11553 (RC)44
P.O. BOX 1504 No. 11553
Addrress 78-437 HWY 111 LAQUINTA CALFORNIA92253
Owner PLATT ORTHOPEDICS
TaLTEe—ime =BUILDING: TYPE CONST. OCC: GRP.
Address SAME
City Zip
LA QCINTA 92253
Contractor
TOLTEC INC
Address
52-447 HARRISOW
c41 Zip
COACHELLA 92236
State Lic.
& Classif. 320.979
Arch., Engr.,
Designer
Address
.P. Number
564-1220 Legal Description
Project Description 2 PARTICYON WALLS
OF$ICE IMPEROVEMENT
398-1404
City 7S a
Lic. # 82@
Tel.
J
City Zip State
I Lic. #
„LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I em 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. 1- '�;,.- F 7 1 .•, .i
Sq. Ft. No.
Size Stories
No. Dw.
Units
New ❑ Add ❑ Alter ❑ • Repair O Demolition ❑
i "`nt._._.. '� I t' `! 1. J•�'�".
.SIGNATURE 31 4r r ...� I 1 - DATE
OWNER -BUILDER DECLARATION Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following @ �' 000
reason: (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Y
permit to construct, alter, improve, demolish, or repair any structure,' prior to its: issuance also
requires the applicant for such permit to filea 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
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.) -
PERMIT
Plan Chk. Dep.
Plan Chk. 'Bal.
Const.
Mech.
Electrical
Plumbing
O 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
S•M•1• .
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.)
❑Jam exempt under Sec.- -• 8. ti P.C. for this reason
Grading
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. O Certified copy is hereby furnished.
TOTAL
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
I=.affirm that there is a construction lending agency for the performance of the
work ch this permit is issued. (Sec. 3097, Civil Code.) .
Lender's Name
Lender's Address I .
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
AMOUNT
$29.25
45.00
.20
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 ". Permit
Validated by:
Validation:
? CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
� 2ND FL. S0. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CARP. S0. FT.
WALL SO. FT. ®
SO FT ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN.
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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.
SO. FT. ® c
BATH TUB
BOND BEAM
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1+/. c
SEWAGE DISPOSAL
LUMBER GR.
SO.FT.GAR ® 3/ic
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 FEEJPLUMB.FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
to NDERGROUND le, Z
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 APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP. /
/
FINAL INSP. /
GRADING
cu. yd.
$ -plus-x$_=$
LUMBER GR.
FRAMINGL
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION-[
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
1'�fA;Xk �/
Fl! -rttpztzt J�M
Tit� of 14a(ouinta
lluitbin4- altb '*afPt� .1�ibTfSiIIlt
This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building!
Code certifying that at the time of issuance this structure was in compliance with the various
ordinances of the City regulating building construction or use. For the following.
BUILDING ADDRESS 78-437
Hwy 111
Use Classification
Office
Bldg. Permit No. 11553
Group B2
Type Construction SIN
Fire Zone
Use Zone CPS
Platt Orthopdics
78-437 Hwy 111
Owner of Building
Address
City La
Quinta CA 92253
Lonnie Day
Dote:
December 14, 1992
Building Official
POST IN A CONSPICUOUS PLACE
I REVISIONS I BY I
SCAL
ofLAWY
Joe I r c
SHEET
or A 84LETS