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/
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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