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MISPLACEDr 4 P.O. BOX 1504 N o . 11120 Building 78-105 CALLE ESTADO Address 54-105 Mendoza LA QUINTA, CALIFORNIA 92253 Owner Phillip Pettibone BUILDING: TYPE CONST. OCC: GRP. Mailing Address same A.P. Number City Zip Tel. La Quinta 92253 Legal Description Project Description POOL Only Contractor Pools Western Poo Address 43-'375 Madison St City Zip Tel.: Tx�dio---] 922111 347-5959 State Lic. City & Classif. C53 348768 Lic. # 1151 Sq. Ft. No. No. Dw. Size Stories Units Arch., Engr., New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Designer Address Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section ,.7000) of Divi/sIZ-oof�tf�e'Business°and-Professions Code, and my license is in full force and f effect. lei -r• -r .... 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 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 penally 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.) Estimated Valuation A 911000 - PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. 70.20 Const.109.00 Mech. • ��, QD Electrical �; • i{1 Plumbing 24.00 ❑ 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 propertywhobuilds or improves thereon, and who contracts for. such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) ❑ I am exempt under Sec. B. 8 P.C. for this reason S.M.I. .90 Grading Driveway Enc. Date Owner Infrastructure WORKERS' COMPENSATION DECLARATION keI hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worr's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) ' Poky No. .Company ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. • ' TOTAL 255.10 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 the work for which this permit is issued, I shall not employ any parson 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 ateMailing Address City, State, Zip REMARKS [� r�i,IV I RVA 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. SQ. FT. ® $ 2ND FL. SQ. FT. POR. SQ. FT. ® GAR. SQ. FT. ® CAR P. SQ. FT. WALL SO. 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 FORMS�� O WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) METER LOOP GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APP./EQUIP. LAUNDRY TRAY 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 //�j FINAL INSP. 'Z IZZ�i Z 44 SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1% c SEWAGE DISPOSAL REMARKS: SO.FT.GAR ® 3/ac HOUSE SEWER 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 GOND. SOLAR SETBACK GROUND PLUMBING 9,A UNDERGROUND A.C. UNIT COLL, AREA SLAB GRADE ` ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS�� O SEWER OR SEPTIC TANK ROUGH WIRING, DUCT WORK ROCK STORAGE FOUND. REINW' t 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. //�j FINAL INSP. 'Z IZZ�i Z 44 FRAMING FINAL INSP. Z 4Z ROOFING + n �/�/ � !/ r (�L�1 Q� L/ d�L REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING 7 FINAL INSPECTION .J ZZ Q2 G CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL • 4(4j 78-105 CALLE ESTADO - LA QUINTA, CALIFORNIA 92253 -.(619) 564-2246 October 5, 1990 To Whom It May Concern: The structure located at 54-105 Mendoza is located in a "B" flood zone per the revised F.I.R.M. (panels 060709 005 A and 0010 A) for La Quinta.. The property was previously designated as zone AO (depth two (2) feet). If you have any questions, feel free to contact me. Sincerely, BUILDING AND SAFETY Tom Hartung Director of Building and Safety TH/lc MAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253