10349 (SFD)4
4v
P.O. BOX 1504 N o . 10349
Building 78-105 CALLE ESTADO
Address 43-365 Carranza LA QUINTA, CALIFORNIA 92253
Owner
$X K14C SSP Pbv Marx Katzman r TK
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number 774--075-019--6
Legal Description lot 7 Block 222
Project Description S F n
Mailing
Address P. 0. boy: 1$13
City
La jnta
Zip
92253
Tel.
'
Contractor
Jack Clark, Jr.
Address
P. 0. Box 1371
City
La Cuinta
Zip
92253
Tela
564.3511
State Lic.
& Classif. 506667
City
Lic. # 1115
sq. Ft. 1630
Size
No. No. Dw.
Stories Units
Arch., Engr.,
Designer
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
City
Zip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm than 1 am licensed tinder provisions of Chapter 9 (commencing with Sectioq
7000) of Division 3 of the Bus)''ness ?fid P,Tofessions Code, and my license is in full force and.
effect. 1 f f r I/
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, 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 dcensed 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 perm
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 enpbyees,
provided that such improvements are not intended or offered for sale. If, however, the burl ng
or improvement is sold within one year of completion, the owner -budder wr7 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 Contractors License Law
does not apply to an owner or 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. 8 P.C. for this reason
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
250.0V
Plan Chk. BBI.271.00
Const.
61 50
•
Mech.
62 Q(}
Electrical
129 „ 23
Plumbing
141. 00
S.M.I.
9 , 40
Grading
20. 00
Driveway Enc.
`0.00
Date Owner
Infrastructure
2067.46
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Workers Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. .Company
❑ Copy is filed with the city. O Certified copy is hereby furnished.
; �� fiS i ' i+) j y : t . `- 1 +J .L ' 4
TOTAL
3 t3 .G . y 33 3 t. 5 to
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 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.)
Lenders Name
Lenders 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
1 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
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 Permit
Validated by:
Validati
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
COLL. AREA
2N0 FL. SO. FT.
ROUGH PLUMB.
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT.
DUCT WORK
DRAINAGE PIPING
WALL SO. FT.
GAS (ROUGH)
DRINKING FOUNTAIN
SO FT ®
HEATING (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GAS (FINAL)
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER HEATER
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
WATER SYSTEM
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GRADING
cu. yd.
$ plus x$
LAUNDRY TRAY
AIR HANDLING UNIT CFM
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1 Vi c
SEWAGE DISPOSAL
SO.FT.GAR @ V4c
HOUSE SEWER
SPARK ARRESTOR
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 /Z
GROUND PLUMBING'Zln Q(
/'.,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 APPJEGUIP.
REINF. STEEL /Q �/
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP. e G�
FRAMING /9�CL/
FINAL INSP.
ROOFING ��
/
Q /� W Ca r 6(!( f A � /Z01 /L1 A t�
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LAiQNUGJ Q V
MESH
INSULATION/SOUND �[N�
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 112/10/911 Type of Permit I La Quinta
No. 111046 Permit #
Owner Name KMC EPP by Mark Kartzman Log #
No. 53375 street Carranza
city La Quinta zip 922853 Study Area 111
APN # Tract # Lot # Square Footage 11630
Type of Development 16ingle 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:
This certifies that school facility fees imposed pursuant to Government Code 53080
in the amount of 1.58. X 11.630 or $ 2,575.40 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 Jack Clark, Jr. Telephone
Name on the check
By James E. Lively F
. yr
Assistant Superintendent, Business Services y
Fee collected /exempted by Vickie J. Durrett
,� Payment Received
Signature /y(�t�LIQ, Check No. 90
Collector. Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
CALVIN C. KAMINSKAS i�; DAN RILEY
Assislanl Commissioner a �> ' Sealer, Welghls & Measures
(714) 275-3000 ' (714) 275-3030 -
\._- s
OFFICE OF
AGRICULTURAL COMMISSIONER
JAMES O. WALLACE, Commissioner
83-612 Avenue 45 Suite 7
Indio; CA 92201
(619) 342-8291
DATE__P CASE NO. RL✓S —//— l 3
DEVELOPER'S NAME :
ADDRESS : g, 0. jZoX /g' / ?
4 9 22L 3
TELEPHONE: : (6 /9) K -- 1� S-3 G
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 Commissioner's £ ice
cc: Indio and Riverside
4080 LEMON STREET, ROOM 19, RIVERSIDE, CALIFORNIA 92501 — FAX (714) 275-3012
Received
Address:
COACHELLA VALLEY WATER DISTRICT
CASH RECEIPT DETAILS �`
Account No. / - ot(s) 4 64)
Service Address ri !Q . �%g�=, .5.�
Meter(s)
❑ Service(s)
❑ Backflow(s)
❑ House Lateral(s)
❑ DetectorCheck(s)
❑ Meter Surcharge
Sanitation Capacity Charge�4
❑ W.S.B.F.C.
❑ Temporary Construction Meter
❑ Turn on Charge
❑ Uncollected Account - Name
❑ Inspection Fee - Tract -
Fee -
❑ Plan Check Fees Water / Sewer -
Tract -
El Bond Payment - A.D. - Bond
❑ Customer Deposit
❑ Other
Remarks:
TOTAL
❑Copy to:
Cash WaterService_-7/--•!�.�
Check.
Mone
Y'. ''•� Cashier
Order + ,} 6VWD-438 (11189)
of
trig
TiN d 14a Ouiuta
jljuitbtn� anb �Safet� 34t*t1t*'!5t*jjn
This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building
Code certifying that of 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 53-365 AVENIDA CARRANZA
Use Classification SINGLE FAMILY DWELLING Bldg. Permit No. 10349
Group R3 Type Construction VN Fire Zone Use Zone SR
Owner of Building KMC MARK KATZMAN, TR Address P 0 BOX 1813
City LA QUINTA, CA
Building Official
By. LONNIE DAY
Dote: APRIL 8, 1992
POST IN A CONSPICUOUS PLACE