15230 (DEMO).t
Buildin
Address ¢9"895 Lego Dr.
Owner
Pl3'IrSell
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
' Mailing
Address Sane -
City Zip Tel.
La Qt1inta jl, CA 32253 •
Contractor
Mr a i`hpri3uit
qd Ir s
YV,985 lhvie. 14-.-ixanja
City Zip Tel.:
92253 564-3587
State Lic. City
& Classif.'. -4,19695 Lic. #
Arch., Engr.,
Designer
Address Tel.
City Zip State
Lic. #
.LICENSED CONTRACTOR'S DECLARATION
I hereby afffiirmshat I am licensed under provisions of Chapter 9, (commencing with Section
700(I f DDiv ion 3 of the B` roes§ and Professions Code, and Ilcense is in full force and
SIGNATURE��+
DATE
OWNER -BUILDER DECLARATION
1 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, after, 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 or 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 rive 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. It, 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.) ..
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
does not apply to an, owner of property who builds or Improves thereon, and who contracts for
such projects with'a contractors) jicensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec B. & P.C. for this reason
Date Owner
r WORKERS' COMPENSATION DECLARATION
r l hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker�'ss�cce•ompensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy Lvo. Company
d((C""opy 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 (S100) valuation
or less.) -
I certify that in the performance of the work for which this permit is. issued, I shall not
employ anyperson 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 of Exemption you should become
subject to the Workers' Compensation provisions or the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked. "
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND
SHALL SUaJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES -UP TO ONE
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
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
Malling. Address
City, State, Zip
No. 15230
LDING: TYPE CONST.• OCC: GRP.
P. Number
,Legal Description
Project Description
Demolition on prior to remodel
Sq. Ft.
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
45.00
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
45.00
REMARKS
ZONE:BY:
Minimum Setback Distances:
Front Setback from
Rear Setback from
Side Street Setbaci
Side Setback fro I
FINAL
Issued by:.
Validated 1
Validation:
r
Line
)\p. Line
ehpr Line
/-INSPECTOR
A
�`
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SQ. FT. ®
CARP. SQ. FT.
WALL SQ. FT.
SQ. 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
BONDING
FLOOR DRAIN .
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH) .
GARBAGE DISPOSAL
FURNACE. UNIT WALL FLOOR SUSPENDED
OTHER APPJEQUIP.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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.
SO. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ: FT. RESID ® 1% c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
REMARKS:
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.
ROOFINGr
w
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION 3 ��
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
r
March 29, 1993
Mr-s..--J-i mmy -Pots a 11
K149-895 Lago--Dr,ive., 1
La-Quinta.,--Ca.- 92253
Dear Mrs Powell,
The Board of Directors, of the Lago La Quinta Homeowners
Association have reviewed your request to more your
air conditioners away from your unit, and next to the
50th St. wail, provided:
1. They are lowered so the tops do not show above
the wail.
2. If any portion of the units extend above the wall,
they must be surrounded with Oleanders so they are in
no way visible from the street.
f
If these conditions are met, permission is granted.
For the Board of Governors,
Lago La Quinta Homeowners Assn
L wrence Kibler Pres.
�CC Board
5
t
11