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15382 (AR)�•�:T Building Address iiT;449s'�T OWher' my, Powell Mailing Address same 'a', City r ITel. Contractor Hike,, Theriault Address K . 78 --sib 5 Avenida Haran j a • City Zip . "Quinta 42253 564-8387 :. State Lic- City ' & Classif.:52874 - Lic. # 373.2 Sq. Ft. No.- Arch., Engr:,, Size Stories'. Designer New O: Add [X Alter ❑ 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 ' 7000) of Division 3 of the'Business and Professions Code, and my license is in full force and effect. • -SIGNATURE DATE OWNEWBUILDER DECLARATION a Estimated: Valuation— ro I hereby affirm that I am exempt from the Contractor's License Law'for the.following 1 b5, '! 24 • 00- reason: (Sec. 7031 5;Busbress and Professions Code: Any city. or county which, requires a,', � a. iy P.O. BOX" 1.504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA.92253 No. 15382 BUILDING:• TYPE CONST. OCC: GRP. A.P. Number Legal Description Project Description Atrium Rne-I -3-arm r -Ad No. Dw Units Repair O - permit to construct, -•after;-improve, demoush, or repair any structure, prior to its issuance •also - .. -, - • ' requires the applicant forsuch 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) of • - - LNvision 3 of the Business•and'Professions Code, or that. he is exempt therefrom, -and the basis- for the :exemption.. Any Section 7031,5 by 'any for Plan Chk. Dep: - alleged violation of applicant a permit subjects the applicantto a cAmIl penally of not more than five hundred dollars ($500). Plan Chk. Bal. 168 U ❑ 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 Const. w J ' Professions Code: The Contractor's License Law does 'not apply to an owner of property who ori, -. bunds or Improves -thereon and who does such work himself,or through his own employees, Mech. 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 •Electrical._-_ 3.u.�sff' of proving. that he did not build or improve for the purpose of sale.) _•-.:,._...-----' -. - j , O'1; as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 34, 00- : struet 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) tfcensed pursuant to the Contractor's License Law.)' S.M.I. 2.57 - •. Grading - O 1 am exempt under Sec B. & P.C. for this reason -' Driveway Enc. ,- Date owner Infrastructure WORKERS' COMPENSATION DECLARATION 4 l hereby affirm that I have a certificate of consent to self -insure; or a certificate of 1lyorker'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. \ yTOTAL 521.42 CERTIFICATEOF EXEMPTION FROM REMARKS �` + WORKERS' COMPENSATION INSURANCE (This section need. -not be completed if the permit is for one hundred dollars ($100) valuation �.; • - ' or less.) - I cert: that in the ty, performance of the work for which this permit is issued;' I shall not _ \ employ any pperson in any manner so as to become subject to the Workers`Compensafion Laws'of Cabf0 r f nia " Date Owner \ NOTICE TO APPLICANT: ff, after making this Certificate, of Exemption youshouldbecome -ZONE: BY: - subject to the Workers' Compensation provisions of- the Labor Code, you must forthwith . comply with such provisions or this permit shall be deemed revoked. - Minimum Setback Distances: - Front Setback from Center Line - Rear Setback from Rear Prop..Line WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND Side Street Setback from Center Line SHALL Sl1BJECT 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 Side Setbac front Property Line ATTORNEY'S FEES;I This is a building permit when properly filled out, signed and validated, and is subject to FINAL DATE W I INSPECTOR ' expiration if work thereunder is suspended for 180 days. I II I certify that•I have read this application and state that the above -information,is.correct. issued by. ! r I! [ I �' 1Uate, Permit :1 agree to comply. with all eity.and county ordinances and state laws relating to building • construction, and hereby authorize representatives iof this / city to enter the above.. mantlonad property for inspection_ purposes Validated b'y: [� Signature of applicant Date 11' . Mailing Address Validation City, State, Zi p �✓ CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBIW FEEC'< 1ST FL. SO. FT. $ UNITS ~ 2ND FL. S0. FT. ROUGH PLUMB. BONDING YARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET IROOF DRAINS j CAR P. SO. FT. DRAINAGE PIPING WALL S0. FT. OTHER APPJEOUIP. DRINKING FOUNTAIN. SO. FT. ® GAS (FINAL) TEMP. POLE URINAL ESTIMATED CONSTRUCTION VALUATION $ GROUT WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER FRAMING GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED ��/(/`��jjj/ /✓/ �� /� V (� LAUNDRYTRAY 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. SO. FT. ®c BATH TUB GAR. FIREWALL SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR ® 3/ac HOUSE SEWER INSULATIONISOUND FINISH GRADING 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 PLU UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCKSTORAGE 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 GRADING cu. yd. $ plus • x$ _$ LUMBER GR: / r/ FINAL INSP. FRAMING FINAL INSP. ROOFING VENTILATION FIRE ZONE ROOFING ��/(/`��jjj/ /✓/ �� /� V (� REMARKS: FIREPLACE SPARK ARRESTOR/` GAR. FIREWALL LATHING&%k, MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION �� 9 CERT. OCC. FENCE FINAL - INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL 1 ' S LAGO LA QUINTA HOMEOWNERS ASSOCIATION P.O. Box 1180 • La Quint"a,• CA 92253 June.16, 1995 Mr. & Mrs. Jimmy Powell 49-895 Lago Drive La Quinta, CA 92253 Dear Mr. & Mrs. Powell: The Board of Governors has reviewed the plans submitted by Theriault Construction Co. covering atrium enclosure, extension of atrium entrance, and addition of a golf cart storage structure. The Board has appr ved the plans.. Very trogy your , Ricl�arci E,lilson l Sec to DESERT SANDS UNIFIED SCHOOL DISTRICT 82-879 Highway 111 NOTICE: Indio, CA 92201 Document Cannot Be Duplicated 619-775-3500 Date 11/9/95 Type of Permit I La Quinta No. 113859 Permit # Log Owner Name Jimmy Powell No. 49895 Street Lago Dr. city La Quinta Zip 92253 Study Area 122 APN # I Tract # Lot # 0 Square Footage 1412 Type of Development Residential Addition INo. 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 EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of 0.00 x 412 or $ 0.00 have been paid to D.S.U.S.D. the property listed above and that building permits and/or Certificates of Occupancy foi 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 a Fee collected /exempted by Pauline Pearson Signature 21., A L-924 o L 0 AP AIQ Ai✓l $0.00 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 for