13579 (AR)AdddPc9 80-575
T4ht Qa
P.O. BOX 1504
78.105 CALLE ESTADO
Hills LA QUINTA, CALIFORNIA 92253
vwlil Mr. & Firs. jack Forrest
lar' ma
La Quinta, CINJ J2253
Contractor
Cad. Tech Buil aro
52711 Ave. Velasco
-ity Zip
State Lic.City
& Classif. B 590090 Lic. # ���
Arch., Engr.;
Designer Paul S. Anderson, AIA
Adpr:. Box 277 Tel. 564-5038
Cit Zip State
Q11-inta, CA 92253 Lic. #C18, 792
I hereby.affitm that I am licensed under, proylsion :of Chapter 9 (commencing with Section
XXI) f Division 3 ofthe Business a@d Profession my license is in fljll force)and
IGNATURE!!'4 t. - r �" DATE
O W N EWBU ILDERFDECLARATION
I hereby affirm that I am exempt from the Contractor's License Law.for the following
reason: (Sec. 7031.5;Suslness and .Professions Code:. Any city or county which requires a
permit to construct, after, Improve, demolish, or repair any structure, prior to its Issuance also
requires the applicant for such permit to rile 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 penally of not more than live hundred dollars ($500).
❑ li 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,
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 contractor(s)licensed pursuant to the Contractor's License Law.)
O I 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 Compen on Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
qjCqWrs filed with the city. ❑ Certified copy is hereby furnished.
_ I
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed If the permit is for one hundred dollars ($100) valuation
01
less.)
I certify that in the performance of thg work for which this permit is Issued, I shall not
employ anyparson in any manner so as to become subject to the Workers' Compensation
Laws of California.
Date owner
NOTICE TO APPLICANT: ft, 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
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 thatA 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 fo 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, Zlp
No. 13579
LDING: TYPE CONST. OCC. GRP.
Number
Legal Description
Project Description Addition/Remodel
Sq. Ft. 130 No. No. Dw.
Size. Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation $9.620.00
�p9(7� a6s2vs 0V /n�
$
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
76.05
Const.
M.00
Mech.
21.00
Electrical
19.55
Plumbing
.00
S.M.I.
.96
Grading
Validated by:
Driveway Enc.
Infrastructure
Validation•
",V -'
TOTAL
2 3 4. 5 6
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 Pfoperty Line
FINAL DATE
L _L— ('INSPIECT OR
Issued by:
1
— w' Permit
l) I=� r' .f JI
Validated by:
i - '
Validation•
",V -'
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
1 '
_
YARD SPKLR SYSTEM
2ND FL SO. FT.
ROUGH PLUMB.
BONDING
MOBILEHQME SVC:
BAR SINK
POR. SQ. FT. ®
STORAGE TANK
GAR. SQ, FT, ®
POWER OUTLET _
ROOF DRAINS
DRAINAGE PIPING
CAR P. SQ. FT.
ROCK STORAGE
FOUND. REINF. �G- [
WALL SQ. FT. ®
-
DRINKING FOUNTAIN.
_
-
URINAL
SO. FT. ®
OTHER APPJEOUIP.
REINF. STEEL
ESTIMATED CONSTRUCTION "VALUATION E
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
'"'` SIGN
WASHER(DISH)
APPLIANCE DRYER
- -FINAL INSP. '
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED-
BOND BEAM
LAUNDRY TRAY
AIRHANDLING' 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
-
SQ. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.. . _ -
'SQ. FT. RESID ®1Yi c.SEWAGE
DISPOSAL
VENTILATION
'SO.FT.GAR ® 3/ic
HOUSE SEWER'
FIRE ZONE ROOFING
PERMIT FEEPERMIT
FEE
PERMITFEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE _ . EL_ ECT: FEESMI'F.EE%
GAR. FIREWALL
THING w'20`.�V
rUMB-7FEE
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 WIRINGDUCTWORK
ROCK STORAGE
FOUND. REINF. �G- [
GAS (ROUGH)
_ METER LOOP
_
HEATING (FINAW . ,
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE .
GROUT
WATER HEATER
SERVICE
- -FINAL INSP. '
BOND BEAM
WATER SYSTEM
$
GRADING '
cu. yd.
-' plus
LUMBER GR.
HAL INSP j- e7 - C- -
AMING / 'lJ ' L G.
s
-FINAL INSP.
ROOFING
-
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
THING w'20`.�V
MESH
INSULATIONISOUND
FINISH GRADING
INAL INSPECTION G
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
TM
PGA WEST
RESIDENTIAL ASSOCIATION, INC.
September 11,,1997
Mr. and Mrs. Forrest
80-575 Cherry Hills
La Quinta, Ca. 92253
Dear Mr. and Mrs. Forrest:
Your request for an architectural variance has been approved by Mr. Don Adolph, Architectural
Committee Chairperson. Specifically, you have the approval to proceed with the addition of 335
square feet to the rear of your unit and to extend the patio of your 80-575 Cherry Hills residence.
We reserve the right to make a final inspection of this change to make sure that it matches the
original request. An approval is based only on the aesthetics of your proposed plan and should not
be taken as any certification as to the construction worthiness or structural integrity of the proposed
change.
We appreciate your cooperation in submitting this request for approval. If I may be of further
assistance, please contact me at the HOA office, (760) 771-1234.
Sincerely,
KelfyvcG(alliard
Operations Manager
cc: Architectural Committee
P.O. Box 1060, La Quinta, California 92253, Telephone 760-771-1234 FAX 760-771-5125
Desert Sands Unified School District
Notice: 82-879 Highway 111
Document Cannot Be Duplicated Indio, CA 92201
619-775-3500
CERTIFICATE OF COMPLIANCE
Date 9/8/97
No. 16051
Owner NameJohn R. Forrest
No. -80-575
City La Quinta
street Cherry Hills Dr.
APN # 769-362-001.
Jurisdiction La Quinta
Permit #
Log #
Zip 92253 Study Area
Tract.# Lot # Square Footage 335
Type of Development Residential. Addition No. of Units 1
Comments
oom addition - patio
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:
Residential Addition 500 Sq Feet or Less
EXEMPT
This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of
0.00 X 335 or $ 0.00 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
r•
Fees Paid By N/A Telephone
Name on the check
By Dr. Doris Wilson
Superintendent ;
. err -- _ •,:
Fee collected /exempted by Ellen Patino Exempt
Check No. N/A.
Signature
NOTICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify,you that the 906 -day approval period in which you may protest the fees or other payment identified
above will begtn,to run from the date on,which;the building or installation permit for,this project is assued or on which they are paid tdthe Districts) or to another public entity auUwrized to
collect them on the, Districtfs)(s) behaR, whichever is earlier.
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