08075 (AR)Building
Address a A-r%gs;
Owner
Mailing
Address 565, 1
City
Lot Ouintst
Contractor
Address
City
4
P.O. BOX 1504
78-105 CALLE ESTADO
Its to% LA QUINTA, CALIFORNIA 92253
No. 080?8
-may,;,,, fit -BUILDING: TYPE CONST. OCC: GRP.
ibis A.P. Number i7/1i71_�1�
Zip Tel.
92M Legal Description
Project Description Rnm MA-44:t4a-
Zip Tela
State Lic.
& Classif.
City
Lic. #
Sq. Ft. 352
Size
No. No. Dw.
Stories Units
Arch., Engr.,
Designer
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
Side Street Setback from Center Line
City
Zip
State
Lic. #
INSPECTOR
Issued by:
Date 90 Permit
Validated by:
LICENSED CONTRACTOR'S DECLARATION
1 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.
Validation:
SIGNATURE 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 to
thconstruct, after, improve, demolish, or repair any structure, prior to'4s issuance also
requires e applicant for such permit to rile 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' 3of 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
^subjeets the applicant to a civil penalty of not more than five hundred dollars ($500). '
' O 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 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.)
❑ 1, 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.)
O I am exempt under Sec: B. & P.C. for this reason
Estimated Valuation
p
1� O
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
1$3.97
Const.
• !
Mech.
'
�✓• 00
Electrical
272
•
Plumbing
33.00
�
S.M.I.
1.26
Grading
Driveway Enc.
Date`' Owner ,
Infrastructure
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. F
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
9r1 0.1 4A h13:L- _ ....+7, 't•.
-
CCA-�
A~ '...�
TOTAL
$419•55
REMARKS
y
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 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 Address
City, State, Zip
�s
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 90 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. SQ. FT. ®
POR. SO. FT. ®
GAR. SQ, FT, ®
CAR P. 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
STORAGE TANK
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
ROCK STORAGE
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
METER LOOP
LAUNDRY TRAY
AIR HANDLING UNIT CFM
OTHER APPJEQUIP.
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. a c
BATH TUB
WATER SYSTEM
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
FRAMING l` L� FINAL INSP..1a(lt"
11 ///
SQ.FT.GAR ® 3Lc
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
t
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 �.( CIVNDERGROUNDX(f�
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 APPJEQUIP.
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.
l
FRAMING l` L� FINAL INSP..1a(lt"
11 ///
{
ROOFING /
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING Cl v-
-IdG61i qj Lo
INSULATIONISOUND / 1
F
FINAL INSPECT
CER e
FFNr.F FINCI
/ , ,�
/g %
W
REMARKS:
INSPECTOR'S SIGNATURES)INITIALS
GARDEN WALL FINAL
C
t��
41
OF
TiN -of 1.4a. Outima
jluttbtn� anb -safe34,111V5113n
This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building'
Code certifying that at the time of issuance. this structure was in compliance with the various
ordinances of the City regulating building construction or use. For the following:
BUILDING *ADDRESS 54-565 Rubio
Use Classification Single Family Dwelling Permit No. 8075
Group R3 Type -Construction VN Fre Zone Use Zone SR
Owner of Building Patrice d' Entremont Address 54-565 Ri,hi n
City La Ouinta, CA
By; _ Lonnie Day
�-' Dote: December j- 1992
Building Offigail "
POST IN A CONSPICUOUS PLACt