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003073 (BLCK)4 P.O. BOX 1504 No. 003073 Building 78-105 CALLE ESTADO Address 54-525 Avenida Carrail'za LA QUINTA, CALIFORNIA 92253 Owner Coachella Valley Land Co.,p TAU BUILDING: TYPE CONST. . OCC. GRP. Mailing Address 732 Williams Poid A.P. Number 774-274-013-1 4-{ 13-x. City I Zip ITel. Palm S=rinasl 52262 1 322-1020 Legal Description Contractor Project Description PlAn A* Starr Construction Address S [Zip 92262 Tel. 322-102e State Lic. City & Classif. A-387934 Lic. # 751 Arch., Engr:, Designer 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 is in full force and effect. SIGNATURE' DATE I ' 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.) ❑ 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.) ❑ 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.) Policy No. Company 4Cbpy 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 =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 or 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 HARD COPY Cs Sq. Ft. 1463 DWNo. Size 475 GAR Stories New IN Add ❑ Alter ❑ PP 150' stimated Valuation PERMIT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS No. Dw. Repair ❑ Demolition ❑ AMOUNT S�n�t R4 4ozi—nn r 33.nn 7R -A7 Q4„nn S_29 anTnn 1113.#S 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 A x/271ATPermit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ UNITS COLL. AREA SLAB GRADE ROUGH PLUMB. YARD SPKLR SYSTEM 2ND FL. SQ. FT. ® HEATING (ROUGH) STORAGE TANK FORMS MOBILEHOME SVC. BAR SINK POR. SO. FT. ® DUCT WORK ROCK STORAGE GAR. SO. FT. ® POWER OUTLET ROOF DRAINS HEATING (FINAL) DRAINAGE PIPING CAR P. SO. FT. ® GAS (FINAL) TEMP. POLE WALL SQ. FT. DRINKING FOUNTAIN SQ FT ® WATER HEATER URINAL ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP. WATER PIPING NOTE: Not to be used as property tax valuation WATER SYSTEM FLOOR DRAIN MECHANICAL FEES GRADING cu. yd. ' $ plus x$ WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED �/ %J/ �� p�• (}A 7 r U V p .-r Z Y-�� _ _,2 LAUNDRY TRAY 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 SPARK ARRESTOR SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/e c SEWAGE DISPOSAL LATHING v- � .- SQ.FT.GAR ® 3/ac HOUSE SEWER GAS PIPING PERMIT FEE *ESHTION/SOUND 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 6 AIR COND. SOLAR SETBACKff4!�65ROUIND 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. V 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. n FINAL INSP. / N 7� FRAMING (� - C FINAL INSP. -7171 PLOOOFING �� D �/ %J/ �� p�• (}A 7 r U V p .-r Z Y-�� _ _,2 D REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING v- � .- *ESHTION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS. GARDEN WALL FINAL 4 P.O. BOX 1504 Building t� S G��Q 7&105 CALLE CALIFORNIAESTAD9 Address J LA QUINTA, ORNIA 92253 Owner C / / / ofiG• flcL �/-� l/i4GLc f G-�N6 eO Z -7p Mailing n Address %Z b0iCL-4 /_V S reoA n Cjty Zip Tel. S,ol2l,�rc�s 5;�ZZ62 32z -4o zo Contractor _5771'9-r--'12- Address 57'1'9 -r--' 12- CO Address 732 (•vrc_c_ts>t.�s .�.4d AWG ltilGS F` 1774 Z I . _.. 2Z— /O Zb State Lic. & Classif. I Arch., Engr., Designer Address Tel. � -X5793¢ APPLICATION ONLY BUILDING: TYPE CONST. OCC. GRP. A.P. Number. 1�.4.2G6L D 7`%¢-Z74w®/3—% Legal Description !jt-c>GC. 3Og> �AL tr' Z8 Project Description �, � " City / I I¢63 410. Lic. #J Sq. Ft. No. Size 47,5C 7,a Stories City v I Zip V I State ` I Lic. # LICENSED CONTRACTOR'S DECLARATION I hereb ffirm that 1t��� apter 9 (commencing with Section 7000 ivlsion 3 of and my license is i full orce and eff S G DATE OWN ER. BUILDEF( 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, atter, 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 (5500). 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, Bulsness and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or anproves 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 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 -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. 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., !j, 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 FINANCE Tf. 66 PERMIT f AMOUNT Plan Chk. Dep. Plan Chk. Bal. m , Const. pO Mech. 00 Electrical Plumbing S.M.I. _6-,92 Grading .o Driveway Enc. .26 , Infrastructure TOTAL a2 No. Dw. Units Newer Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation,,#, 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 Propert p j REMARKS y Line FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: Desert Sands Unified School District CERTIFICATION OF PAYMENT OF SCHOOL FACILITY FEES CD 11ixp ` ' TO: City of La Quinta DATE: �y Department of Community Development 78-105 Calle Estado La Quinta, CA 92253 This is to certify that " z�•� , developer of which is located at C j within this Distri , has paid school facility fees imposed pursuant to the authority generated by Government Code Section 53080 in t e amount of covering a total of 39 square feet of irKlsidential or ( ) industrial/commercial development and that building permits for this footage in this development may now be issued by your jurisdiction. Q�Q-�— /// :�/ - v� C rz cue• `-y�'wt ei for DESERT SANDS•UNI•IED SCHOOL DISTRICT /W1hititje - Building Department ® Yellow - Facilities Planning • Pink - Accounting • Gold - Developer e, r / 3 7e7 (10)-37