11109 (SFD)Building,
AAA. 5
•
j
P.O. BOX 1504 � N o . 11109
7&105 CALLE ESTADO
Ramirez 78-105
QUINTA, CALIFORNIA 92253
Owner
`.Tom & Susan Toles
Mailing 4$--100 Beverly Fir.
Address }
Cit!�.B. Zip 92260 Tel. 346-7767
Contractor I
,,Ira
T1 IeS
Address
same as above
P
State Lic. City
& Classif. B 3.59948 1 Lic. #
Arcn., tngr.,
Designer Jim Avenell
Address Tel.
64-2808
City Zip 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 -BUILDER DECLARATION
1 hereby affhyn that I am exempt from the Contractor's License Law for the following -
reason: (Sec. 7031.5,Busimess and Professions Code: Anycity 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 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 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 ($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 'reproves thereon and who does such work himself or through his own employees,
provided Nat 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 irnprove for the purpose of sale.)
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con►
strucl 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 L &'P.C. for this reason
Date OwnerJ�Giii rf'�
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.
CERTIFICATE OF EXEMPTION FROM
WORKERS'. COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars (S100) 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 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.)
Lenders 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
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number 77.3--262-048
Legal Description Lot 15 Block $i Unit 18
Project Description SFS%
Sq. Ft -No.
Size
No. Dw.
Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Pertik does
not include block wall
Or pool
Estimated Valuation
97,506.10
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
531..50
Const.
530.50
Mech.
49-00
Electrical
129.76
Plumbing
144.00
S.M.I.
9. Ria
Grading
20. 00
Driveway Enc.
r, .00
Infrastructure
1104.94.
Precise .y
a31
\t \
TOTAL
3644lSO' 3644.50
REMARKS
fifir`
}�
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. ® $
2ND FL SO. FT. ®
POR. SQ. FT. ®
GAR. SO. FT. ®
CAR P. SO. 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
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH) METER LOOP
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPIEQUIP.
LAUNDRY TRAY
AIR HANDLING UNIT ' r 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.
SO. FT. ® c
BATH TUB
FINAL INSP. �,
SO. FT. ® c
WATER HEATER
MAX HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1% c
SEWAGE DISPOSAL
REMARKS:
SQ.FT.GAR ® V4c
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PLCK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE Jn 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 APPIEQUIP.
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 �V t'7/
FINAL INSP. / ��
L 4
ROOFING / �]�
!�� _ ^ / r�p
J^ -32 e /
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
n
THING R01Cin
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTORS SiGNATURESfINI1111ALS
GARDEN WALL FINAL
j !
Y� -- 78-105. CALLE.. ESTADO' - LA 'QUINTA, CALIFORNIA. 92253 - (619) 564-2246
1�or 11tt, FAX (619) 564=5617 .
September 22, 1992
Riverside.County Assessor
46-206 Oasis Street, Room 406
Indio ,• CA' 92201
RE:- APN 773-2.62-008
Lot 15 Block 82
Dear Sirs.:,
Please be advised that the above,, referenced 'parcel number was
assigned an address -of 52-311 Avenida Ramirez We have change this'
address to read 52-380 Avenida Ramirez and°would appreciate you,
changing your records to reflect the same. :
Your prompt attention} to this matter will be appreciated.
Sincerely,
BUIAD ING AN S ETY DEPARTMENT
L PE.'Carl i
Counter Technician
/lc
cc,: Tom.& Susan Toles
MAILING ADDRESS P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253