08115 (SPIN)7%
P.O. BOX 1504No. 081-15
Building -714.150 RMo 78-105 CALLE ESTADO
Address >-LA QUINTA, CALIFORNIA 92253
01:0er
Jancice Li Todd
BUILDING: TYPE CONST —OCC GRP.
Mailing
Address
City Zip Tel.
Contractor
Address
City Zip Tel.:
X
State Lic. City
& Classif. Lic. #
P
Arch., Engr.,
Designer
Address Tel.
City
Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I herebyaffirm 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:
DATE
OWNER -BUILDER DECLARATION
I 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 t; 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 provisionsof the -Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division J 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).
0 1, 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. If, however, the building
orimprovement 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.)
0 1, asowner 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.) -
0 1 am exempt under Sec.B. & P.C. for this reason
Dale 10 ': rf'�cwne, "k1f h 1+ 1 -1 PVs '—f S
WORKERS' COMPENSATION DECLARATION
Ihereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, Ora certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. . . company
0 Copy is filed with the city. 0 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 thip 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: It, 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
Ihereb y affirm that there is a construction lending agency for the performance of the
work for which this permit ls.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 it work I ereunder is suspended for 180 days.
Icertify that
he" have read this
h 's application
PI I cat'0 n and state that the above information is correct.
I .
I
agree
rgee to comply
om p Iy with all
city
and county tyor d 'n nr es and state laws relating to building v
con stru ction, and . hereby authorize representatives of this city to enter the above-.
mentioned prop a 'y for
inspection
n pect, 0 n p urp O.e S.
Signature of applicantDate
Mailing Address
City, State, Zip
A. P. Number
Legal Description
Project Description* Special Inspectilen
Sq. Ft. No.No. 'Dw.
Size Stories Units
New 0 Add ^0 Alter 0 Repair 0 -Demolition.Ei
Estimated Valuation
PERMIT AMOUNT
Plan Chk. Dep.
Plan-'Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Jnfrastructure
SMtal Insua*tJon-
TOTAL
-1100.00
REMARKS
10TAC r _1109'. 00
ZONE:
BY:
Minimum Setback
Distances:
Front SetbackfromCenter Line
Rear Setback from Rear Prop. Line
—Side Street Setback from Center Line
Side Setback from Property.Line
FINAL DATE
INSPECTOR
Issued by:
Date U1/90Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. $
2ND FL. SD. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. SO. FT. @
WALL SO. FT. ®
SO FT ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAIII-
DRA 1S , SE PIPING
DRINKING FOUNTAIN.
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
ROUGH PLUMB.
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GAS (ROUGH)
LAUNDRY TRAY
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 ® 1114 c
SEWAGE DISPOSAL
LUMBER GR.
SO.FT.GAR ® 3/<c
HOUSE SEWER
FRAMING
FINAL INSP.
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
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.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
//�
719— G✓
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 '
4
78-105 C,ALLE ESTADO LA QUINTA, CALIFORNIA 92253 (619) 564-2246
FAX (61.9) 564-5617
July 3, 1990 '
Ms. Janice L. Todd
51-650 Rubio
.La Quinta, CA 92253
SUBJECT: ADDITION TO51-650 RUBIO
Dear Ms. Todd:
Upon inspecting your addition at' 51-650 Rubio on July.2, 1990
we can verify the following:
1 The addition complies with the City of La Quinta
property line setbacks.
2. All glass is dual glazed.*
3. The addition appears to have been completed in
n a
workmanlike manner.
4. The emergency egress meets UBC codes.
5. There is 30 -inches of clear work space by electric
panel per NEC 1987 codes.
However, we are unable to verify the R values of insulation.in
walls. or ceiling. We cannot verify the nailing of roof
sheathing, 'framing, drywall, or -lath..
If you have any questions please contact the undersigned.
Very truly yours,
TOM HARTUNG
BUILDING & SAFETY DIRECTOR
VhAt'41 #944_�
Mark Harold
Building Inspector
LTRMH. AW" ADDRESS P.O. BOX 1504 LA Cal -NTA, CALIFORNIA 92253