SFD (368906)610ILUMV rCKM11
PERMIT NO. DEPARTMENT OF BUILDING & SAFETY FIELD 7//;
368906 COUNTY Of RIVERSIDE
CONSTRUCTION
ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
G `�'
IST FL. '� ; U
2ND. FL.
j Z% +'
SQ. FT. @ $ � / G
UNITS
Community
�' • s
SQ. FT. @ t
YARD SPKLR SYSTEM
FOR.
GAR.
CAR P.•
WALL
SQ. FT. @ —
MOBILEHOME SVC.
BAR SINK
SQ. FT. @ ..� ' POWER OUTLET
ROOF DRAINS
SQ. FT. @
DRAINAGE PIPING
SQ. FT. @
DRINKING FOUNTAIN
SQ. FT. @
URINAL
ESTIMATED CONSTRUCTION VALUATION $ - %-S -^
Set Backs
WATER PIPING
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
VENT SYSTEM FAN EVAP. COOL HOOD
SIGN
WASHER (AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
Dbl $
LAUNDRY TRAY
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE,TEMP/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. @ - c
BATH TUB
Address City Zip
t
'�'�t
SQ. FT. @ c
WATER HEATER
$
S0. FT. RESID @1'/.c
SEWAGE DISPOSAL
S0. FT. GAR @ 31, c
HOUSE SEWER
Total Fees
$ �
Address
/ •�
GAS PIPING
PERMIT FEE
Zip
PERMIT FEE
PERMIT FEE
DBL.
TOTAL FEES
/01-F,,
MOB. HM. FEE
MICRO FEE MECH. FEE
PL. CK. FEE. CONST. FEE ELECT. FEE
0/ e
SMI FEE
FEE PLUMB. FEE
PERMIT NO.
13689061
Job Address
Space
Zip
Owner
Community
�' • s
Valuation
$
Date
Dist.
Off.
I F.C.C.
MH.Permit Fee I $
Micro Film Fee
Cop $
Use of Permit 14
�.
Parcel No.
6"7�—Ll 31 n
Use/Case No.
Ck. By
Mech. Fee Dbl $
PI. Ck. Fee $
Set Backs
Lot Size
'
..
Construction Fee Obl $
Legal Description
•�"" y
F 5
S R
Electrical Fee Dbl $
Zone Restrictions
Group
Type
SMI Fee $��
Plumbing Fee
Dbl $
Bond Amt.
$
Plan No. t,
♦ G �i'
PI ecker l k&W49P
Final Dote
Inspector
Unit
Sp. Insp. Fee $
Demol. Fee
$
Const. Lender Branch
Supplime Numbers
/
Registr. Fee $
Mileage Fee $
Address City Zip
t
'�'�t
Witness Fee $
Reinsp. Fee
$
Owner/Agent_ i. _.i
Tel.
Zip
Total Fees
$ �
Address
/ •�
City
Zip
M.O. 0 N.C. Cash Chgo n
Received by
Contractor -
Tel.
License#
Trees required
Sewage System
_
Address
Ci ry Zip
T LL P
Sewer District
Form 284-208 (Re,8/78)
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK
FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH
THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN
ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
verified by:
NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION
DATE INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS j
1
Set Back
33
Ventilation System
t
2
Ftgs & Frms
34
Plenums & Ducts I
2A
Slab Grade
35
Furnace Comport.
i
3
Steel
36
Inlets & Outlets
4
Grout Blocks
37
Combustion Air I
5
Bond Beams
38
Compressor j
6
Roof Deck
39
Appl. Clearance
7
Framing
40
Fire Damper
8
Vents
41
Smoke Detection Device
9
Garage Fire Wall
42
Commercial Hood
10
Fireplace P. L,
43
Final
10A
Fireplace T. 0. E]
No
ADDITIONAL INFORMATION
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Loth
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Botts)
12B Ceiling (Botts)
12C Ceiling (Blown)
14 Final
PLUMBING APPROVALS
15 Ground Plumb
16 Water Piping
17 Rough Plumb
18 Vents
19 Sewage Disposal
20 Sewer
21 Woter Heater
22 Water Softener
23 Water Service
24 Gas Test
25
Final
Tank Pit L.Line
REAR OF PROPERTY LINE
PSL P/
ELECTRICAL APPROVALS
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final
STREET NAME
� Ct/
P.O. BOX 1504
Building
Address ss 44--537 AvenLda Montero LA QUINTA CAL CALIFORNIA 92253
Addr
r
Mr. & WS. John skolay
Mailing
Address 49-537 Av+e$ida llmtera
City Zip Tel.
• _
Contractor
Address
ty - ------.jZip '_ jTel.
BUILDING: TYPE CONST
A.P. Number
Legal Description
Project Description
SOF D.
State Lic. City
& Classif. B -Y 316634 Lic. # Sq. Ft.
Size
Arch., Engr.,
Designer New ❑
Address I Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm.that I am licensed nu de'ryorovisions of Chapter 9 (commencing with Section
7000) of DiYiai6nn 3 of the Business and Professions Code, and my license is in full force and
effect ( �! E` I(+ 77" A, �a_4ri
_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
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
O I, as owner of the property, ormy 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,
t,.. 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
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. 3800, Labor Code.)
Policy No. Company
O Copy is filed with the city. ❑ Certified copy is hereby furnished.
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 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
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 Address
City, State, Zip
No.
Stories
a y
No. 08535
OCC: GRP.:
No. Dw.
Units
Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
323.50
Mech.
?0y fn
Electrical
27.00
Plumbing
54.00
S.M.I.2.52
Grading
Driveway Enc.
-Infrastructures
fjT
TOTAL
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 918190 Permit
Validated by:
Validation:
F
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. SQ. FT. ®
POR. SQ. FT. ®
GAR. SQ, FT. ®
CAR P. SO. FT.
WALL SD. 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
SLAB GRADE Ova
FLOOR DRAIN
MECHANICAL FEES
BONDING
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
SEWER OR SEPTIC TANK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
DUCT WORK
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 ® 11/4 c
SEWAGE DISPOSAL
BOND BEAM
SQ.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 COND. SOLAR
SETBACK
GROUND PLUMBING &
DERGROUND
0/4
A.C. UNIT
COLL. AREA
SLAB GRADE Ova
Ak—
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING,
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)/03 a
7
46 METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
i�
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ -plus-x$_=$
LUMBER GR.
FINAL INSP.
FRAMINGFINAL
INSP. 1
ROOFING
� n
"P�
111
^
/ A
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
I-Amr.Zo 2Q Lp
MESH
INSULATIONISOUND 0
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
DESERT SANDS UNIFIED'SCHOOL DISTRICT
82-879 Highway i11 •
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated (619) 347-8631
Date 8/17/90 Type of Permit I La Quinta
No. 10102 Permit #
Log #"
Owner Name Mr. & Mrs . John Skolay
No. 49-537 street Avenida Montero
city La Quinta zip 92253
Study Area
APN # 'Tract # F Lot # � , Square Footage 508
Type of Development Residential Addition No. of units'.
Comments
At the present time, the Desert Sands Unified School' District does not collect fees on
garages/carports, covered patios/walkways, residential additions.under 500 square feet,
detached accessory structures or replacement .mobilehomes. It has been determined.
the above-named owner is exempt from paying school fees at this time due to the -
following reason:
EXEMPTION NOT APPLICABLE
This certifies that school facRity•fees imposed pursuant to Government Code 53080
in the amount of 1.58 X . 0 or $ 802.64 have been paid to D.S.0 S.D. for
the property listed above and that building permits and/or:Certificates of.Occupancy for
this square footage in this proposed project may now be issued.
Fees Paid By Craig_ Conklin' Company Telephone 34_ -Q
Name on the check tW_ ` 1
By. John D. BrookstP
v r.
z '
Associate Superintendent, Business Services '
Fee collected /e d by Joan. Larson
Payment Received.: x�
Signature
O.i`r�-ov. - Check`'\e ` 71,116
•
Collector: Attach a copy of County or City plan check application form to District copy.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
v