SFD (07309)Tihf 4 4 Q"
P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address 54.140 Mendoza LA QUINTA, CALIFORNIA 92253
Bill Thompson
Mailing
Address PO Box 804
City ZipTel.
.. La Quinta 92253 664-4977
Contract ST m
Address
Zip Tela
State Lic. City
& Classif. I Lic. #
Arch., Engr.,
Designer
Address Tel.
City ZipI State I
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that 1 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. i4 .'7 ..rel.. 1X, -7—
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 Coder 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
Me provisions of the Contractors 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 civ8 penally cf 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, suisness and
Professions Code: The Contractor's License Law does not apply to an owner or property who
budds or improves thereon and who does such work himself or through his own employees,
provided that such knprovements are not intended or offered for sale. If, however, the building
or Improvement is soid 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 contractors) 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
Workers 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
(Ibis section need not be completed it 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 ppeerson in any manner so as to become subject to the Workers' Compensation
Laws
of California
Date owner
NOTICE TO APPLICANT. N, alter 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 shaft 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
Lenders 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 certity that 1 have read this application and state that the above information is correct.
1 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. 07339
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number 774-223-007
Legal Description LOT 16
Project Description SFO
Sq. Ft. 1466 No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation $85,963
PERMIT
AMOUNT
Plan Chk. Dep. o '�
Plan Chk. Bal.
174.73
Const. _
5576.50
Mech.
103.89
Electrical
�, O
Plumbing
156.00
S.M.I.
6.
Grading
20. (
Driveway Enc.
20.00
Infrastructure
1.852.05
TOTAL $3,324. bg
- - 1r%l /'
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
3/7/
90
Issued by: Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
COLL. AREA
SLAB GRADE 3 ��
ROUGH PLUMB.
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
HEATING (ROUGH)
STORAGE TANK
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
ROUGH WIRING.
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (ROUGH)
DRAINAGE PIPING
CAR P. SD. FT.
HEATING (FINAL)
OTHER APPIEOUIP.
WALL SO. FT.
GAS (FINAL)
DRINKING FOUNTAIN.
SO FT ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
SERVICE
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GRADING
cu. yd.
$ plus x$
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FINAL INSP.
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
FIRE ZONE ROOFING '
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1% c
SEWAGE DISPOSAL
SQ.FT.GAR ® V4c
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE 1PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK �3 G O /' �9
GR U BING 14VI
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE 3 ��
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
S ER
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPIEOUIP.
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 +1! O
FINAL INSP.
/�
ROOFING 4- 3 W 2O
ell- ,to
//J�j/z7/fJ�
REMARKS:
VENTILATION
FIRE ZONE ROOFING '
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING Poly l
MESH
INSULATION/SOUND M-1 Q
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
'
GARDEN WALL FINAL
Desert Sands Unified School District
CERTIFICATION OF PAYMENT
OF
SCHOOL FACILITY FEES
T0: City
UIWZ
Department of ��'mma A"vbV
C�tfn�PyC. DevelopmeDATE:
nt
78-105 Calle Estado
La Quinta, CA 92253
%A
90
This is to certi y that
developer of
located at _ which is
this District, has paid school fac' it fees imposed 1 within
authorit generat d b y p pursuant to the
$ q ( y Government Co e ecti jt 530 0 in a mount of,
covering a total of
square feet of ( ) side tial or / V
( ) industrial/commercial development and that buil Ing permits for
this footage in this development may now be issued by your jurisdiction.
for DESERTSANUNIFIED SCHOOL DISTRICT
White - Building Department • Yellow - Facilities Planning • Pink - Accounting 0 Gold - Developer
(10)-37
COACHELLA VALLEY WATER DISTRICT
/CASHEC IPT DETAIL
Received
Address*
Account No. 4/) Q Lot(s)
Service Address
Q)4eter(s)
XService(s)
0 Backflow(s)
0 HouseLateral(s)
0 Detector Check(s)
0 Meter Surcharge
VSanitation Capacity Charge
0 W.S.B.F.C.
0 Temporary Construction Meter
0 Turn on Charge
o uncollected Account -Name
0 Inspection Fee - Tract -
PPP Fee -
0 Plan Check Fees Water / Sewer -
Tract -
0 Bond Payment - A.D. --Bond
Assmt.
0 Customer Deposit
0 Other
Tract
G.A.;Code
TOTAL $
Remarks:
0 COPY to:
Cash
Water Service' --t-,
Check
Money
Cashier
Order
CVWD-438 (11189)
71.
OFFICE OF
AGRICULTURAL COMMISSIONER
AND
`�,•,r WEIGHTS & MEASURES
CALVIN C. KAMINSKAS
JAMES O. WALLACE 4080 LEMON STREET, ROOM 19 Assislant Commissioner
Agricultural Commissioner RIVERSIDE, CALIFORNIA 92501 CLEMENT BENVENISTE
Meclor of Welghls & Measures (714) 787-2561 Sealer
49613 Highway 86, Suite B12
Coachella, Ca. 92236'
(619) 342-8291
DATE P/ `�_ CASE NO. -PC-,Q LS rq/ yy LA h 0
DEVELOPER'S NAME- `fit-"
ADDRESS- -i> • O • ?S D q
Lz� U O--L-A--c"k- CA
TELEPHONE: ( 6(1) S(.Q L( 4 a -7 %
OCA
L(3_.Q0 L,,_+0_ , C A s Lova A
Dear Developer: 6tnp
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 from plant material listed, this office must be notified
inn ediately.
Thank you for protecting and preserving the Coachella Valley's pest -free environment.
Agricultural Commission 's Office
cc: Indio and Riverside Office
T_ jbf 4 4(4j Q"
78-105 CALLE ESTADO - LA QUINTA, CALIFORNIA 92253 - (619) 564-2246
August 14, 1990
To Whom It May Concern:
The structure located at 54-140 Avenida Mendoza in La Quinta is in
a "B" Flood Zone, according to F.E.M.A. flood map, parcel numbers
060709 0005 A.
Sincerely,
BUILDING AND SAFETY DEPARTMENT
Tom Hartung
Building and Safety Director
TH:es
LTRTH001
MAILING ADDRESS- - P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253