10348 (SFD)Building
Address 53_375 Carranza
Owner ittlir P.P;)
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
No. 10348
ijf7 by .1aXk Kartzman TrusteeBUILDING:
TYPE CONST.
OCC. GRP.
Mailing
Address P. 0. Box 1813
A.P. Number 774--075-020`6
Legal Description
Project Description
Lot 8 Block 222
SFD
City
La Quinta
Zip
92253
Tel.
564-6530
Contractor
Jack Clark, Jr.
Address
F. 0. Box 1371
City
Zip
Tel.'
LaQuinta
92253
564-3511
State Lic.
City
& Classif. 506667
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 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 is1n full torte 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 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).
❑ 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.)
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
250.00
Plan Chk. Bal.
^r 7 f� h -
1 0
! 1 . 0 v
Const.
612.50
Mech.
62.00
Electrical
129.23
Plumbing
141. 00
'
❑ 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 I am exempt under Sec. B. 8 P.C. for this reason
S.M.I.
9. 40
Grading
20. 00
Driveway Enc.
20.00
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
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
3582.59 3332.59
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
REMARKS
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.)
1 certify that In the performance of thq work for which this permit is issued, I shall not
employ anyperson 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.
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
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.)
Side Street Setback from Center Line
Side Setback from Property Line
Lender's Name
FINAL DATE
INSPECTOR
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.
Issued by:
Validated by:
Date Permit
Signature of applicant Date
Mailing Address
Validation:
City, State, Zip
\
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES,
1ST FL. SQ. FT. ® $
UNITS
SLAB GRADE )
ROUGH PLUMB.
2ND FL. SO. FT.
HEATING (ROUGH)
YARD SPKLR SYSTEM
a
FOR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
`
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
~
CAR P. SQ. FT. ®
REINF. STEEL
DRAINAGE -PIPING
TEMP. POLE
WALL SQ. FT.
DRINKING FOUNTAIN.
WATER HEATER
SO FT ®
FINAL INSP.
URINAL
BOND BEAM
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
=$
NOTE: Not to be used as property tax valuation
FINAL INSP. A101192 L�
FLOOR DRAIN
FINAL INSP. CD
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FIRE ZONE ROOFING
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
SPARK ARRESTOR
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
FINISH GRADING
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1Vi c
SEWAGE DISPOSAL
CERT. OCC.
SQ.FT.GAR ® 3Ac
HOUSE SEWER
FENCE FINAL
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
ROUND 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. A101192 L�
FRAMING ! 31*
FINAL INSP. CD
ROOFING /42-2,b),
2 ( L
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. F REWALL
THING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSP ECTION`G� ��
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
ARROWN PRINTING. INbla SSW 7100 aaataa•ci
P.O. BOX 1504 APPLICATION ONLY
Building3 , S Av�kDA Co, iM- LA QUINTA, CALIFORNIA 92253
Address ..
Own r_
G IM >4Z1_ Yui' 2ev A Ta U&
� BUILDING: TYPE CONST. f OCC. -GRP.
Mailing '
Address V ' U B v -K f �f 3 A.P. Number —7 % C4. 01 -D L
City Zip Tel.
LA LJ(PYA (� V.L-C"3 $(cif _ (, Legal Description Z.t� B C -(L Z%z
Contractor Project Description
I Ar - 2
idress P. 6 g4X /37f
Glt(,y _ Llp
�_ CS � L N M
State Lic.
& Classif. S o (o b6
%
Arch., Engr.,
Designer
Address
c?ZZ. r3 --5,6 Y— 3 Sr f
City
Lic. #
el.
City I
Zip I
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I h�t.
1 am icon ed under 1 Ions of Chapter 9 (commencing with Section
700tin ss an P es ns Code, and my license Is in full arca d
eff L
DATE
OWNER -BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License Law for the following
as
reon: (Sec. 7031.5,Buslness and Professions Code: Any city or county whichrequires a
permit to construct, after, hVrove, demolish, or repair any structure, prior to its Issuance also
requires the applicant for such pemrft 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 (1500).
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. It, however, the building
or improvement is sold within one year of completion, the owner-bu0der will have the burden
. of proving that he did not build or Inprove for the purpose of sale.)
b 1, as owner of the property, am exclusively corifracting 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 contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec. a• & 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
Workefs 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.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed, B the permit Is for one hundred dollars (5100) 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'
Compe, ,aion
Laws pf California.
Oate_Li3IOwner /V) )CA W 19:7\
NOTIC O APPLICANT: It, eller making this Certftioate of Exemption you should oma
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
ZONE:
BY:
Minimum Setback
Distances:
Sq. Ft.
SlIe 16 30
New ❑ Add ❑
No. No. Dw.
Stories Units
Alter ❑ Repair ❑ Demolition ❑
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE
INSPECTOR
Issued by:
Estimated Valuation
Validated by:
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
271, AD
Const.
6
Mech.
2 —
Electrical
r 2 3
Plumbing
S.M.I.
Qr.
Grading
--
Driveway Enc.
---
nfrastructur
p
17 5- 3 3a... 9
TOTAL
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:
Validation:
CONSTRUCTION ESTIMATE
-GROUND PLUMBING
NO. ` ELECTRICAL FEES NO.
PLUMBING FEES
1ST FL. SO. FT. @ $
Iff
UNITS
.i
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ARD SPKLR SYSTEM
Y
FOUND. REINF.
2ND FL. SO. FT. @
METER L60P
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL) _
TEMP. POLE
MOBILEHOME SVC.
GROUT
BAR SINK
SERVICE
POR. S0. FT. @
BOND BEAM
WATER SYSTEM
1
"GRADING -
- Z.cu. yd.
S Plus x$
-
_ �__ -, • _
=S
LUMBER GR.
POWER OUTLET
-FINAL INSP.
ROOF DRAIN:,
FINAL INSP.
GAR. SO. FT. @
ROOFING
REMARKS:
VENTILATION
DRAINAGE PIPING
CAR P. SO. FT. @
FIREPLACE
WALL SO. FT. @
7A9,0-
DRINKING FOUNTAIN
GAR. FIREWALL
SO. FT. @
,
LATHING
URINAL
MESH
ESTIMATED CONSTRUCTION VALUATION - $
-
r
WATER PIPING
NOTE: Not to be used as property tax valuation
7<,
- !.
FLOOR DRAIN
MECHANICAL FEES
CERT. OCC.
WATER SOFTENER
.�
VENT SYSTEM FAN EVAP.000L HOOD
fq
SIGN
INSPECTOR'S SIGNATURESIINITIALS
WASHER(AUTO)(DISH)
APPLIANCE - ---- --• - DRYER - -
--- -
-"- `;
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY -TRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM - B.T.U.
,
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
= ,c POLE,TEMIPERM
LAVATORY
'
HEATING SYSTEM FORCED GRAVITY
—' AMPERES SERV ENT
SHOWER
BOILER B.T.U.
a I SO. FT. @ c
BATH TUB
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 11/. c
SEWAGE DISPOSAL
SO.FT.GAR @ Vdc
HOUSE SEWER
GAS PIPING
PERMIT FEE
.rLPL.
PERMIT FEE
r
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
H.FEEEE
CONST. FEE
ELEC . FEE
SMIFEE
PLUMB.FEE
6.� •�a
-
612 5v
1/-1'r
`�/ �o
Iyt, rV
t .
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 L60P
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL) _
TEMP. POLE
GROUT
"'WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
1
"GRADING -
- Z.cu. yd.
S Plus x$
-
_ �__ -, • _
=S
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
CALVIN C. KAMINSKAS
Asslslonl Commissioner
IM) 275.3000
OFFICE OF .
AGRICULTURAL COMMISSIONER
JAMES O. WALLACE, Commissioner
83-612 Avenue 45 Suite 7
Indio, CA 92201
'(619) 342-8291
DAN RILEY
Seder. Welghls & Measures
(7M) 275.3030 .
DATE CASE NO. P C - n c,iS // - 13 - 71A
DEVELOPER'S NAME :Irm c 2&,l� cl'_114
ADDRESS: 6r,
I'ELEPIIONE: (Gl 9) 56 Y — 6 S' 3 0
Z2J_
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
imnediately.
Thank you for protecting and preserving the Coachella Valley's pest -free environment.
Agricultural Conmiss' n is Office
cc: Indio and Riverside
4080 LEMON STREET, ROOM 19, RIVERSIDE, C/\LIFORNIA 92501 — FAX (714) 275-3012
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated (619) 347-8631
Date 12/10/91 Type of Permit I La Quinta
No. 11045 Permit #
Owner Name KMC EPP by Mark Katzman Log #
No. 53365 street Carranza
city La Quinta zip 922M Study Area 111
APN # Tract # Lot # Square Footage 116W
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:
This certifies that school facility fees imposed pursuant to Government Code 53080
in the amount of1.58 X 11.630 1 or $ 2,575.40 have been paid to D.3.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 Jack Clark Tele phone^ '"
Name on the check `
By James E. Lively
Assistant' Superintendent, Business Services
Fee collected /exempted by Vickie J. Durrett
Signature
Payment Receive&`
Check No. 87
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
WN
a'(�'II►''.
Tit�r of 14a (Guinta
1111t*tbton� anb �'dfjot�r 31t*llt*�stolln
b
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 53-375 Avenida Carrariza
I.
SINGLE FAMILY DWELLING10348
Use Classification Bldg. Permit No.
!
Group R3 Type Construction VN Fre Zone Use Zone SR
,I
Owner of Building KMC EPP BY MARK KARTZMAN Address P'. 0. BOX 1813
TRUSTEE
City LA QUINTA, CA 92253 LONNIE DAY
BY;
Q,��f.Date: AUGUST 10, 1992
71
Building Official
"Y4 POST IN A CON9PI000U9 PLACE
COACHELLA VALLEY WATER DISTRICT r
CASH RECEIPT DETAIL
Received From: - -�'` Date:
Address: ^' f✓l/ / �i fi .!-1/� -���Z��J� �G.�s�
TractAccount No. U Lot(s)r
'
Service Address —� l®� ��?1� l Z-�i�f --� G.A. Code
Meter(s)
❑ Service(s)
❑ Backflow(s)
❑ House Laterals)
❑ DetectorCheck(s)
❑ Meter Surcharge
Sanitation Capacity Charge
❑ W.S.B.F.C.
❑ Temporary Construction Meter
❑ Turn on Charge
❑ Uncollected Account - Name
❑ Inspection Fee -Tract -
Fee -
❑ Plan Check Fees Water 1 Sewer -
Tract -
❑ Bond Payment - A.D. - Bond
Assm't.
❑ Customer Deposit
❑ Other
TOTAL $
Remarks:
❑Copy to:
Cash 40
WaterService
d C � � �r:.. „�i.
Check 1
Money Cashier
Order CVWD-438 (11189)