001572 (SFD)~ P.O. BOX 1504 No. 001572.
Building 78-105 CALLE ESTADO
Address S4-585 awnift %3bi 1 LA QUINTA, CALIFORNIA 92253
Owner
' o"' 2 " BUILDING: TYPE CONST. V N OCC. GRP. RC 3 •
Mailing
Address P.O..B= 23M A.P. Number 774-27"01 Lot 4
City Zip Tel.
uldio 9201 347-7171 Legal. Description
Contractor Project Description•••
Address
aboM
City. _ .... Zip ,. Tel:
abMM
State Lic: City DIM 1592
& Classif. Lic. # 202 Sq. Ft. No. No. Dw.
- Arch., Engr., ... .
Size GAR 430 . Stories - Units
Designer New EJ Add ❑ Alter ❑ Repair ❑. Demolition ❑
Address Tel.
City Zip State
' Lic. #
• LICENSED CONTRACTOR'S DECLARATION M
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section'
7000) of Division -3 of the Business and Professiioons'Code, and my license is in full force and
effect....yrt
SIGNATURE •r' DATE
OWNER -BUILDER DECLARATION Estimated Valuation
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 $ 81.447.60
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 .kcensed 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, arid'the basis
for the alleged exemption. Any violation of Section 7031..5 by. 'any applicant for a permit Plan. Chk. Dep.
subjects tAeplicant to a civil penally of not more than live hundred dollarsy8500)." ' . ••_ : Y
❑ I, as owner.of`the_property, or_my employees with wages as their sole compensation, will Plan .Chk. Bal. 31.8.52
do the work;'and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. 379rr00
Professions Code:, The Contractor's, License Law does not apply to an owner of property who ' t�yif.f�
.. builds or improves thereon ?arid ,awho does such work himself or through his own employees, Mech. ' �. y 1.00
provided' that such improvemenis are not intended or offered for sale. If, however, the building
or improvement is sold,wfihfn•one year of completion, the owner -builder will have -the burden Electrical' ��
of proving that he did not buildor implove for the purpose of sale.) _ .. '
O I, as owner of the property,12
am exclusively contracting with licensed contractors to con- Plumbing 89.0
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' S•M•I. 5.1111
such projects with a-contractor(s) licensed pursuant to4he Contractor's License Law.) -
O I am exempt under Sec. B. 8 P.C. for this reason Grading
Driveway Enc. 20.00
Date owner Infrastructure i.221.n
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.. O Certified copy.is hereby furnished.
_ TOTAL
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 the work for which this permit'is issued, 1• 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
ZONE:
-BY:
' subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
Minimum Setback Distances: '
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 applicant A'� i^ Date
Mailing Address
Validation:
City, State, Zip
A 2 4 8 5 4 3 L1S566 Ch
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT. ®
POR. SQ. Ff.
GAR. SQ, FT. ®
CAR P. SQ. FT. ®
WALL SO. FT. ®
SO. 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
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
t ff
LAUNDRYTRAY
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.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
LUMBER GR.
SQ.FT.GAR ® 3/ac
HOUSE SEWER-
EWER_GAS
/i
GASPIPING
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 y A
UNDERGROUND
A.C. UNIT
COLI. AREA
SLAB GRADE
i
ROUGH PLUMB/O
W BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
$EWER OR SEPTIC TAN
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF,5/r9,p�L
aV
t ff
GAS(ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP.
FINAL INSP.
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FRAMING /Q �4..�
ROOFING �Q
/i
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
C
^/CATHING 16 /4 Q
MESH
~
') I INSULATIONISOUND /V G g5
v 77
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
1, oQY /0 �6 Yy
��f1Ep
o
—0 Desert Sands Unified School District
N BERMUDA DUNES
RANCHO MIRAGE 82.879 HIGHWAY I I 1 0 INDIO, CALIFORNIA 92201-5678 O (619) 347-8631
INDIAN WELLS H
PALM DESERT a
d' LA OUINTA
�o INolo September 3, 1985
City of La Quinta
Department of Community Development
78-105 Calle Estado
La Quinta, CA 92253
Re: 54-585 Rubio, La Quinta
Gentlemen:
The developer of the above referenced .lot
has - mi,ti'gated its impacts on our overcrowded °s-ch.00l s by -payment
of the amount of $628 per unit to.be applied to th.e cost=of
.district educational facfli:ties made necessary -by such.new
development.
Sincerely;
John D. Brooks
Assistant Supe.ri,ntende.nt
Business Services
JDB/crm