003176 (SFD)P.O. BOX 1504 N o . 003176
Building 78-105 CALLE ESTADO
Address 52-480 Avenida Carrara LA QUINTA, CALIFORNIA 92253
Owner
Mailing
Address
City Zip Tel.
Contractor
OiiLeiihtii.t' er
Address
City'
State Lic.
& Classif.
Arch., Engr.,
Designer
.. lZip
City
Lic. #
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. r,.
_SIGNATURE - A -rA'• I ° - Y'r•' DATE
f 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, atter, 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, 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.)
❑ 1, 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 a 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
❑ Copy is filed with the city. 0 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., 9, 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. -
BUILDING: TYPE CONST. OCC. GRP.
A.P. Number 773-291-001
Legal Description
Project Description Single F mi3y Mml2ino
Sq. Ft. No. No. Dw.
Size- - 1544 Stories Units
New ❑ Add ❑ Alter ❑. Repair ❑ Demolition ❑
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from.Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
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.)
Side Setback from Property Line
Lender's Name
Lender's Address
FINAL DATE
INSPECTOR
This is a building permit when properly filled out, signed and validated, and is subject to
Estimated Valuation
expiration if work thereunder is suspended for 180 days.
I certify that I have read this application and stale that the above information is correct.
Issued by:
PERMITAMOUNT
I agree to comply with all city and county ordinances and state laws relating to building
T.
'Plan Chk. Dep.
S2 alta
Plan Chk. Bal.,.
Validated by:
�,�►
Const.447„00
Mailing Address
Validation:
Mech.
Electrical
Tq
Plumbing��
^
S.M.F.
Grading
T)_AfI
Driveway Enc.
-7n_00
Infrastructure
TOTALa..�ri
REMARKS
VPD W14.
Izf`l+ (¢.j_Q{5
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from.Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
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.)
Side Setback from Property Line
Lender's Name
Lender's Address
FINAL 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 I have read this application and stale that the above information is correct.
Issued by:
Date OVIA/A% 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
T
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMING'FEES
1ST FL. SQ. FT. ® $
UNITS
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
DUCT WORK
ROCK STORAGE
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
METER LOOP
HEATING (FINAL)
DRAINAGE PIPING
CAR P. Q. FT.
GAS (FINAL)
WALL SQ. FT.
DRINKING FOUNTAIN
SQ FT ®
WATER HEATER
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
WATER SYSTEM
FLOOR DRAIN
MECHANICAL FEES
GRADING
cu. yd.
$ plus x$
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
/9
LAUNDRY TRAY
AIR HANDLING UNIT CFM
REMARKS:
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
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
MESH
INSULATION/SOUND
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
ACK /� ��
GROUND PLUMBING U
7
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 'I g, /•
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
l
ROOFING
/9
A
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
OC
y ,I�Al-00,
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
s
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS,
GARDEN WALL FINAL
P.O. BOX 1504 APPLICATION ONLY
Building `�Z 78-105 CALLS ESTADO
Address.)
ddress y� D l.4 e r1 i# rrZ ft LA QUINTA, CALIFORNIA 92253
Owner M I
ri 'n'�t'�' M :0 Ff �� �)-' , t' Ga��� BUILDING: TYPE CONST. OCC. GRP.
Mailing '
Address A.P. Number 773 Z f/"
City Zip Tel.
Legal Description
Contractor Project Description
Address /
City Zip Tel..
State Lic. City
& Classif. Lic. # Sq. Ft.,J�/ No. No. Dw.
Arch., Engr.,
Size S� 7 7 Stories Units
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel. I L 3O
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
70(10) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.
SIGNATURE DATE
OWNER-BUILDER DECLARATION Estimated Valuation
1 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 Me 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
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 Plan Chk. Dep. -� �-0, 4 ,7
subjects the applicant to a civil penally of not more than rive hundred dollars ($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal.
do the work, and the structure is not Intended or offered for sale. (Sec. 7044, Bulsness and Const.
Professions Code: The Contractor's License Law does not apply to an owner of property who i
builds or mproves 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 -
orImprovement is sold within one year of completion, the owner-builder will have the burden Electrical /71,0Z
of proving that he did not build or improve for the purpose of sale.)
,O 1, as owner of the properly, am exclusively contracting with licensed contractors to con- Plumbing ,I,1r + fl. '1 a A •� f. 'I A ! QQ
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law ww
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 to the Contractor's License Law.)
•
❑ I am exempt under Sec. a, g P.C. for this reason Grading 00
Driveway Enc. 2.0
Date 1-i - ? owner -�'� -- �- �� �'' �-^ - Infrastructure-7:5- Q
PI, r. f- AIL.4ev Z 5� a 0-
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. ❑ Certified copy is hereby furnished.
TOTAL � v c7 � � � . �
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed fl the permit is for one hundred dollars ($100) valuation 02.2 S07
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.
Dateowner!"�
r —/� >:t/_
NOTICE TO APPLICANT: If, ager making this Certificate o of - Ezerription you should become ZONE: BY:
subject to the Workers' 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
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Ciro code.) Side Setback from Property Line
Lenders 'Name r
Lenders Address /V FINAL 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 I have read this application and state that the above information is correct. Issued by: Date 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:
i
Signature of applicant`-� r ��• -� I — 'Dale- -1-" -C�/
Mailing Address? v -'`�c� eJ, .M, i ,_- _ Validation:
City, State, Zip / i, t . 1h �i , t •i -� t 2
BUILDING DIVISION
CONSTRUCTION ESTIMATE Allib
GROUND PLUMBING
UNDERGROUND
NO. ELECTRICAL FFAAL
NO. PLUMBING FEES
1ST FL. y SQ. FT. ® �Q
ROUGH PLUMB.
BONDING
UNITS
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
2ND FL. SQ. FT.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
YARD SPKLR SYSTEM
HEATING (FINAL)
//
REINF. STEEL
GAS (FINAL)
MOBILEHOME SVC.
BAR SINK
GROUT
POR. SQ. FT. 0 I
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GAR. y SQ. FT. ® /
LUMBER GR.
POWER OUTLET
FINAL INSP.
ROOF DRAINS
FINAL INSP.
CAR P. I SQ. FT. @
ROOFING
DRAINAGE PIPING
WALL SQ. FT:.®4r .DO
O
DRINKING FOUNTAIN
U 0 SQ. FT. ® '
%
SPARK ARRESTOR
URINAL
ESTIMATED CONSTRUCTION VALUATION $19
C
WATER PIPING
NOTE: Not to be used as property tax valuation
MESH
FLOOR DRAIN
INSULATIONISOUND
MECHANICAL FEES
FINISH GRADING
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
FENCE FINAL
APPLIANCE DRYER
INSPECTOR'S SIGNATURESIINITIALS
GARBAGE DISPOSAL
GARDEN WALL FINAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM. B.T.U.
I
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
¢
HOUSE SEWER
GAS PIPING
PERMIT FEE
K%
PERMIT FEE
l
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE
PL.CK.FEE CONST. FEE
ELECT. FEE
SMI FEE
PLUMB. FEE
6 " O
3! 3. 9 y'
79 '*6,12
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 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.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
All /`ca fe's i S 5 (t d
Desert Sands Unified School District
CERTIFICATION OF PAYMENT
OF S1'J
SCHOOL FACILITY FEES fid
TO: City of La Quinta DATE:
Department of Community Development
78-105 Calle Estado
La Quinta, CA 92253
This is to certify that Ok-z—
developer of , which is
located at �2 / J0 within
this District, has paid school faci ity fees imposed"Pursuant to the
authorit enerated by Government Cole Se tion 53080 the amoun of
Ill—
$9-316 ( �y �.�e, ZAP.,;: — —�- - / on )
covering a total of square feet of (d-I—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•UNI IED SCHOOL DISTRICT
White - Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer
. / / / (10)-37
POFFICE OF 0
RICULTURAL CO -M MISSIONER
4080 LCMON STREET, R00.M 19
RIVERSIDE, CALIFORNIA 92501
(714) 767.2561
Dear Developer/Landscaper:
46-209 Oasis Street,.P. om 14
Indio, CA .92201
(619) 342-8291 '
s._
E. LEON SRAUGY
COMMISSIOUFJ1
MMES O. WALLACE
ASSISTANT COMMIWOXER
Thank you for inquiring with the Agricultural Commissioner's Office regarding
local quarantine laws.
Any diseases or insects associated with the plants/landscaping material presented
on your landscaping plans do not pose a threat to the Coachella Valley Citrus,
Date, Crape, Vegetable, or Field Crop industry.. Ve therefore approve your
landscaping plans.
If however., any substitutions of plants/landscaping materials within your plans
occurs between now and the actual planting date, you must contact this office
within 48 hours before eelivery into the Coachella Valley. Also, the substituted
plants/Landscaping material must be held for inspection upon arrival. Any sub-
stituted landscaping material found infected/infested with quarantine pests will
be irLnediately treated or shipped out of the Coachella Valley at the discretion
of the Agricultural Cocmissioner's Office,
Lander penalty of perjury, I.the undersigned will comply with the above.
Authorized Agent:
Fare �ep)"q E' `�. C.7o!"Gio t't Date 6
Signature
Permit Number(s)
Z
Developer ?ng - j1,.? 21 W. Address5-3-? jD GL„e L �, 4 ,-- , !,
s 6 y -Z
AGRICUL�
TU AL CG'- ;ISS10" til S /?P -AL� zz4/OVDate. 6 -
1067
Authority cited: Agricultural Code; Sections 6301, 6461, 6452, 646+, 6501, 6521-
6524
cc: 2 Plan Clicic:, Ir.dio Office, Riversice O Tice