SFD (10977)P.O. BOX 1504
Building��-2w48�- � r U 78-105CALLEESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner
Jesus Madrid
Mailing
Address Box 804
City Zip' ' Tel.
..UaQuinta 922.5 3. 3�'6--1Q(;
Address"
City- zip-, ,-, ✓,. Tel.? ..a-
State Lic. �-/�'"�/ City c
& Classif. Lic. # rw
Arch., Engr.,
Designer
Address - Tel.'
City lZip I State
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. 'y f J
_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;Susiness and'Professions Code:•Any city or:county which requres 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 rive hundred dollars (E500).
❑ 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 appy 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.) 1
❑ 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.)
O 1 am exempt under Sec. B. & P.C. for this reason
No. 10977
BUILDING: TYPE CONST. OCC: GRP.;
A.P. Number
Legal Description Lot 5 Black 93
Project Description
SFD
Sq. Ft. 4 �� No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ . Demolition ❑
-Permit includes block wally permit does
not, include pool
valuation
PERMIT .
Plan Chk. Dep'
Plan Chk. Bal.
Const.
Mech.
Electrical,
Plumbing
S.M.I.
Driveway Enc.
Date Owner I Infrastructure
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
❑ Copy is filed with the city.. 0 Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WO R KERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars (5100) valuation
or less.)
I certify that in the performance of Ing 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
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 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.
Signatureof applicant Date
Mailing Address
City, State, Zip
TOTAL
REMARKS
86,326.00
BY:
Minimum Setback Distances:
AMOUNT
250.00
Rear Setback from Rear Prop. Line
245.77
Side Street Setback from Center Line
581.00
Side Setback from Property Line,
55.50
FINAL DATE
124.84 '.
Issued'by:
141.00
Validated by:
6.09
20.00
} {{20.00
1805.33
3250.08
3000.08
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. ® $
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
LAUNDRY TRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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
BOND BEAM
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1 Vic
SEWAGE DISPOSAL
LUMBER GR.
SO.FT.GAR ® 3yic
HOUSE SEWER
FINAL INSP! �/��
G
ROOFING
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PLCK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE en PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBIN l
UNDERGROUND
A.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 /
L
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
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. 7
FRAMING
h
FINAL INSP! �/��
G
ROOFING
y� (
0 �� t„! J-14 /G) G� �1
e
�%ttiyS--31a�
WQ r (/ f (�/�
v !�l l v' L
ILIO
n
qla
REMARKS:
VENTILATION
FIRE ZONE ROOFING '
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
H G Z
MESH
INSULATION/SOUND76 W 9.1 k,
FINISH GRADING
FINAL INSPECTION l
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
4
P.O. BOX 1504 APPLICATION ONLY
Building n 78-105 CALLE ESTADO t
Address 5 a - is d li j� i Z C' LA QUINTA, CALIFORNIA 92253
Owner .. _.
maning
Address �a� Fp 4
City
I—— La V► -NT A .
Contractor
Address__-. _._ _
city _
3 �xso
i K-) quir AvT
State Lic.-�
& Classif'
Arch., Engr.,
Designer _
Ziq -42-
S 3 1Tel. 3 q 6 -1 4 O
Qu( Ld E2
Zip
1� 92-zS3
Tel.. ' -
4454 45L
City
Lic. #
BUILDING -TYPE CONST. OCC: GRP:--
A.P. Number
Legal Description r'
Project Description
5 ED- _
I� •
Sq. Ft.
Size
New.A7
No:
-Stories
No. Dw.
Units
Add ❑ . Alter ❑ Repair ❑ -Demolition ❑
Address
Tel.
City
Zip
State
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 Contractors 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 O
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).
I, as owner of the property, or my employees with wages as their sole compensation, Will
it the work, and the structure is not intended or offered for sale. (Sec. 7044,.Bulsness,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.) -
O I, as owner of the property, am exclusively cont
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 lwho?p Gds orImproves, thereon, and, who -contracts for
such projects with a contractor(s) licensed 'pursrfant to the Contractor's License'Law.) " .Y : s
❑ 1 am exempt under Sec. B. & P.C. for this reason
Y
Estimated Valuation
PERMIT AMOUNT
-
Plan Chk. Dep.
-
''Plan Chk. Bal.
Const.►
McCh.;;!'',
Electrical- -
-,
Plumbing
Grading
Driveway: Enc.
Date - owner s -•- i "4.: '%
nfrasfrUctur
WORKERS' COMPENSATION DECLARATION �r
I hereby affirm that I have a certificate of consent to self -insure, or a`certificate of.
t Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy�y
❑Copy is filed with the city.om0 Certified copy is hereby furnished.
t
; q }� (]
003 82sX` i`t A 5 <�c 7 K
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 -
or less.) j
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 1
Laws of California. J
Date Owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become ZONE: ! BY:
subject to the Workers' Compensation provisions of the Labor Code, you!must forthwith Minimum Setback Distances:
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY i
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
BUILDING DIVISION
.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
i
Issued by: Date Permit
Validated by: �•
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. a $
2ND FL. SQ. FT.
POR. SO. FT. ®
GAR. SQ. FT. ®
CAR P. SQ. FT.
WALL SQ. FT. ®'
SQ FT ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
I ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE - DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEQUIP.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
REMARKS:
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 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 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
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated (619) 347-8631
Date 5/26/92 1 Type of Permit
No. 11418 Permit #
Owner Name Jesus Madrid Log #
No. 52085 street Avenida Navarro
city La Quinta zip 92253 Study Area 113
APN # Tract # Lot # Square Footage 11466
Type of Development Single Family Residence 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 facility fees imposed pursuant to Government Code 53080
in the amount of 11.58 1 X 1466 or $ 2,316.28 have been paid to D.&U 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 Jesus V. Madrid Telephone 396-1404
Name on the check
By James E. Lively ��,yNNW -
Assistant Superintendent, Business Services
Fee collected /exempted by Shelley D. Bennett
Payment `Received,
SignatureD-6 H ^�+v '` Y Q
Check_ Y. No. 103
Collector: Attach a copy of county or city plan check application form to dis%_rict co�ny'(r ill waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accoi'iAtin--'
DATE `� 5� Z CASE NO. �f C�` _ S- /S `% 2
DEVELOPER'S NAME: 'eg�Q $ S IV c.o�i� cel
ADDRESS: e O
C? -
TELEPHONE:
Dear Developer:
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
immediately.
Thank you for protecting and preserving the Coachella Valley's pest -free environment.
` Agricultural Commissi er's Office
cc: Indio and Riverside
i
y i
1
4880 LEMON STREET, ROOM 19, RIVERSIDE, CALIFORNIA 92501 = FAX (714) 275-3012
t
is
Of of
CALVIN C. KAMINSKAS
r : s DAN RILEY.
a
Assistant Commissioner4
Sealer, Weights & Measures
(7.14) 215.3000
C (714) 215.3030
OFFICE OF
AGRICULTURAL COMMISSIONER
"JAMES O. WALLACE, Commissioner
83-612 Avenue 45 Suite.7
Indio, CA 92201
(619) 342-8291
DATE `� 5� Z CASE NO. �f C�` _ S- /S `% 2
DEVELOPER'S NAME: 'eg�Q $ S IV c.o�i� cel
ADDRESS: e O
C? -
TELEPHONE:
Dear Developer:
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
immediately.
Thank you for protecting and preserving the Coachella Valley's pest -free environment.
` Agricultural Commissi er's Office
cc: Indio and Riverside
i
y i
1
4880 LEMON STREET, ROOM 19, RIVERSIDE, CALIFORNIA 92501 = FAX (714) 275-3012
'`'��
• !
• I
� � � ���� a� Qom. -
�� * i
14
OF
Ed (ouinta
•��
��i�
!'
�Ltt��tn �tn� ���1�P� �t�t�tun � '���!� �
.
This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building
Code certifying that at the time of issuance this'structure was in compliance with the various i
ordinances of the City regulating building construction, or use. For the following:
BUILDING ADDRESS 52-085 Navarro'
''! ;;
� •
' ! ;
3 Use -Classification Single Family Dwellinq Bldg. Pormit No.'10977. '
Group RI Type Construction VM Fire Zone Use Zone RR
I X
'I I
Owner of Building Jesus Madrid Address P.O. Box 804 I I
I
III
City La Quinta, CA
- By; _ Lonnie Day - • � I i
i
Date: Nom=Mhinr 1 4, 1999
uild ng Official
POST IN A CONSPICUOUS PLACE __