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10454 (SFD)j t`il -t P.O. BOX 1504 (!: M( o. 10454 Building 51-3$0 Ramirez LA QUINOTACCALIFORNIA92253 Address . Owner Exnecta:.ion Construction Mailing BUILDING: TYPE CONST. OCC: GRP. Address 54-1-95 Diaz 773-083- 008 A.P. Number City Zip Tel. L©t 1? Blo--k 66 La Quinta 52?_53 564-0793 Legal Description Contractor Project Description S amb Address SFD City Zip Tel.: State Lic. City g & Classif. 613446 Lic. #, i&'b—Sq. Ft. x614 No. No. Dw. Size Stories Units Arch., Engr., Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. ?ermit does not induce block City Zip State wall or pool 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 Businessand Professions Co , a, And my� lic�ense i(9. n full,fo(,r�cetalnd+� effect.EJB IL.� J C SIGNATURE` - f i" \ DATE OWNER -BUILDER DECLARATION .I hereby affirm that I am exempt from the Contractor's License Law Jor the following reason: (Sec. 7031.5,Susiness 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 L 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 ,q� subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ` 6 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 orimprovement 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 Estimated Valuation 98,555.00 - PERMIT Plan CFik. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. 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 O,V;Copy is filed with the city. ❑ Certified copy is hereby furnished. - TOTAL CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the . permit is for one hundred dollars ($100) .valuation or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must .forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information' is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives -of this city to enter the above-. mentioned property for inspection purposes. Signature of applicant -Date- Mailing ateMailing Address City, State, Zip REMARKS AMOUNT ?$b.3 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 Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS A.C. UNIT 2ND FL. SO. FT. SLAB GRADE YARD SPKLR SYSTEM POR. SD. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO, FT. ® POWER OUTLET ROOF DRAINS CAR P. SO. FT. ® DRAINAGE PIPING WALL SO. FT. DRINKING FOUNTAIN. SO FT ® ROCK STORAGE URINAL ESTIMATED CONSTRUCTION VALUATION $ GAS (ROUGH) WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES REINF. STEEL WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(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, TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER. B.T.U. SO. FT. ® c BATH TUB FRAMING Q�LW SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR ® V4c 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 /I PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING 7 `OUNDERGROUND A.C. UNIT COIL, AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS Z $ "'SEPTIC TANKUGH 2341 WIRING. DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM $ GRADING cu. yd. plus x$ =$ LUMBER GR. ,/ �9Z FINAL INSP.0 [[[ FRAMING Q�LW FINAL INSP 2 C ROOFING 3 %2 _ D �� C1 !� , D REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LAW, G �L MESH INSULATIONISOU% 1� 1(.2 17 FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESJINITIALS GARDEN WALL FINAL j e � P.O. BOX 1504 APPLICATION ONLY Building `//3go 7&105 CALLE ESTADO Address LA QUINTA, CALIFORNIA 92253 Owner Mailing Address <7 1/a City Lia Civ 1, Contractor , City State Lic. & Classif., Arch., Engr., Designer. Address BUILDING: TYPE CONST: OCC. GRP., /11� A:P. Number 77.3- 0r .3 — Zip > Tel. S6 L/ - U 3 Legal Description Project Description Zip Tel.. City y 6 Lic. # Sq. Ft. No. No. Dw. Size Stories Units ! New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Tel. City I ZipI 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 effect. SIGNATURE DATE OWNER-BUILDERDECLARATION 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'perrhityto 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 of Section 7031.5 by 'any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500). [ I, as owner of the property, or my employeesewith•wages as their sole compensation, will do the work, and the structure is not intendedor offered for sale. (Sec.' 7044, Buisness and Professions Code: The Contractor's Licensei,LNv 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.) 1.1 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 Licensee Law.) 171 1 am exempt under Seca B. & P.C. for this reason N I Date Owner WORKERS' COMPENSATION DECLARATION hereby affirm that 1 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 0 Copy is filed with the city. ❑ 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 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 of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permitshall 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. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives sof this city to enter the above. mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State;' Zip 1. BUILDING DIVISION 41 Estimated Valuation ` PERMIT y AMOUNT Plan Chk. Dep.: Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Y,nfrastructure TOTAL -�..e. REMARKS y♦ yy�� q (y� ( nn (n� (n1 I rll 4fc_ t l.tt7 '7+ � 1• '+. R"Of cam'_ _ 4 D t VV 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 Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO, ELECTRICAL FEES NO. PLUMBINb FEES 1ST FL. SO. FT. @ $ UNITS ' 2ND FL. SO. FT, @ BONDING YARD SPKLR SYSTEM POR. SO. FT. @ MOBILEHOME SVC. BAR SINK GAR. SO, FT, Fq POWER OUTLET ROOF DRAINS FOUND. REINF. GAS (ROUGH) DRAINAGE PIPING CAR P. SO. FT. 0 OTHER APPJEQUIP. REINF. STEEL WALL SO. FT. TEMP. POLE DRINKING FOUNTAIN SO, FT. GROUT URINAL ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP. WATER PIPING NOTE: Not to be used as property tax valuation WATER SYSTEM FLOOR DRAIN MECHANICAL FEES =$ WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(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, TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. ® c BATH TUB SO. FT, p c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1 I c SEWAGE DISPOSAL LATHING SO.FT.GAR @ 3/ac HOUSE SEWER MESH GAS PIPING PERMIT FEE INSULATION/SOUND 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 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 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. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESJINITIALS GARDEN WALL FINAL i DESERT SANDS UNIFIED SCHOOL DISTRICT 82-W9 Highway 111 NOTICE: Indio, CA, 92201 Document Cannot Be Duplicated (619)347-8631' Date 1/13192 1 Type of Permit La . Uinta . No. 111113 Permit # Owner Name Expectation Construction Log # No. 51380. street 'Ramirez city La Quinta zip 92253' study Area 112 APN # Tract .# Lot # Square Footage 13228 Type of Development Single Family Residence No. of units 0 Comments ..r,1.gAO RnrmirP7.'-:1R14_ ..9;1'29..; RamirP.71�R'14 kniiarP•PPPt At the present time, the Desert. Sands: Unified School District does not collect fees on garages/carports, covered patios/.walkways, resideiitial additions under 500 square feet, detached accessory 'structures or replacement• mobilehomes. It.has been determined the above-named owner is exempt from paying school fees at this time due to the following reason: EXEMPTION NOT APPLICABLE This certifies that school fatality fees imposed pursuant to, Government Code 53080 in the amount of 1.58 ' X F� or$ 5;100.24have been paid to D.S.U.S.D. for the propertylisted above and that building;:perm t -and/or-Certificates of Occupancy for this square footage in this proposed project`may'now be issued. Fees Paid By Expectation Construction Name on the'check By James E. Lively Assistant Superintendent, Business Services n ae ` 're6-O'79�i iephon Fee collected /exempted by Vickie J. Durrett Payment Received SignatureCheck No. 579 Collector: Attach a copy of county or city plan check application form to district copy for all waivers. Embossed Original- Building DeptJApplicant Copy Applicant/Receipt Copy - Accounting