, Gi��i.1 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 ,JA.C. UNIT ' 2ND FL. SO. FT. SLAB GRADE YARD SPKLR SYSTEM POR. SO. FT. p MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS SEWER OR SEPTIC TANK DRAINAGE PIPING CAR P. SO. FT. DUCT WORK ROCK STORAGE WALL SO. FT. 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 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 ® 11/4 c SEWAGE DISPOSAL FIRE ZONE ROOFING SO.FT.GAR ® 3/ac HOUSE SEWER FIREPLACE 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 PLUMBIN ,) (pt1NDERGROUND 2� ,JA.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.IEOUIP. 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�� f HJJA t Y al iVl lM� G� �(/1 REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION 3,f,,i CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL 9 Fes_ ;,!1993 11:41 563-3739 ^ Y ALLSTATE� EL PASEO ANTM You're in good hands. T0: Building and Safety City of La Quinta Attn: Kelly PAGE 01 John Standish Senior Account Agent 73-260 F1 Paseo #2-R Palm Desert, Ca 92260 (619) 773-0055 (619) 568-3739 FAX SUBJ: Verification of Worker's Comp. Drury, Dane and Melanie La Quinta, Ca 92253 DATE: April 16, 1993 Dear Kelly, Per instructions from our mutual customer, Dane Drury, please find the attached certificate to confirm workers compensation in place as a rider on his homeowners insurance. This will cover him in his endeavor as an owner -builder in the construction of his swimming pool. Should you have any questions or concerns, please take time to call me. Tkhan�s, and Rest Regards, n Standish for Account Agent 'is /mss attachment - 1 - R2853 �,•0.4"o/ 1993 11:41 568-3739 �.; f ALLSTATE EL PASEO PAGE 02 �rlf sued by: © ALLSTATE INSURANCE COMPANY "s' ❑ ALLSTATE INDEMNITY COMPANY DECLARATIONS PAGE The POLICY PERIOD shall begin on the first date shown below with no fixed date of expl- Policy Number 0 99 873004 H 03/2.3 ration. (See reverse side foradditlonal Policy insured Person pane and Melanie Drury HW/JT Provisions.) Address 54-085 Avenida Mendoza PREMIUM PERIOD I_ocellonofLa Quinta, California 92253 Property Inau rod March� , 1993 (It other then •boVe) Same as Mailing March 23, 1994 At 12:01 A.M. Standard Time 4 +�x At Location of Property Involved 8"llon I Only 1. Name of First Mortgagee; — Not Applicable r Address: 2. Loss Deductible(s) applicable; s 250.00 to 1083 to covered property from all insured perils, except theft and windstorm and hail damage to the Dwelling. $ — to lose to the Dwelling from windstorm and hall_ $ 250.00 to 1033 from theft, 3. Dwelling is of construction and is occupied by one families. Insurance Is provided only with respect to those of the following coverages which are Indicated by a specific limit of liability applicable thereto. SECTION COVERAGES LIMITS OF LIABILITY PREMIUMS A Dwelling Protection g 105,000 - •::; C Personal Property Protection � 73,000 X Family Liability Protection Each Occurrence _.. $ 100,000 Each Person Y Guest Medical Protection Each Accident $ 1,000 " >' 31 $ 25,000 PACKAGE PACKAGE PREMIUM i $ 345.00 ADDITIONAL PREMIUM $ )None PREMIUM i'': TOTAL PACKAGE PREMIUM $ 345.00 WC COMPENSATION (Residenoe Employes) Claeaiflcat10n Code Number Estimated Number . a'}��{. 3, t:: 144'+EYi•, ; , • 'it '+ t r31t '���.�ti, " ',tl a ICtt#fif}E.P 41.VWORKERS' i? I(`il�".L6Dt�'%i,l N', PACKAGi pfiEMIUM 1t) Inservants 0013 Outservante 0912 Occasional iz :'i+�E=: ��k�i� �f� � SCHEDULED PROPERTY PREMIUM $ None TOTAL PREMIUM PERIOD PREMIUM 345.00 Sub)*at to the bllowling f=orms and Endomefllents: April 16 1993 PalmD��er�. Ca Aufhorized Agent Date Countersigned at wvsso-t P, L) '00 jot r-3' POOL AREA TO BE ENCLOSED I MINIMUM 5'FT. HIGH FENCE. ALI. GATES TO BE SELF-CLOSIP AND SELF- LATCH! NG. I-- cily0c A C) UN TA TY D E PA, F, TMENT ("C"N'TRUCTION CZ F, A L E CC -' 3 DATE 7-5 _/ Dane Marcus Drury 54-485 Avenida Mendoza La Quinta, CA 92253 Is City Of La Quinta • RE: Spring loaded gate To Whom It May Concern: This is to inform you the two large gates located on the south side olfthe property are securely locked at all times. The only time these gates are open,, is when the motorhome parked there is to be moved. At which time there is always an adult present until the gate are closed and locked again. Thank you for your cooperation in this matter. Sincerely, Dane M. Drury