The URL can be used to link to this page

08155 (SFD)Building . Address 33-725 Retirw Owner JW Smith Mailing Address 0 VP. 11 m-mida4S City I Zip ITel. Cont City. lZip -State Lic. City Classif. Lic. # Arch., Engr., Designer Address Tel. City I Zip I State Lic. # 414 a P.O. BOX 1504 N o . 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 CP 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 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 construct, alter, 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). ❑ 1, 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.) ❑. 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 notapply to an owner of property who builds or improves thereon, and who contracts for such projects. with a contractor(s) licensed pursuant to the Con/r..n ' License Law.J O 1 am exempt under Sec. B. & P.C. for thi t s� Date f "Owner/d.a 1[/'" WORKERS' COMPENSATION DECLARATION 1 hereby affirm that I have a certificate of consent to self insure, or a certificate of .Worker's Compensation Insurance, ora 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'COMPENSATIONINSURANCE (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 Exemptionyou should become subject to the Workers' Compensation provisions or the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Ihereby 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 t Lender's Address This is a b0llding 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 -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.: P. Number 774..191.. 0815 Legal Description Project Description Otinglcr. Gtamll3 MM114EW Sq. Ft. 17M No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ r Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. 250.00 Plan Chk. Bal. 285.40 Const. 525.00 Mech. 75.00 Electrical 134.73 Plumbing 145.50 S.M.I. 5..73 Grading 20.00 Driveway Enc. 20.00 Infrastructure 2.129.38 h• , TOTAL 3693.80 34.43.80 REMARKS a`•Y�� r. r w .w - .o ... ,.. 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 6125190 Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. $0. FT. ® $ UNITS ROUGH PLUMB. 2ND FL. S0. FT. STORAGE TANK YARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS OTHER APPJEOUIP. REINF. STEEL DRAINAGE PIPING CAR P. I SQ. FT. GROUT WALL SQ. FT. SERVICE FINAL INSP. DRINKING FOUNTAIN. SQ FT ® WATER SYSTEM FINAL INSP. URINAL ESTIMATED CONSTRUCTION VALUATION $ LUMBER GR. WATER PIPING NOTE: Not to be used as property tax valuation /, 7/c f%�`�GY/ �l FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FIRE ZONE ROOFING GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FIREPLACE LAUNDRY TRAY AIR HANDLING UNIT CFM SPARK ARRESTOR 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 SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR ® V4c HOUSE SEWER FINAL INSPECTION % 9� 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 PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR 11 SETBACK b% QQ GROUND PLUMBIN � I'd UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE 8 yt% ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING. DUCT WORK ROCK STORAGE FOUND. REINF. 6g GAS JROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE 7 ZS GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM FINAL INSP. GRADING FINAL INSP. k7 (f'� cu. yd. $ plus x$ =$ LUMBER GR. FRAMING // ROOFIN /, 7/c f%�`�GY/ �l �/J�/fjf� /� C Qn /�i — REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING M,✓ MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION % 9� CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL )DESERT SA IDSA NIF:IED SCHOOL DISTRICT x 82 879Highway 111 ° NOTICE:, ry Indio,,CA #92201. f s Document Cannot Be"'Duplicated (619)' 347-8631 Date 7/Ifi/90y` Type`ofP.ermt La uinta. No. 10037 Permit It Log # Owner Name J.W. Smith 4. No. Street -See Below qty La Quinta zp < '92253 stuay area .111 APN'fact "6 Lot #' Square Footage134M Type of Development Single Famrly lRn eS dece No. of unite Comments a -;-w -' • : ; . � � � t4�.; _ . .5X;725 R_m1 aiaj 5i=7�5=Ramirez At the present time, the Desert Sands1Unifi6dtSchoo1 District does "not. fees on garages/carports; covered patios%walkways; residential'additions under.500 square feet, detached' accessor-y:.structures or,:replacemeiit mobilelomes: 'It liasbe'en.determined the above-named.owner is exempt,from p4yin-6 khobl-fees -at, this.�time due to the following reason: EXEMPTION NOT APPLICABLE This certifies .that school,fac ility fees unpose ij pursuant to, Government Co& &080 in the amount of: : X 433 n ar $ 5,42414 have been 0� �i, paid to D.SU:S.D. for ., h pe - s,aiicUor Certificates of Oocu • the property fisted above, and that buil panty, for qu this s 00tip in this proposed Prof ectmay.howrW.issued. ` .,t Fees Paid By eJ.W.":Sm- ith`.and- Assoc:',"Inc. Telephone 564-1899 Name on the check By John D: -Brooks-.: , Associate Superintendent, Business services" ' .,;.' Fee couected /exempted' by:- -'Shelley D: Berri"ett ,.viyment,Re�eivFcl- . Signature C:leck No. 005 T �.. Collector: Attach a copy of County or`City plan check :apphcagon form tOIMAirict'copy. Embossed Original- Building NPUApplicant :Copy Applicant/Receipt 'Copy -Accounting COACHELLA-VALLEY.'WATERPISTRICT�' CASH RECEIPT DETAIL N2