05533 (SFD)P.O. BOX 1504 No. 05533
Building 78-105 53-190 RUBIO LA QUINTAC
Address CALIFORNIA 92253
Owner
Aaron & Lim Hamilt(
Ma'4ling
BUILDING: TYPE CONST. OCC: GRP.
Address P. 0. TI(m 1281 A.P. Number 774-043-0'10
City Zip Tel. Lot 15
La Qt�lant 92253 Legal Description
Contractor C➢vneri3uilcier Project Description SFD
Address
City Zip Tela
State Lic. City
& Classif. Lic. # Sq. Ft. 1;573 No. No. Dw.
Arch., Engr.,
Size Stories Units
Designer New ❑ 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
7001]) t. of Division 3 of the Business and Professions Code, and my license is in full force and
effec
SIGNATURE DATE
OWNER -BUILDER DECLARATION Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following $87,690.00
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 PERMIT AMOUNT
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 of Section 7031.5 by *any applicant for a permit Plan Chk. Dep. 250.00
subjects the applicant to a civil penalty of not more than five hundred dadars ($500). Z49. 0
❑ I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal.
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Suisness and Const.
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, Mech.
provided that' such improvements are not intended or offered for sale. f, however, the building _
orimprovement is sold within one year of completion, the owner -budder will have the burden
Electrical
o/ proving that he did not build or Improve for the purpose of sale.)
O 1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing : f)
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 frnproves thereon, and who contracts for S.M.1. 6.10
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
111 am exempt under Sec B. & P.C. for this reason Grading id
-,� Driveway Enc. 20.0
Date '' y`Owner �✓" fUeyt, "A,''i , Infrastructure 0
34.715
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
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need riot be completed it the permit is for one hundred dollars (E100) 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 j
Date Owner f ¢ f
NOTICE TO APPLICANT: ff, after making this CeWfrcate 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 property 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
Mailing Address
City, State, Zip
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 3/17189 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
COLL. AREA
/SETBACK
6G 6LAB GRADE
ROUGH PLUMB.
YARD SPKLR SYSTEM
2ND FL. SO. FT.
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
DUCT WORK
ROCK STORAGE
FOUND. REINF.
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL G/ �d
GAS (FINAL)
DRAINAGE PIPING
CAR P. SO. FT. ®
WALL SO. FT.
WATER HEATER
DRINKING FOUNTAIN.
SERVICE
FINAL INSP.
URINAL
SO FT ®
WATER SYSTEM
ESTIMATED CONSTRUCTION VALUATION $
GRADING
cu. yd.
$ plus x$
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
I
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
REMARKS
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, 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.
SO. FT. RESID ® 11/. c
SEWAGE DISPOSAL
MESH
SO.FT.GAR ® 3/ac
HOUSE SEWER
INSULATION/SOUND
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
ROUND PLUMBING` _
UNDERGROUND
A.C. UNIT
COLL. AREA
/SETBACK
6G 6LAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
S ER OR SEPI IF
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL G/ �d
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
O(/ BOND BEAM �v
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
/
• � f/ lig^
tiQ`q
}�J
_ 2 f /nG
./ jam`
t
REMARKS
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
G LATHING —15 C1
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
Desert Sands Unified School District
CERTIFICATION OF PAYMENT
OF %A
SCHOOL FACILITY FEES qA
NOTICE: THIS DOCUMENT
SENT CANNY c�
TO: City of La 09- 5 zPVP 'ICATEQ D7� E:
Department of Community'Development
78-105 Calle Estado
La Quinta, CA 92253 `
This is to certif that U 0-W J -�
developer of which is
located at - nwithin
this District, has paid school facility fees imposed pursuant to the
Sup ho ri ,gerygra d by overnment C de Sectio 53080 in the 'amount
Aho-a
covering a total of f1rZ f2 -s64a--feet of (44
) residential or
( ) industrial/commercial development and that building permits for
this footage in this development may now be issued by your jurisdiction.
Ck tb 1, -Ig
. !2h R i pl-"' -n -
for DESERT SANS •UNIFIED SCHOOL DISTRICT
White - Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer
(10)-37
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DAILY WORK SHEET
JOB
NAME
JOB NO.
DATE
TECH. ,
LOCATION
CLIENT
HOURS
WEATHER
EQUIPMENT
NO.
TEST
LOCATION
ELEVATION
OR DEPTH
DRY
DENSITY
PERCENT
MOISTURE
MAXIMUM
DENSITY
RELATIVE
COMPACTION'
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COMMENTS:'
SOIL TESTING, INC.
Phone (619) 340-9492