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PLBG (0002-225)LICENSED CONTRACTOR DECLARATION I her6by affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License # Lic. Class Exp. Date l2 EX0, date �`�U Signature of Contractors° OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: ( ) I, as owner of the property, or my employees with wages asytheir sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business & Professionals Code). ( ) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code). ( ) I am exempt under Section , B&P.C. for this reason Date Signature of Owner WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ( ) I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. (\)/ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers.' compensation. insurance carrier & policy no. are: Carrier Policy No. n J..l. Jl Vw1. j4 1 (This section need not be completed if the permit valuation is for $100.00 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, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those'provisions. D te: C U Applicant Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subjeci to the conditions and restrictions set forth on his application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a_result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the y, above-mentioned propert_,forinspection purposes. 18ignature (Owner/Agent)4', — Date _ PERMIT# BUILDING PERMIT 401lit-II.S DATE VALUATION LOT TRACT JOB SITE ADDRESS 49-951_;�1$1�%1'yi> *?A l�'fl.�U1N�QERO APN — OWNER CONTRACTOR/DESIGNER/ENGINEER ISI ii)1,'7yT' 1:Y)Ji �'-t i7f'f`1?cT/1 <L"'1tlY:=3 l''F:Yd\lTf`+P V0 illiX 1115 &Z33 t ?!W/1T.fUN Rb. iND1 , CA 92201 QU)[vTA. i.<7# ' 1ZZ` i PAUM Ui?:+ERF CA 92261 USE OF PERMIT s IJ.I,tlf�3�S11\1� 1 �, rsmzosQii 6 Citi'S. APi'LCi&Fli7'EuvD6tv4WN:rteiJ;i!N6 :iir_AP AUL' !'. T 'rf,4`1�^'�'Ati�y '�'q�+l� 64,IPNT nE •!i ''t A'f`g1 �P'K!!'A3 2,A i164 {1 �e1� jj YYgg �'9 S y A1 �Y.')p'1�JJ .l Y.LV YG1 k '�,t1 \a \,/.; *.J A' IA Y.�W kY3;J1Y ✓ 2 f• i9JYJ PLU14i31NU Fh-E -47.5(f Z0( r(-�I•%f.(tir�NKr fR`rr0N nrvr W,A_rr HtiCW ;� af� r "IPS PH 16 T.rrs RECEIPT I DATE 0010, /1O I $37,540 DATE FINALED INSPECTION RECORD OPERATION DATE I INSPECTOR OPERATION DATE I INSPECTOR - BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts x Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K to Wrap F.A.U. Reaming Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final BLOCKWALL APPROVALS POOLS - SPAS steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test Appliances e C Final Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Ftough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) COMMENTS: '^ N y ZZ zf' � do � � ro - z eQ• ..•.�, �-- < I - t� p , 0Tg>y Zl CITY OF LA _ QUINTA _ .� BUILDING& SAFETY DEPT - �\ �,�.,Mldas - - APPROVE FOA CONSTRUCTION r � '.' • OATS . Z. 6�`pp �F. 7 COLIINW OF RIVERSIDE H'EAL'i i-9 DEPARTMENT OF EWIRONMENTAL HEALTH __I=ced Sewage Disposal ^�Trsiier Park X/tT Gal. Septic Tank ( ? G��Tv %•✓7 jr f�pt., Hotel Sq. Ft. pf Leach dine r Dwe ling Ex�lr. (�a ) /— No. �Dia_�BI^'a4 TD -?-r AAD Seepage Pil m /IEPcACE 6X/ri7n/6 C6mWercial Building Connection to Sewer Swimming Pool Connect to Existing S.S.D.S. _f:o on-site regenerating wafer softening devices may be. discharged into the individual sewage disposal <4ystem herewith approved without clearance from the Water G I� ntrol Board. X Water supply servj�� thi�installation must be from an approvk so rce t'X1f �C lJ(�t/P TAll sewage dis, ��iSla ftn must conform with requirements of currerd Uniform Plumbing Code. Any cutting, gradin or filling in excess of two(2) feet will nullify sewage disposal approval. Approval has been obtained from the Regional Water Quality Control Board for installation of the sewage disposal system. This is to certify that the Riverside County Environmental Health Services approves the subsurface sewage disposal plot plan t!o/obtain building permit for i stallation, construct!P1'. DATE �— l�f -Od BY Z4�&- "NTAJN1W%F-XPANSI0N AREA. MIN: �. 0 FfIOM ANY WEU h ^,UJ MIN. 10' FROM ANY tXIMEPTREE OR WATER MAIN, -to yam,/ ,off l(�°i� 4 -4A -Al DEPARTMENT OF PUBLIC HEALT IS VALID FOR ONE 1 ]prO•" = m platy by tpe L"a�a��et ' YEAR l3eait6 of Riveride County does not relieve the ). FROM DATE OF APPROVAL � or Architect of the responsibility for the sew ',at or Architectural deeiorm" j 7rti o -P S' 3- lav CITY OF LA QUINTA BUILDING &.SAFETY DEPT. APPROVED FOR CONSTRUCTION OATIE BY, . L NUMBERS R'S PARCEL COUNTY OF RIVERSIDE HEALTH SERVICES AGENCY ASSES Sa S E DEPARTMENT OF ENVIRONMENTAL HEALTH PERMIT APPLICATION FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM APPLICANT. Submit this form with four copies of a SCALED plot plan (1-20 SCALE) drawn to County specifications as indicated on the attached check list. A non-refundable filing fee is required when the application is submitted. Check must be made payable to the County of Riverside. Approval of this applica- tion shall remain valid for a period not to exceed one year from date of payment. CMS # .; T�� Agent, Contractor -Contact Person Address City State Zip Telephone Qr Owner Address City State Zip Telephone e Z 0 'Job Property Address - ` rl - 9&/ Ay-eJ1D* A ^/ mr"?0 City Zip IU Lot Size ater Agenc '..ell /!�a��,f . Use of Permit, P/P, SUP PUP, etc. a�PiALf 61f (I fiFl� F!'�Q6rshr Legal Description �� S` i s 7 S�fi' Jf P welling, M�ite�Prep.aetc� Signature of O'plicant � 1/� r /� j r+ :4 '� b Date r CHECK BOX IF REQUIRED If any box is checked, this application shall be considered rejected until ❑ Detailed Contour Plot Plans Required (1 to 5 foot interval) the information is provided and the fee paid. Resubmittals later than 90 days after date noted below may require repayment of fees. ❑ Staff Specialist Lot Inspection Required m ❑ Holding Tank Agreements Completed Thomas Bros. Page Grid Z Z ❑ Certification of Existing S.D. System Required ~ ❑ Date Lot Inspection Completed: Initials ❑ WOCB Clearance Required LU (Attach for DOH -SAN -007, Santa Ana Region Only) Remarks: ❑ Soils Percolation Report Required ❑ Maintenance Booklet Provided ❑ Special Feasibility Boring Report Required ❑ Final Inspection by Department of Environmental Health is required. ❑ Rereview Required Initials Date Please call 24 hours PRIOR to inspection. G/42�Soils � /�Ic An w1ilm 1 1,44a " mAy,7" �� 7 tAio Percolation BoringReport b i'f He/Project# - Date .4 p y Soils Map Page 1 Soil Type Approved By /" � %��' ��" -Date �`� ` 7 e 7C:4 rr a, No °of Systems 915, Pj^'(� T pe of System(s) �' Holding Tank (� Replacement i No. Dwelling Units 11COlfP Bedrooms, t flits 4:1,11• (1) Septic Tank ��rJ(o Soil Rate Greaj'htcp/k t. Trap ❑ New ❑ Addition ❑ Existing gy1i f. % 4( l � _Gal. 4cGireasICSand • Gal. Sq. Ft. Bottom Area Total Linear ',Ft. Sidewall Allowance f+ /,CY f� F/i�Gtmig Leach Bed sq. ft. of Bottom .rock/ sq, ft, running ft. Inlet Tested Dep ❑ NA Install\ Line(s) ft. long ft. wide with min. _"',inches rock below drainlines or Proposed Bottom Tested Depth U Z Leach lines/bed special design for slope: (3) Pit Diameter No. Pits Pit Below Inlet (BI) Seepage Pitmaximum.,= z Other: O w Applicable-16 Total Depth Avowable Depth 1 W N/A. _ .. Overbur an Factor? �' 'S ' , r TD� Well Review Approved: - Date: Well Drilling Permit # SIGNATURE } - Grading Plan Approved: Date: �lV/ SIGNATUREyy/,°i��'r I"V�sja��'LCr✓�9'� �aa6� (✓✓ Sewer Verification Approved: Date: � Plan Check Only Approved: Date: REMARKS:. � v �(:L�n�,r�� si1�'�4 /�J ,, d>�ii��j ,s 16 r 4p �,9 ., 5� U )`ld t111-3G� /e'l '- • This application iwIAPPROVE /DENIEf) for"the: e.�tegoryrcheokedin,.SECTION=B� FOR OFFICE USE ONLY ,above; regarding the d'esTgn f a subsurface disposal system as indicated on the acompanied plot plan, using the requirements set forth in SECTION C above. A build- ��f ®� 3, ing permit is necessary for the installation of the above -designed system. No con • Is In the 100% Revenue code Fee struction permitted required reserved expansion area. (1) Septic Tank must be 100' minimum from any wells. _ 0 Check #f Date `f Initial °) (2) Leach lines must be 100' minimum from any wells, including expansion area. Q (3)�Sewer lines must be 50' minimum from any wells. 12 O (4) Seepage pits must be 150' minim�u�m[f�rom any wells, including expansion area. iw CITY OF LA QUINTA U) S BUILDING & SAFETY DEPT. % `i�N Signature of Health Official " .�' APPROVED FOR CONSTRUCTION Date DATE DEH -SAN -122 (Rev 9/98) Distribution: WHIIt—Unice rue; Yti-LUW—Applicant; FINK—slag. uept.; UUi-utrvrluL—Flans/mecoras EC SEWER SERVICE, INC. dba ECONO SEWER SERVICES P.O. BOX 192 • PALM DESERT, CA 92261 (7601346-2793 17601 328-7760 J00 WOREIRDER r `' -11831 FAX (760).347-4978 DATE OF ORDER r7� SERVICE CODE PHONE TECHNICIAN HELPER STARTING DATE TOTAL LABOR PLEASE PAY FROM THIS INVOICE. NO STATEMENT WILL BE MAILED. TOTAL MATERIALS BILL TO TYPE OF WORK DATE COMPLETED T ❑ CLEAN DRAINS' ❑ OTHER 46 R ss Z ❑ SEPTIC TANK ❑ GREASE TRAP CI :1, L� (/ ❑ SEEPAGE PIT J B NAME AND LOCATION ADDITIONAL WORK NEEDED: TANK SIZE: PAYMENT TERMS NET 10 DAYS FROM DATE OF SERVICE 1/2% PER MONTH CHARGE AFTER 30 DAYS. DESCRIPTION OF WORK: CONDITION OF TANK BEFORE SERVICE Good _ Trash & Garbage _ Excessive soap _ Fair _ Overflowing _ Sand _ Poor _ Blockage _ Repairs Needed Very Poor _ Odor Roots _ More frequent service needed ❑ No one home ❑ Total amount due Signature for above work: or I hereby acknowledge the satisfactory completion of the above described work. ❑ Total billing to be mailed after completion of work TOTAL PUMP DISPOSAL FEE TOTAL LABOR PLEASE PAY FROM THIS INVOICE. NO STATEMENT WILL BE MAILED. TOTAL MATERIALS DATE COMPLETED T WORK ORDERED BY TOTAL AMOUNT $ ❑ No one home ❑ Total amount due Signature for above work: or I hereby acknowledge the satisfactory completion of the above described work. ❑ Total billing to be mailed after completion of work Building Address 49-931 HONTEBO ROBERT FIELDS Mailing Address SALE City Zip .. LA QUINTA • 92253 Contractor 44 Quhtr6u P.O. BOX 1504 •j N 0. 10 7 V V 78-105 CALLE ESTADO l j� LA QUINTA, CALIFORNIA 92253 BUILDING: TYPE CONST. OCC. GRP. - Tel. 564-1338 Address . 80-450 AVE 50 City Zip Tel.: INDIO 92201 345-1153 State Lic. City & Classif. C-27 589274 Lic. # 1761 Arch., Engr., Designer Address Tel. CityZip State Lic. # LICENSED CONTRACTOR'S DECLARATION . I hereby affirm that I am licensed under provisions of Cater 9 (commencing with Section 7000) of Division 3 of the Business and Professions'Cod , and'my icense is in fu I foice and ' '�/ �. effect: — r •„!' �..:,.f" may. `! OWNER -BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for the following reason: _(Sec.. 7031.5,Susiness and Professions Code: Any city. or county which requires a ' permit to construct, after, 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'cW1 penalty of not more than rive 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 knproves thereon and who doessuch 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 Improvefor 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, ora certified copy thereof: (Sec: 3800; Labor Code:) Policy No. Company [ 1 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: 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 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 P. Number .Legal Description Project Description 5 t $ 67* BLOCK SCALL ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line s Side Setback from Property Line r• FINAL DATE - INSPECTOR Issued by: Date --Permit Validated by: Validation: Sq. Ft. Site No. Stories No. Dw. Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $10450 PERMIT AMOUNT Plan •Chk. Dep. Plan Chk. Bal. Const: 45.00 Mech. Electrical Plumbing S.M.I. .20 Grading Driveway Enc. Infrastructure TOTAL 1 $45.20 r V, REMARKS ��" °41 M .0 of F� 1'Tl inti' $5-:N ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line s Side Setback from Property Line r• FINAL DATE - INSPECTOR Issued by: Date --Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ 2ND FL. SO. FT. POR. SO. FT. ® GAR. SO. FT. ® CAR P. SO. FT. WALL SO. FT. ® SO. 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 HEATING (ROUGH) WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER DUCT WORK GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED GAS (ROUGH) LAUNDRYTRAY AIR HANDLING UNIT CFM OTHER APPJEOUIP. 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 GRADING cu. yd. $ plus x$ SO. Fr. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1+/. c SEWAGE DISPOSAL FINAL INSP. SO.FT.GAR ® V4c 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 x 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 Ly SEWER OR SEPTIC TANK ROUGH WIRING. DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM.L 4� WATER SYSTEM GRADING cu. yd. $ plus x$ =$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION- ("Ir CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESlINITIALS GARDEN WALL FINAL P.O. BOX 1504 NO. 003152 Building 78-105 CALLE ESTADO AddressQo ca�Rx+?;v9 LA QUINTA, CALIFORNIA 92253 Owner Robert Fields , - _ BUILDING: TYPE CONST: Mailing OCC: GRP. Address Same A.P. Number ` 617-441 AM City Zip Tel. (I1tt�.nta 92253' 64:-1339 Legal Description ContractorProject Description �.. _.. " lRa addition . .. .. , _ Address .. . 4I-595 Lima HO -11 Road City Zip Tel.. Bermuda Butes 914,201 345-544 7 State Lia City & Classif. _ &F(1114-66 Lic. # Sq. Ft. 293 No. No. Dw. Size Stories Units Arch., Engr:; Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State Lic: # LICENSED CONTRACTQR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Sedtion 7000) of Division 3 of the Business and Professions Code, and my license is in full force and ..effect.. t _ SIGNATURE DATE OWNER -BUILDER DECLARATION EStlmated V81UatlOn I hereby affirm* that I am exempt from the Contractors License Law for the following .•. reason: (Sec. 7031.5,Business and Professions Code: Any city_ or.county .which requires. a - fi 1 T ;Vle11 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 .. ..;.PERMIT ' AMOUNT the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000)of - - - ' Divisiori'3 of the Business arid 'Professions. Code, or that. he is exempt therefrom, "and the basis for the Any Section 7031.5 'any for Plan Ghk. Dep. alleged exemption. violation of by applicant a permit subjects theapplicant to a'civil penafty of,nofmore than five hundred dollars' ($500).'- . Plan Chk. Bal. 0 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, Bufsness'and' "Const. '�',� fifth. . Professions Code: The Contractor's License Law does not, apply: to an ,owner of property -who . %4 _ builds or improves thereon and who does such work himself or through his own employees, Mech.' . 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 -Electrical -a�El of proving that he did not build or improve,/or the purpose of sale.) - 0 I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing strucl the.projecl. (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 S•M,I,. • such projects with a contractor(s) licensed pursuant 4o the Contractor's License Law:) .. Grading - .. • - ....0.1 am exempt- under Sec. _.B. & P.C. for this reason Driveway Enc. Date owner' Infrastructure WORKERS' COMPENSATION DECLARATION ' "I hereby affirm that 1 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 0 Copy is filed with the city.. 0. Certified copy is hereby furnished. TOTAL CERTIFICATE OF EXEMPTION FROM . REMARKS WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is , for one hundred dollars ($100) valuation - »,1; +4 4 A fc c E n ham,_ S t_ 11):111t Tt or less.). .... .. _ .. ... .. .. .. certify -that in the performance of thg work for which this permit is issued, I shall not Q, , _ 4"' PE �. u�� t s ! t 3 � 4tl.; 1V J employ any person in any manner sous 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 ZONE: BY: subject'to the Workeis' Compensation provisions of the Labor .Code, you must forthwith comply with such provisions or this permit shall be deemed revoked.' - Minimum Setback Distances: ' Front Setback from Center Line Rear Setback from Rear Prop. -Line CONSTRUCTION LENDING AGENCY. Side Street Setback from Center Line 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.) . ' Side Setback from Property Line Lender's Name Lender's AddressFINAL;DATE INSPECTOR 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 1 have read this application and state that the above information is correct. Issued by: Date All 9 FR7 Permit 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. Validated by: Signature of applicant Date Mailing Address Validation: City, State, Zip , HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ 2ND FL. SQ. FT. ® POR. SO. FT. ® GAR. SO. FT. ® CAR P. SO. FT. p WALL SQ. FT. ® SO. FT. ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM `r BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING NOTE: Not to be used as property tax valuation A.C. UNIT FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER HEATING (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM I 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 REINF. STEEL SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR ® 3/ac HOUSE SEWER GROUT 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 UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADEfn 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 /� �..hC L �� IJ �Lt!L / �'�i r REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK.ARRESTOR GAR. FIREWALL LATHING MESH QG•�NSULATION/SOUND S'1 v FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL Desert Sands Unified School District CERTIFICATION OF PAYMENT OF tW • SCHOOL . FACILITY FEES 6Lv� T0: City of La Quinta DATE: -7177 Department of Community Development • 78-105 Calle Estado La Quinta, CA 92253 , This is to'certify that developer of laa which is located at" 419- 3 Q�-�-1 within this District, has paid school facility fees imposed pursuant'to the authority generated by Government Code.Se tiost 530 0 in a amount of covering a total of.-' equare feet of '( residential or ( ) industrial/commercial development and that building permits for this footage in this development may now be issued by your jurisdiction. for DESERT SANDS UNIFI D SCHOOL DISTRICT White - Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer .8 a - (10)-37