04250 (SFD)TAh
, t44Q
P.O. BOX 1504
Building 52-900 ftntirea 78-105 CALLE ESTADO
Address ' "LA QUINTA, CALIFORNIA 92253
Owner - I I
Coachel. 1a Valley brand Co.
Address 247 E. Tailetuits Way. 02
City Zip Tel.
Fnlm':=ings 92262 322-1020
Contractor
Address
Zip I Tel.
. Larc �1%1. ! i3 v,ay
& Classif. Lic. # 9
Arcn., tngr.,
Designer
Address I Tel.
City lZip ( State
` Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under -provisions of Chapler1(commencing with Section
7000) of Divislor 3 of the Business and,Prr`ofessiohs C,oddpMaind my license is in full force and,
effect.
SIGNATURE le / <DATE
OWNER -BUILDER DECLARATION
I,hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sac. 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
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 allegedexemption. Any violation or Section 7031.5 by 'any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
0 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.)
0 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.)
0 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consen!�,.totlelf-insure, or a certificate of
Worker's Compensation Insurance, or a certified copy tfiere'ofN(Sec. 3800, Labor Corte.)
Policy No. Company"�-
❑Copy is filed with the city. O Certi:copy is hereb`yfuni
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars (5100) 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 Address
City, State, Zip
04250
BUILDING: TYPE CONST. OCC. GRP.
A.P. Number 773-323-008
Legal Description
Project Description .' . •
Sq. Ft. 14 10
Size
No.
Stories
No. Dw.
Units
New 0 Add O
Alter 0 Repair 0 Demolition 0
Carmcfe 426 °
Pence 1741
Estimated Valuation
$75t505
PERMIT
AMOUNT
Plan Chk. Dep.
$250.00
Plan Chk. Bal.
$ 39.14
Const.
364.00
Mech.
33.00
Electrical
74.17
Plumbing
105 , 00
S.M.I.
..
Grading
20 00
Driveway Enc.
2U.00
Infrastructure
. U6
TOTAL
ow. sbu .J.I
REMARKS i x
�1.11' a it"t)1' f'ti� t't,'# "i1jc:f, . RT to
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 17 6ET8O8R
Issued by: Date Permit
Validated by:
Validation:
WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL SO FT (p $
UNITS
COLL. AREA
2ND FL SO FT. a
YARD SPKLR SYSTEM
POR SO FTa
MOBILEHOME SVC.
BAR SINK
GARSO. FT.
POWER OUTLET
ROOF DRAINS
CAR P. SO FT. is
DUCT WORK
DRAINAGE PIPING
WALL SO. FT. /d
DRINKING FOUNTAIN
SO. FT. rd
HEATING (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WAS HER(AUTOYDISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GRADING
cu. yd.
$ plus x$
LAUNDRYTRAY
AIR HANDLING UNIT CFM
IKITCHEN 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
VENTILATION
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 1Ii. c
SEWAGE DISPOSAL
FIREPLACE
SO.FT.GAR @ A:c
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.PEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB FEE
STRUCTURE PLUMBING ELECTRICAL HEATING 8 AIR COND. SOLAR
SETBACK
,ROUND PLUMBIN Q-
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 APP.IEOUIP.
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.
/O
ROOFING C
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR'
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIAlS
GARDEN WALL FINAL
'
Desert Sands Unified School District
CERTIFICATION OF PAYMENT
0
NgIC.E: THIS D0CUMENTE�,bIwr�
LITY FEES �1
BE OUPUCAT ED.
TO: City of La Quinta DATE:��-
Department of Community Development
78-105 Calle Estado
La Quinta, CA 92253
This is to ertify that G ti
developer of r which. is
located at — pp within
this•District, has paid school faci ity fees imposed pursuant to the
authority p generated v nment de Sectio -n5530 0 in the amount of
covering a total of /<f/O y-/_�409 square feet of (L_-),--residenti " or
.( ) industrial/commercial development and that building permits fcr
this footage in this development may,now be issued by your jurisdiction.
-for DESERT SANDS'UNIFI SCHOOL T
White - Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - De,.eloper
Q1007
F R 1 \ OI f If E OF E. LEJN SI'AUGY
AGRICULI URAL_ CONIMISSIONLtt JAMIE O WALLACE
J �. �) ��. AND
ASStStX I r�) IMISSlO'SEr.
O �VLIGI ITS S Fi NIC/�SURLS CLEMENT BFNVE:�ISIE
v n
[ S ... Stalin
49-613.11wy $6, Suite 11-12
��,_ .•'� Uunchel.ln, 6 9223E
Mq 619-342-8291
D11TE 2 8 sip' ` ME rte. 99 n S OC 2-0 C
DEVELOPER'S 14AME:
ADDRESS I Li £.' � w �
2 2.
TELL•NIONEt 322 - 'La
--roe
Dear Developers,
After reviewing your landscapi.ttg plans, X11 plant ttaterial listed is r►ot it'
violation of quarantine.laws govertlittg the Coachella Valley. IE _substitutions
do occur and they differ (run plant in-aterial listed, this office innist be notified
ittiinediately.
Thank you for prvtecthIg and preserving the Coachella Valley's pest -free enviroment.
Agricultural` Camu ssi I is UL f ice
cc: Indio and Riverside Office