10568 (BLCK)Building
Address 53-430 Carranza
Owner
David ROSS Miller
lityl 4
P.O. BOX 1504 ,� iC f N o .
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253-
Mailing
Address P. 3. Bor. 722
City Zip Tel.
La Ouintta 92253
Contractor
Pacific Trades
Address
State Lic.
& Classif. 425381
Arch., Engr.,
Designer
Address
Lic.# 1955
Tel.
CityI Zip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I~Ifereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
�e7#0f00)`of Division\3 of the Business and Professions Code, and my/license is in full force and
t acct. L
GNATURE '.-y✓' - 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, 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,
I provided that such Improve are not Intended or offered for sale. If, however, the building
or improvement is sold within+bne 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 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.)
O 1 am exempt under Sec. B. 8 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.)
PolicyPo. Company
O!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: 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 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
10568
BUILDING: TYPE CONST. OCC. GRP.
A.P. Number
Legal Description
Project Description
Fool only & 854 of 5' Mock wall
Sq. Ft. No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Pxnl — AA `Gott
Wall — $1,840
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
76.05
Const.
117.00
Mech.
21.00
Electrical
30.00
Plumbing
27.00
S.M.I.
1.00
Grading
Driveway Enc.
Infrastructure
TOTAL
272.05
REMARKS
I _+ t tt. 17 1 v i Iit_ t + f
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. SO. FT. ® $
UNITS
2ND FL. S0. FT.
COLL. AREA
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT.
FORMS S
DRAINAGE PIPING
WALL SQ. FT.
ROUGH WIRING.
DRINKING FOUNTAIN.
SQ FT ®
ROCK STORAGE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GAS (ROUGH)
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
REINF. STEEL
WATER SOFTENER
VENT SYSTEM FAN EVAP.0001- HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
SERVICE
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
FINAL INSP.
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
J�
I
SQ.FT.GAR ® 3Vac
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 PLUMBIN
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS S
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
J�
I
4�
/
�` t -
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
T4tyl
"
78-105 CALLE ESTADO — LA QUINTA, CALIFORNIA 92253 - (619) 564-2246
FAX (619) 564-5617
May 28, 1993
Pacific Trades
P.O. Box 722
La Quinta, CA 92253
Dear Mr. Miller:
It has come to the attention of the City of La Quinta Department of
Building and Safety that your building permit number 10568 at 53-
430 Carranza has expired.
According to the Uniform Building Code, Section 303(d), no further
work shall be performed on the above permitted job -site until a new
permit has been issued or an extension granted. An extension of
this permit can be requested in writing within 14 days of the date
of this letter.
If a final inspection has not been requested due to an oversight by
either yourself or your contractor, please schedule that final
inspection within 14 days to resolve this matter. Failure to do so
will result in further action by the City.
Please contact me at your earliest convenience. We appreciate your
immediate attention to this matter.
Sincerely,
BUILDING AND SAFETY DEPARTMENT
Lonnie' `'lay
Building Inspecto
kt
Attachment
MAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253