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12710 (SFD)1 44 1 P.O. BOX 1504 N o . 12710 Building 52-995 Ave. Rubio 78-105 CALLE ESTADO Address LA QUINTA, CALIFORNIA 92253 Owner David Ross Miller mailing Address P.B. Box 722 City Zip Tel. La Quinta, C 92253 CIV&a,acTTic Trades Ad reU. Box 722 11LDING: TYPE CONST. OCC. GRP. P. Number 773-312`'026 Project Description --iia ouinta, ml- 92253 -.. 342-8363 State Luc. B x}25381 City 1955 & Classif. Lic. # Arch., Engr., Designer Address Tel. City (Zip (State Lic. # �\ k\ i `""LICENSED CONTRACTOR'S DECLARATION b I hereb'taffirm,that I am'Iicensed under provisions of Chapter 9 -(commencing with Section Z000) of ivision`3'ofjtthu Business and Professions Code, and my license is in full force and j 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, alter, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such ,permil to file a 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 thathe 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). ❑ 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 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.) ❑ 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 contractor(s) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec. B. & P.C. for this reason Date Owner 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 ❑� Py is filed with the city. 0 Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE I (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 or 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 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.) Lender's Name Lender's Address 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 ateMailing Address City, State, Zip Io.,)t 13 dock 170 SPD Sq. Ft. No. No. Dw. Size 1257 Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Permit includes patio and wooden fence. Retaining walla and/or pool permits to be obtained separately. Estimated Valuation $77,215.00 PERMIT AMOUNT Plan Chk. Dep. 250.00 Plan Chk. Bal. 215.73 Const. 540.50 Mech. _ 55.50 Electrical 117.53 Plumbing 144.00 s.M.l. 7.72 Grading 20.00 Driveway Enc. 00 Infrastructure 11690.10 Precise Plan 25.00 TOTAL 3,066.13 \j2,816.13 REMARKS 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 / Validated by:', Validation: �1 A " r CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PIL IBING MEES 1ST FL. SQ. FT. ® $ UNITS ROUGH PLUMB. BONDING t 0 t STORAGE TANK YARD SPKLR SYSTEM -- 2ND FL. SQ. FT. DUCT WORK e FOUND. REINF. MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® REINF. STEEL GAS (FINAL) /IS TEMP. POLEI "—Z7' ? C/ v POWER OUTLET ROOF DRAINS GAR. SQ. FT. ® FINAL INSP. BOND BEAM WATER SYSTEM FINAL INSP. _ FINAL INSP. DRAINAGE PIPING CARP. SQ. FT. ® LUMBER GR. FRAMING .� 7 ��j O� WALL SQ. FT. ® ,n �, Z/� 7 `L� 5`"Y' C nl ' ��� --4 7 ✓VL- (� ` L/ Pell DRINKING FOUNTAIN. REMARKS: URINAL SO. FT. ® VENTILATION ESTIMATED CONSTRUCTION VALUATION $ FIRE ZONE ROOFING WATER PIPING NOTE: Not to be used as property tax valuation FIREPLACE FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED 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. SQ. FT. @ c BATH TUB SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR ® 3/ac HOUSE SEWER GARDEN WALL FINAL 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 r NDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWEFr;19" PYfCfitkfi UGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL GAS (FINAL) /IS TEMP. POLEI "—Z7' ? C/ v GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM FINAL INSP. _ FINAL INSP. ADING cu. yd. $ plus x$ _$ LUMBER GR. FRAMING .� 7 ��j O� ROOFING p[// �/� �l� ,n �, Z/� 7 `L� 5`"Y' C nl ' ��� --4 7 ✓VL- (� ` L/ Pell REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL p,(/ LATHING MESH INSULATION/SOUND %�. FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL TA 4 u�l'Gv. P.O. BOX.1504 Building. Jc` QU�t1 V LA QUINTA CALIFORNIA DO Address 92253 Mailing , Address e City Zip Contr?tor Address C A 0-k City lZip Tel.. State Lic. City C 8 Classif. 6 y Lic. # _l Arch., Engr., Designer Address Tel. CityZip State Lic. # /\ LICENSED CONTRACTOR'S DECLARATION I hereby agirr�t' th,&a�,Lam licensed undet provisions of Chapter 9 (co menci g with Section 7fXX)pof Df iis�io�/3 01 he Busine s and Professions Code, and my lice se is i full torce,and effec��`K W - � i 1 t �Cl �! 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 to 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 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 or Section 7031.5 by any applicant for. a permit subjects the applicant to a civil penalty or not more than five hundred dollars ($500). I"; 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 or 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 or completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale.) t'I 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 contractor(s) licensed pursuant to the Contractor's License Law.) 17 1 am exempt under Sec. B. 8 P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION 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 l7 Copy is filed with the city. O 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 the 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 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.) 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 thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct. 1 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, Slate, Zip BUILDING DIVISION APPLICATION ONLY BUILDING: TYPE CONST. OCC. GRP. A.P. Number �i 3 Legal Description E b T I .� 11c (1 v Project Description Sq. Ft. No.' No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS y ZONE: t BY: Minimum Setback Distances: FINAL DATE I Rea' -tba kc� RearLqrop. It _Sid3e� treet Setback from Cent .r R Issued by: rsv Date Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES, 1ST FL, SO. FT. @ $ UNITS SLAB GRADE 2ND FL, SQ. FT. @ BONDING YARD SPKLR SYSTEM POR. SQ. FT. @ MOBILEHOME SVC, BAR SINK GAR. SO, FT, @ POWER OUTLET ROOF DRAINS CAR P. I SD. FT. 0 GAS (ROUGH) DRAINAGE PIPING WALL SO. FT. OTHER APP./EQUIP. DRINKING FOUNTAIN SQ. FT. @ 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 SYSTEM WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP, GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM 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 SO. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID @ 1'A c SEWAGE DISPOSAL GAR. FIREWALL SQ.FT.GAR @ 3/<c USE SEWER LATHING #GASPIPING PERMIT FEE PERMIT FEE RMIT 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 APP./EQUIP. 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 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 DESERT SANDS„ UNIFIED SCHOOL DISTRICT 82-879 Hi liwa '111 NOTICE: Indio, CA 9220.1 Document Cannot Be 'Duplicated 619-775-3500 x:4. Date 1/25/94 Type ofPermit•l La.Quinta No. 12631 ' - Permit # l Log Owner Name. David Ross Miller': No. 152995. � Sti eet,,Avenida Rubio: a . City La Quinta Zip 92253 :Study Area 113 APN # 773'=312-026 Tract #` Lot41013' Square Footage 1257 - Type of Development Single Family Residence No. of units Comments At the present time, the Desert. Sands .Unified School District does, not collect fees on garages/carports, covered patiostwalkways, residential additions unde'r.500 square feet, detached accessory structures or` replacement mobilehomes. It has-been determined the above-named owner is e.xem. f from paying; school' fee's at this time due to the following reason: EXEMPTION NOT APPLICABLE t This certifies that school facility fees imposed pursuant to in the amount' of 1:65` . ' X' 1257 or $x2,074.05 ,' the ;property listed above and that building;permits andlo,j this square footagi in this,proposed prolect_may now be4s Government Code 53080 have•beeri paid'to-.D.S.U.S.D. for Certifieafes of Occuvancv for Fees Paid By David .= Ross Miller. - Telephone Name on`,the check: s By' Dolores A. Ballesteros - Superintendent Fee collected4exempted.by. 'Vickie. Durrett i Payment Received' 117r Signature -Check `No. 3943 Collector: 'Attach a copy.of county or city plan'check application -form to district--copyfor all waivers. Einbossed Original- Building-Dept./Applicant" Copy Apphcarit/Receipt Copy - Accounting i j� �45' � }� tis• I I li, II. DO PF r r it It ;I i;A.1 j. It 1*11htlttj �ilt1 ctf i` ti�tt�it I l;I This Certificate issued pursuant to the requirements of Section 306 of .the UhiformfiBuilding I _ h Code certifying that at the'time,of issuance this•structure was in compliance`with the various z ordinances of the City regulating building construction 6i'use. For the following: 'I BUILDING ADDRESS 52-995 Avenida Rubio II Single Family Dwellings 127:10 j` Use Classification Bldg. Permit No:: Group R3 Type Construction VN Fire Zone Uss Zone SR Owner of Building David Ross Miller address P • O. Box 722 City La Quinta, CA 92253 By; Mark Harold' (I I Dote: January 309, 1995 I' I I I �� 'I• may" t �I r' Building Official POST IN A CONSPICUOUS RAC[ �,,. -'' .'�°""--r - - ..'_ -Ytl����l .?i�'>M''JM':c-.i.�s..o/MMi.c•, -..�._rf... �li.vm;..r