9924 (SFD)TW�l
i
P.O. BOX 1504 �..., No. 9924
Building 53-160 CA$$ANZA 78-105 CALLE ESTADO � `�l)
Address LA QUINTA, CALIFORNIA 92253 1�
Owner 1
GENERAL CONTRACT MGMT.
BUILDING: TYPE CONST. Sill OCC: GRP.
Mailing
Address P 0 BOY, 59
A.P. Number
City Zip Tel.
LA QUINTA, CA 92253 554E-1486 Legal Description
Contractor Project Description SPD
SAME
Aaaress
SAME
City
Zip
New ❑ Add ❑
TeL
SAME
State Lic.
City
& Classif. 524325
Lic. #1235
Arch., Engr.,
$8$,b51.00
Designer
AMOUNT
Address
Tel.
CityI Zip I State I
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 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 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 civil penalty of not more than five hundred dollars ($500).
O 1, 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
or 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 propertywhobuilds 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
Date Owner
WORKERS' COMPENSATION DECLARATION
I herebyaffirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certifie% op 1erof.`Seeci4 0, Labor Code.)
Policy NO. -'
o. Company •7
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--
erformance ofthg.work.for.which,this,VL-rmit is issued, I shall not
employ any person in any manner so -'is to becomeasubjecPto'the'Worker ' _Compensation
Laws of California
Date L '= - ry 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
LN -1 :A2'i:
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:
Sq. Ft.
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
$8$,b51.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
252.43
Const.
590.00
Mech.
55.50
Electrical
125.82
Plumbing
141.00
S.M.I.
8.90
Grading
20.00
Driveway Enc.
20.00
Infrastructure
19956.40
TOTAL:3,
REMARKS
LN -1 :A2'i:
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
1ST FL. SQ. FT. ®
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SO. FT. ®
CAR P. Q. FT. ®
WALL SQ. FT.
SQ FT ®
ESTIMATED CONSTRUCTION VALUATION
$
UNITS
YARD SPKLR SYSTEM
MOBILEHOME SVC.
BAR SINK
POWER OUTLET
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
$
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1114 c
SEWAGE DISPOSAL
SQ.FT.GAR ® Vac
HOUSE SEWER
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 PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
�!�
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
f /
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
r/ Al
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 Ll I �1
FINAL INSP.
ROOFING&
� rJI
O� //i/�
1/jr
�1ilel
26/G
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING 4-/)W 1 Al
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION +
CERT. OCC.
FENCE FINAL
INSPECTDR'S SIG NATURES/iNITEALS
GARDEN WALL FINAL
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated (619) 347-8631
Date 8/13/91 1 Type of Permit I La Quinta
No. F10801 Permit #
Log #
Owner Name General Contract Management
No. 53160 street Avenida Carranza
city La Quinta zip 92253 Study Area 112
APN # 774-051-008 Tract # I J Lot # Square Footage 11537
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 F—.58-1 X 11.537 lor$2,428.46 have been paid to D.S.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 General Contract Management Telephone 564-1486
Name on the check
By James E. Lively
Assistant Superintendent, Business Services
4?)y"a?1
Fee collected /exempted by Shelley D. Bennett {
Payment Rec'eive'd '
Signature Q,Q2L:4 0Check-f.No:' 3,11-3, Y
L'
Collector: Attach a copy of county or city plan check application form to district`copy for all waiVa
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
F 14 is
zt
A k pan�m
C4 of '14a Quinta
�
utin,4 r�n� �Stt�et� �Y�r�sion
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
ordinances of the City regulating building construction or use. For the following.
. BUILDING
ADDRESS
53-160 Carranza
Use Classification
SFD
Bldg. Permit No. 9924
Group R3 Type
Construction
VN Fire Zone
Use Zone SR
Owner of Building General
Contract
Mgmt. Address P.
O. Box 59
City La Quinta, CA
92253
By.
Lonnie Day
6/23/92
Dote:
Building Official
SCAT IN A CONtl?ICUOU! OLACt