001571 (SFD)P.O. BOX 1504 No. 001571
Building 78-105 CALLE ESTADO
Address 52-80 AVeni& RobiO ' LA QUINTA, CALIFORNIA 92253
Owner
Pick Ictinsm Qmst' BUILDING: TYPECONST.R 3
Mailing
OCC: GRP: '
Address .P rx'WW A.P. Number 773-312`a016 Wt 3
City Zip Tel.
$.O 92201. 347-7171 Legal Description
Contractor
qy�� Project Description..%?:.
.. LCdf4:ZS �� dJsxE:t►'f�a '
Address.
-.City Zip Tel.
abwa
State Lic. City
& Classif. • Lic. # 202, Sq. Ft.DM 8592 No. No. Dw.
Size rn A'In Stories Units
GArch , Engr:
Designer New M Add ❑ Alter ❑ Repair ❑ 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' "
7000) of Division 3 -of the Business and Professions'Code, and -my license is in full force and
effeP�
SIGNATURE "- DATE
' OWNER -BUILDER DECLARATION Estimated Valuation /t�{ gy
I hereby affirm that I am exempt from the Contractor's License Law for the following ° SIS' 47.601
reason: (Sec. 7031.5,Business and Professions- Code: Any city or. counly..which requires a .
permit fo 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) of. '
Division 3 of lhe'Buslness and Professions Code, or that. he is'eriempt therefrom,' and the basis e .plan Chk. D .
for the alleged exemption. Any violation of Section 7031.5. by 'any applicant. for a permit p
subjects'lhe applicant to a civil penalty of not more than five hundred dollars ($500).
C
O I, as owner of the property, or my employees with wages as their sole compensation,Plan.
, will Chk'. Bal. �.�•.72
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Cl)nSt. 37
Professions Code: The Contractor's License Law does not apply to an owner of property. who - � o
00
ip builds or improves thereon and who does such work himseff or through his own employees, .- �.pe.•ti4�
provided that such improvements are not intended or offered for sale. It, however, the building Mech.. �' 3•
or improvement is sold within one year of completion, -the owner -builder will have the burden Electrical - 7Llw..i2
of proving. that he did not build or improve for the purpose of sale.) . [� !��1
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing [S9st G
struct the project. (Seca 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 V S. M.I. 5 - 71
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
❑ 1 am exempt under Sec. B:8 P.C. for this reason
Driveway Eno. G0'.Q0
Date Owner Infrastructure 1.221.71
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.
TOTAL --L135.06
CERTIFICATE OF 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 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: It, after making this Certificate of Exemption you should become -
ZONE:
BY:
subject to 'the Workers" Compensation provisions of the tabor Code, you must forthwith
Setback
Distances:
comply with such provisions or this permit shall be deemed revoked.
Minimum
.
Front Setback from Center Line
Rear Setback from.Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line—
I hereby affirm that there is'a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Side Setback from Property Line -.
Lender's Name
Lender's Address
FINAL DATE
INSPECTOR
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: -- -
Issued by:
Date Permit
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.
Validated by:
Signature of applicantA Date
Mailing Address '`. �_. _ _
Validation:
City, State, Zip '
A1969
7 16 2j 35,06 CK
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SQ. FT. ®
CAR P. I 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 if 1
7/
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEOUIP.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
TEMP. POLE
v �O
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.
SQ. FT. (& c
BATH TUB
FINAL INSP.
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
VENTILATION
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 74?3
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE �S
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS if 1
7/
j
SEWER OR SE 'i
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. l� C
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
v �O
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP.
FRAMING ' Z7
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
'z
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS.
GARDEN WALL FINAL
• ��FIEp,` s
�xx\I !C'
Desert Sands Unified Sc�o"olD18tt1Ct
' y •BERMUDA DUNES - t -�} ` ... .
RANCHO MIRAGE 82-879 HIGHWAY: 111 A INDIO; ,CALIFORNIA 92201-5878 01619) 347-8831
;
►' INDIAN WELCSH ` d
y FALIN;oESERTJuly 16, 1985
Jt„' LA OUINTA4�ZQ
INDIO, y
t
City of La Qui nta'
Departmen.t-•of Commu`ni ty De;ve.1 opmen•t
78-105 ; Cal l e;: Esta7&. ”
la Qu i'n to , CA 92253
Re . 52-8.0.5: Rubio
Gentlemen:
The developer„o:f the above .referenced lot'
has'mi.ta ga:te`dt i;ts impacts on our overcrowded schools bypayment
of the-. ambuh`tof $628 per unit to be a.ppl i'ed tok.the cost of
district educat"Ional..fac�l':ia�es made necessary'by suchsnew
,
M
development:
Sincerely,,
Jolie D Brooks ` -
Assi s'tant °Superfintende.nt
B,usi;ness S`ervi:ces
JDB/crm