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07624 (RPL)BuiIdirj Address Owner Mailing Address City %4 Contractor #7-200 tArteaga i+ a Zip P.O. BOX 1504 78-105 CALLE ESTADO LA,QUIIVTA, CALIFORNIA 92253 Address BY: AtL es M City Zip Estimated Valuation $1S 1 c Z/�/�� PERMIT 92201State Plan Chk. Dep. Lic. $105.30 Fel.yudio & Classif. 476807 Mech. # Arch., Engr., 27.00 Designer 24-00 Address - 1.0§ Tel. CityZip State Lic. # LICENSED [l E.DCONTRACRyS DECLARATION I herebv affirm-thaHwam`l censl_eO uner_nrewsionc of rhnnt0r Auanmmanrinn.WHh X-1. n 1- hereby affirmmthat I am exempt fpdm—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 or 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 rive hundred dollars (5500). i ❑ 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 I 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 i Date - Owner WORKERS' COMPENSATION DECLARATION Ihereby 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 it 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 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. 07624 BUILDING: TYPE CONST. OCC: GRP. A.P. Number SWMA 7t nA Borrie Legal Description Project Description ' - ~ . Pk�n►4 7GA -t - Sq. Ft. No. No. Dw. Size - - -Stories - Units New ❑ Add ❑ After ❑ Repair ❑ Demolition ❑ REMARKS to kV' .YYhY7Y �W i�fi t z. ar.. ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Estimated Valuation $1S 1 c Z/�/�� PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. $105.30 Const. 162.00 Mech. 30.00 Electrical 27.00 Plumbing 24-00 S.M.I. 1.0§ Grading Driveway Enc. Infrastructure TOTAL REMARKS to kV' .YYhY7Y �W i�fi t z. ar.. ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setbw-k from Property Line FINAL DATE INSPECTOR 4119/90 Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS COLL. AREA 2ND FL. SQ. FT. ROUGH PLUMB. YARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK r GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. I SQ. FT. DUCT WORK DRAINAGE PIPING WALL SQ. FT. ® GAS (ROUGH) DRINKING FOUNTAIN SQ FT ® HEATING (FINAL) URINAL ESTIMATED CONSTRUCTION VALUATION $ GAS (FINAL) WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER HEATER WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER WATER SYSTEM GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED GRADING cu. yd. plus x$ LAUNDRY TRAY AIR HANDLING UNIT CFM KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE, TEM/PERM 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 ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR @ 3/4c HOUSE SEWER SPARK ARRESTOR 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 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. l 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 NOTICE: THIS,;�0.'��a�dEi�lt�CVIL1�tll�Vi10E OF PAYMENT BE DUPLICATED, SCHOOL FACILITY FEES TO: City of La Quinta Department of Community Development I 78-105 Calle Estado La Quinta, CA 92253 DATE: This is rtitfy tha to developer c , wh'ch is located at v �,�v 'thin this District, has paid school facility fees imp sed pursuant to the authority generate by over nt Code a oft 53 80 in thyy amQytn o. $ �y�s fJU ) covering a total of square feet f ( residential or ( ) industrial/commercial development and that building permits for this footage in this development may now be issued by your jurisdiction. I. - for DESERT SANDS U IF,eD5 SCHOOL CT White - Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer (10)-37