09350 (BLCK)Building
Address 54—
Owner
M/7-1/ Rnci
Mailing
Address
City
Contractor
CSrA i n r
Address
TWIVI u
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Zip I Tela
* 1R R*i -ito Alb
State Lic. City
& Classif. S -419634 Lic. #
Arch., Engr.,
Designer
Address I Tel
CityI Zip I State I
Lic. #
I herebyaf�jrrtitthat I am licefis)d unde prr ovls'�ons of C abler 9 (co�rnmencing with section
DO�t f ivision 3o f the Business ani Prof sons Cod�(and MVicense is in full force and
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).
❑ 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
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 am 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-irisure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
Opy is filed with the city. O Certified copy is hereby furnished.
�Z"� CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed it 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 or 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
No.
BUILDING: TYPE CONST. OCC: GRP..
P. Number
Legal Description
09350
Project Description
,ra I
%?N%t o 4 rt # ng
Tara 1 1
Sq. Ft.
Size
No.
Stories
No. Dw.
Units
New ❑ Add ❑
Alter ❑
Repair ❑ Demolition ❑
Estimated Valuation
i 5
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
i k
Grading
Driveway Enc.
Infrastructure
L1t�.A3tii�,:f
��a :l.f �'r "r7.1•F'�
TOTAL
ASJA
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
Validated by:
Validation:
T
Permit
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. S0. FT. ® $
UNITS
COLL. AREA
2ND FL. SO. FT.
ROUGH PLUMB.
YARD SPKLR SYSTEM
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
SEWER OR SEPTIC TANK
ROUGH WIRING
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
FOUND. REINF.
GAS (ROUGH)
DRAINAGE PIPING
CARP. SO. FT. ®
HEATING (FINAL)
OTHER APPJEOUIP.
WALL SO. FT.
GAS (FINAL)
DRINKING FOUNTAIN.
SO. FT. ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER HEATER
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE' DRYER
GARBAGE DISPOSAL
FURNACE UNIT, WALL FLOOR SUSPENDED
FINAL INSP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
�A� .}— ,Q'— ® `-
4�
` .1
/44ft
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.
SO. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
GAR. FIREWALL
SO.FT.GAR ® 3hc
HOUSE SEWER
LATHING
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 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 APPJEOUIP.
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
�A� .}— ,Q'— ® `-
4�
` .1
/44ft
��
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACEKfV
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
•4 �W
P.O. BOX 1504 APPLICATION ONLY
Building �/ 78-105 CALLE ESTADO
Address S ! - 380 'A1Jewl0;1\ 0144A LA QUINTA, CALIFORNIA 92253
Owner
Qo 7-;i Sc4-O BUILDING: TYPE CONST. OCC. GRP.
Mailing
Address A.P. Number / �f
City Zi
Legal Description ��()
Contractor Project Description
Address
City Zip Tel
p�lf�2Z..6
State
State Lic. City
& Classif.'j?_( 31 �6 j �� Lic. # Sq. Ft. 2 No. No. Dw.
Size Stories Units
Arch., Engr.,
DesignertZ4: New ❑ Add ❑ Alter ❑ Repair.❑ Demolition ❑
Address Tel. `
City Zip State
Lic. #
LICENSED CONTRAC R'S D CLARA�TION
I herebyaffirm t am licensed un$1 pr rasions Chapter 9 (commencing with Section
7000) of Division, of the Busin ss d rofe'ssions ode and my license is in full force and
effect.
c,.,u.r„o Hero
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, Bussness 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.)
❑ 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 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. & 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.)
Polic�y o� Companyrn i Pu r.
t3 Copy is filed with the city. ❑ 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 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.
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 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
BUILDING DIVISION
stimated Valuation
/5 2 360. /O
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
/
Const.
, t71D
Mech.
Electrical
2, . Q
Plumbing
t5S , dV
S.M.I.
O
Grading
�—
Driveway Enc.
'F-qfrastructur
jp .
�...�”
99- 7
TOTAL
REMARKS
t
00518Z iv14 14 trtt— �
,c n r VIAA TTiThf 00
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
IST FL. SQ. FT. ® $
2
UNITS
BONDING
HEATING (ROUGH)
STORAGE TANK
2ND FL. SO. FT.
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
YARD SPKLR SYSTEM
FOUND. REINF.
-2— O
Q
MOBILEHOME SVC.
OTHER APP.IEQUIP.
BAR SINK
GAS (FINAL)
POR. SO. FT. ®
GROUT
WATER HEATER
SERVICE
GAR. % SQ. FT. ® 1 37h
1 bol
IPOWER OUTLET
WATER SYSTEM
ROOF DRAINS
GRADING
cu. yd.
$ plus x$
CAR P. SO. FT.
LUMBER GR.
FINAL INSP.
DRAINAGE PIPING
FINAL INSP.
WAIL SO. Ff. ® 1700
—
DRINKING FOUNTAIN
REMARKS:
SO. FT. ®
VENTILATION
URINAL
ESTIMATED CONSTRUCTION VALUATION $ 15"g,
36 0 ID
FIREPLACE
WATER PIPING
-�
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
GAR. FIREWALL
MECHANICAL FEES
LATHING
WATER SOFTENER
MESH
VENT SYSTEM FAN EVAP.COOL HOOD
2=6
SIGN
WASHER(AUTO)(DISH)
-9
APPLIANCE DRYER
FINISH GRADING
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
272, `
CERT. OCC.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
INSPECTOR'S SIGNATURESIINITIALS
KITCHEN SINK
'^
ABSORPTION SYSTEM. B.T.U.
GARDEN WALL FINAL
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
33—
POLE, TEMIPERM
—
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
1_5D
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
—�
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE
PL.CK.FEE _
CONST. FEE
SMI FEE
PLUMB. FEE
y�6 . oo
�y
?.2-54-0
JELEdT.FEE
17,2- 09
13 --�?o
107, OD
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.IEQUIP.
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
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated (619) 347-8631
Date 1/10/92
No. 111108
Owner Name
Type of Permit
Rod Seto/Craig Conklin Co.
No. 54380 street Avenida Carranza
city La Quinta zip 92253
La Quinta
Permit #
Log #
Study Area 111
APN # Tract # Lot # ® Square Footage 12587
Type of Development I 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 1.58 X 587 or $ 4,087.46 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 Rodney/El_ydia Seto Telephone
Name on the check
By James E. Lively
Assistant Superintendent, Business Services
Fee collected /exempted by Shelley D. Bennett
Signature D
- &'��J�
Payment Received
.F. Check : No,. 585
Collector: Attach a copy of county or city plan check application form to district capylor all tiaivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
CALVIN C. KAMINSKAS
Assistant Commissioner
(714) 275.3000
OFFICE OF
AGRICULTURAL COMMISSIONER
JAMES O. WALLACE, Commissioner
83-612 Avenue 45 Suite 7
Indio, CA 92201
(619) 342-8291
DAN RILEY
Sealer, Weights & Measures
(714) 275-3030 .
DATE l5� t (� �[ I CASE NO. P(
DEVELOPER'S NAME: �r pr Q Co Z •� "i
ADDRESS : '-? (2- O` :A� I � \ ` '1iz- q
ZZ
TELEPHONE-
143
ELEPHONE: (t¢ ) 3 O
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:
Agtbkultural Commissioner's Office
cc: Indio and Riverside
4080 LEMON STREET, ROOM 19, RIVERSIDE, CALIFORNIA 92501 - FAX (714) 275-3012