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13416 (AR)Building Address Owner Mailing Address City Contractor Address. City State Lic. & Classif. Arch:, Engr., Designer 46815 Highla •4 T awaav P.O. BOX 1504 N O . J.131410 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 BUILDING: TYPE CONST. OCC: GRP. 46816 Highland Pala A.P. Number Zip Tel. L.Q. .9-2253 Legal Description Project Description Boot Addition 4 Owner Builder Zip City Lic. # Sq. Ft. Size Q New ❑ No. sQ. f a: o Stories Add EX Alter ❑ Repair ❑ No. Dw. Units Demolition ❑ 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 70 OO) of Division 3 of the Business and Professions Code, and my license is in full force and effect. _SIGNATURE DATE `z�`. OWNER -BUILDER DECLARATION Estimated Valuation I hereby affirm that I am exempt from the Contractor's License Law for the following reason: 7031.5,Susiness Professions Code: Any 125. 522. Ufa (Sec. and 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 PERMIT AMOUNT ' the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) or Division 3 of the Business and Professions Code, or that, he is exempt therefrom, and the basis for the alleged Any Section 7031.5 'any Plan Chk. Dep. ' exemption. violation of by applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ❑ I, the Plan Chk. Bal. 168.0 3 as owner of 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 The Contractor's Const. '��Q ~ Code: License Law does not apply to an owner of property who builds or improves thereon does himself through his . - and who such work or own employees,' provided that* such improvements are not intended or offered for sale. If, however, the building Mech. 27. 00 .. or improvement is sold within one year of completion, the owner -builder will have the burden Electrical 7�[� f 3 6 0 2. 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- Plumbing . strucl 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 .S.M.I. ' . ' 2. 56 such projects with a contractor(s) licensed pursuant to the Contractor's License Law:) - . Grading ❑ 1 am exempt under Sec. B. & P:C. for this reason Driveway Enc. Date Owner Infrastructure 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 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 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 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 TOTAL REMARKS% ` ZONE: BY: ' ~ Minimum Setback Distances:; _ r; .' 0 r w Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback, 66MIGe ter Line Side Setback from Pr pe rt ''n FINAL DATE IKI ECTORR Issued by: Date" jA AP`T qrp it ' g , 4 / Validated by: V Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS SLAB GRADE AV r r% C,` - BONDING YARD SPKLR SYSTEM 2ND FL. SQ. FT. FORMS SEWER OR SEPTIC TANK POR. SQ. FT. @MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS HEATING (FINAL) OTHER APPJEQUIP. DRAINAGE PIPING CAR P. _ SO. FT. @ GAS (FINAL) . TEMP. POLE WALL _ _ SQ. FT. DRINKING FOUNTAIN. SQ. FT. ® - - _ - - URINAL ESTIMATED CONSTRUCTION VALUATION' $ BOND BEAM 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(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED REMARKS: 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 SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1+/4 c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ec HOUSE SEWER 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 AV 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 / l—Z�qy[� FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH ' INSULATIONISOUND-(��(�C FINISH GRADING FINAL INSPECTION v CERT. OCC. FENCE'FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL a 4� 4jqtt �Q . rl DESERT SANDS UNIFIED SCHOOL DISTRICT 82-879 Highway 111 NOTICE: Indio, CA 92201 Document Cannot Be Duplicated 619-775-3500 Date 4/20/94 1 Type of Permit I La Quinta No. 112779 Permit # Log Owner Name Bill & Melinda Burkett No. 46815 Street Highland Palm City La Quinta Zip 92253 Study Area 109 APN # I Tract # I J Lot # 0 Square Footage 1488 Type of Development I Residential Addition I No. of units 0 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: Residential Addition 500 Sq Feet or Less This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of 0.00 x 488 or $ 0.00 have been paid to D.S.U.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 n/a Telephone Name on the check By Dolores A. Ballesteros Superintendent Fee collected /exempted by Vickie J. Durretts-- Signature Check No. n/a 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 Certificate of Compliance: Residential (Page 1 of 2) CF -1'R Date Project Title ;J Building Permit 0 Project Address �— Plan Check /Date Telephone Documentation Author _ _ Field Check / Date compliance Method (Package, Point System orcomputer) Climate mono _ - -- - - GENERAL INFORMATION Total Conditioned Floor Area: Building Type: (check one or more) Front Orientation: Number of Dwelling Units - Floor Construction Type: _q -L3 o n2 Single Family ✓ Addition Mufti -Family Existing -Plus -Addition North / East / South / West / All Orientations (Input orientation in degrees and circle one.) Slab / Aaised Floor (circle one or both) BUILDING SHELL INSULATION Construction Component Insulation Assembly Location/Comments Type R Value U Value (attic to garage, typical, etc.) 2 Wall .............. Roof ............. Roof ............. Floor ............. Floor ............. Slab Edge .... FENESTRATION Fenestration Area Fenestration Orientation (sf) U -Value Front..... Front..... Left....... (5) 01-115 Left ....... Rear..... Rear..... ( ) 7c Right..... (n)_ r, ; 5 Right..... ( ) Skylight ....... Skylight ....... THERMAL MASS Shading Devices Exterior r('t i IP, Overhang es/no Type/Covering Area Thickness (slab/exposed, tile, etc.) (sf) (inches Location/Description kitchen, bath, etc. ago Revised January 1992 Framing Certificate of .Compliance: - Residential (Page 2- of 2) CF -1 R. Project Title Date i unn�nq ofuen tv rnGoripora-�e exrst� ^� �AS k�-�► bc�t nof- u -sig HVAC SYSTEMS fo G co ala ��l/ �1 , p J Note: Input hydronic or combined h dronic C l'Ulr e y data under titer He stems, except Design a n Heating Equipment Type (furnace, heat Minimum Efficiency Distribution Type and Locatinn Duct or Cooling Equipment Minimum Duct Type (air conditioner, Efficiency Location Duct Thermostat Configuration heat pump, evap. Cooling) (SEER) (attic, etc.) R -Value Type (split or package) WATER HEATING SYSTEMS . Water Heater Distribution Rated' Tank Number Input (kW Capa in System or SM/hrm mall., Energy' Factor or Recovery External Tank Insulation 1. For small gas storage (rated input 5 75,000 Btu/hr), electric resistance and heat pump water haters, list Energy Factor. For large gas storage water hatem (rated input 2 75,000 Btu/hr), list Rated Input, Recovery Efficiency and Standby Loss. For Instantaneous gas water haters, fist Rated Input and Recovery Efficiency. SPECIAL FEATURES/REMARKS (Add extra sheets if necessary) COMPLIANCE STATEMENT This certificate of compliance lists time building features and performance specifications needed to comply with Title 24, Parts 1 and 6, of the California Code of Regulations, and the administrative regulations to implement them. This certificate has been signed by the individual with overall design responsibility. When this certificate of compliance is submitted for a single building plan to be built in multiple orientations, any shading feature that is varied is indicated in the Special Features/Remarks section. Designer or Owner (per susiness & Professions Code) Name: Tide/Firm: Address: _ n ls?'3 Telephone: c;6„4q - n q a Lic. 8: (signature) (date) Enforcement Agency Name: Tide: Agency: Telephone: (signature/stamp) (date) Revised January 1992 Documentation Author Name: lida/Fim,: Address: Telephone: (signature) (data) y6 2 (s PC>, IL4-1 AA04-6 14 �; i I LLJ a 4� COO W O _ © LLIU i m 3 ul U- ®® Q O o U-) w J . 06Z ch LU 9 NOTICE: THIS IS NOT A BUILDING PERMIT APPLICATION TO CONSTRUCT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE 15 DISTRICT Permit No 284 199A 9/74 CANARY—FILE, -PINK—^PPLICANT do it /, Owner Architect — —_ Contractor__—._ .._ a f'� m Address / �frrL!�� �1•��1 Addres Address___ —_— -- � City �-s• — City City Phone �— Phone _ Phone----------.— hone— _---__—.—cc cc W I (we) the undersigned, hereby certify and acknowledge that I (we) have read the application and agree that if Curb and Gutter, ar-J Z Paving, and/or Dedication of right of way is required by the County of Riverside, the Riverside County Department of Building and Safety 3 shall not make a Final Inspection until said requirements have been met. I am also aware that no work is to be done within the County R/W O without an encroachment permit. NOW, therefore, it is agreed that I (we) will not occupy said property and will not cause said property to be occupied until I (we) ha%e complied with all laws of the County of Riverside and the State of California governing said property. DATE , �� __ SIGNATURE OF OWNER AND/OR AGENT e ' Approval by Signature from the Following Departments Listed Below Must Be Obtained Prior to the Issuing of a Construction Permit. -2- ��j I SPACE NO. 1 USE OF STRUCTURE JOB ADDRESS y } /�/j�y� ° SIA6 IiAMILY ❑ DUPLEX ❑ 'z _ / '01 O Z F W LEGAL DESCRIPTION O� TY _ - APARTMENTS ❑ AGRIC. (- Q — COMMERCIAL ❑ INDUSTRIAL '^ COMMUNITY ''� ALTERATIONS CC Z NO. OF SUBMITTED PLANS — USE OF PERMIT _ 4 CASE NO. __ —_ p Z NO. OF PA ING SPACES REQUIRED — NO. OF BUILDINGS NOW EXISTING - Q ZONE SETBACfKS: FRONT SIDE REAR _ J m GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE __ 1 61 3 3 3 SETBACK ORDINANCE # — OF FEET REQUIRED ON STREET DATE_�/ =�Q SIGNATURE OF LAND USE OFFICIAL - DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET -- — z CURB AND GUTTER REQUIRED: YES ❑ NO ❑ —STREET l- ac a CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑ W HAS AN ACCEPTABLE, APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET D o• IMPROVEMENT? YES ❑ NO C-1 cd DATE SIGNATURE OF ROAD DEPT. OFFICIAL I SWIMMING POOLS PUBLIC QW SEWAGE DISPOSAL _ FOOD ESTABLISHMENT WATER POLLUTION REMARKS FLOOD CONTROL— F z AIR POLLUTION DIV OF HWY -0 cc o a — YOUR PROPERTY MAY BE SUBJECT a o FLOOD. RIVERSIDE COUNTY ASSUMES NO RESPONSIBILITY IN EVENT OF FLOOD. 284 199A 9/74 CANARY—FILE, -PINK—^PPLICANT Address DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE _.n — __(17- Address 17. OWNER -BUILDER VERIFICATION /4-, / /" "0."-.4 'a An "owner-builder"building permit has been applied for in your name and bearing you.r,; s gnature�.. 1 , ` , ;q .. ,; L:. 1 .., , +v�C (, � ci t} %t;1 ;''1 •1� ... il_1�'j,: , ' l [: �••1.! .. J? ;3.. � .•, iv '_ ' ).r }♦1! %i,. .. ,' ,3: :'c:j; I Please complete and return'thfs information. in th"e envelope provided at your r';qt-, ear.l'.iest.,opportunity oto, avoid unnecessary, delay -in processing and issuing your I.;z,-building permit: •No building permit will .be issued -,until ,,this.verificationgis received. 1. I personally plan to provide the major laboraandmateria•1s'for,con-'�'''.. struction of the proposed property improvement- (yes �oi% no)- .Xo .5 ' 2. I (have/have not) signed an application for building permit for the proposed work. 3. I have contracted with the following person (firm)'to provide the pro- posed construction: Name Address I Contractors License No. Phone c ity,�, 4. I plan to provide portions of the work, but''I h'ave"hir'ed'th'e'fol'lowfng' person to coordinate, supervise, and provide the major work: T .(..••: 1. �- Name Phone Address .City; (», ,�; , •,? _ ' Contractors License No. %t. 5. I will provide some of the work but I have contra cted�(hired) the,fol- ? C11c lowing persons to provide the work indicated: -" -I =4-�;.--' °r' 1 L,% Name `� Phoner, I.-4 1"' Type of work Address{ ^ n /'7 1 �` -47 r (r .. l i. ;C.. 3V. (.�,. (. la �i i �t:.i1 �'c�i.L.; � -':i 1 � ;'r4 L:�te'• :'i � .. 1 ., ,1 C "•r .� r 1` -.000, + ,•.� r ~„� , it l.= 1• 91_r, r "��/ / <— / J� r• , �, .Fi rt •,F.; t,>GCa.4C;1 SignaturetProperty(Owner Date � :f1J• , ' •' 284-2002 7/80!;l r>;;:. ;tr; DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE OWNER -BUILDER INFORMATION Dear Property Owner:. An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements .specified. For your protection you should be aware that as owner -builder you are the responsible party of re- cord on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the pro- per permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and, where required, to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection. ' If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. If you are an employer; you.must register with the state and federal government as an employer and you are subject to several obligations including state and federal,income tax withholding, federal social security taxes, workers' compensation insurance, disability insurance costs, and unemploy- ment compensation.contributions. There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if'you wish, the U.S. Small Business Administration). .For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents.. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "owner - builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits a:re not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your community or at 1020 N Street, Sacramento, California 95814.. Please complete and return the enclosed owner -builder verification"form so that we can confirm that you are,aware of these matters. The building permit will not be issued until the verification is returned. . Sincerely, DEPARTMENT OF BUILDING AND SAFETY Leopoldo Rojo, Jr. Director 284-2001 7/80