0004-187 (SFD)P.O. BOX 1504 78-495 CALLE TAMAMPICO
LA QUINTA, CALIFORNIA 92253
TEL 760-777-7012
INSPECTION REQUEST,": -
760 -777-7153
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INSPECTION RECORD
OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR
BUILDING APPROVALS MECHANICAL APPROVALS
ter- et f3aeksI Underground Ducts
Fpirrt5 g Foo{in[js
Ducts
�1ab Gracie
Return Air
Electric Bond
steel
Combustion Air
(FW[Et S
�•toof Deck dz%P
Exhaust Fans
z.K. to Wrap - -OfJ CE
F.A.U.
;gaming 7
Compressor
Equipment Location
insulation
Vents
fireplace P.L.
Grills
Virep!ace T.O.
Fans & Controls
!
party Wall Insulation
Condensate Lines
Gas Piping
Darty Wall Firewall
PLUMBING APPROVALS
C-Aeriol• Lath
[7rvwall - Int. Lath _
Filial
POOLS -SPAS
BLOCKWALL APPROVALS
steel 1
met Backs s
Electric Bond
(FW[Et S
Main Drain
Bond Beam -
Approval to Cover
Equipment Location
i
Underground Electric
Underground Plbg. I est
!
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Vlfater Piping
Plumbing Final
Plurnbing Top Out
Equipment Enclosure
5hovrer Pans
O.K. for Finish Plaster
Laii w
mini Cuvei
5ewerColsnecftan y5 Da
Encapsulation
Test
Final
COMMENTS:
Final
Lltllty Notice(Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit I
Low Voltage Wining
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp Use of Power
Final
Utility Notice (Perm)
Building
Address
Owner
V YY1(� i L .► � f
Mailing n O�
Address
r—iClty � � Z� Z
Contractor
Address -" -
t -A- s At,
ty lZip
z
:9.cti"•;,',^.!:"t.X`-�v.:-".�:'.���-�-�-"L',� "`a F•e"`r'C",:'S`'•:iS'�+e:
�f''P`O�rBOX 1504 APPLICTI ONLY
-11849t CALLETAMPICO
N (%„ LA QUINTA,CA}LIFORNIA 92253
j
BUILDING: TYPE CONS-T.t L j OC FIR
C� A.P. Number _ -1 `moi — Z-1 a— OZ3
Tel. (�L �� ^�
3q � . Z�Z(� Legal Description /0 � i Z c ,7 Z�� � L`'F
State Lic.,,LIo #
cpr-
& Classif.j- S3 '73 3 3
Arch., Engr.,
Designer
Address Tel.
CityI Zip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm -that I am If under provisions of Chapter 9 (commencing with action
effect.
the Business d Professions Code, and my license is inffulJ/6rcAe_and
effect. � � �V
SIGNATURE I -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 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 toa civil penalty of not more than live hundred dollars ($500).
I.: 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.)
IA 1, 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.)
I"! I am exempt under Sec. B. & P.C. for this reason
Date Owner
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
r:l 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 (SI00) valuation
or less.)
I certify that in the performance of thF 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
Project Description
Sq. Ft.�� No. I
Size Stories /
No.�Dw.
Units
New` Add ❑ Alter ❑
Repair ❑ Demolition ❑
r
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
,TJ/
flu
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
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:
WHITE = FINANCE .' YELLOW = APPLICANT PINK = BUILDING DIVISION
x t'Sa ds`Ufiifaed Schoo1!.District
Y iDeser47950=Dune
Nohce Palms'Itond'
_., _ S filJa Quenta,:�C�i 92253
Document•Can_not Be Duplicated 760 771' SSiS Y
rCERTIFICA'fE ®F COIVIPLIANCE.
IDate'v 5/2/00 ,: 'APN # 774-243=0:10,
No. 20381: ;` ; r Jurisdiction La Quinta
,Owner NamelGlturiliil,.Inc. } ' Permit #
No 54-465,street Avenida Rarriir'ez � ; c • Log #
City La Quinta ,iip 92253 Study,Area
~' Tract # Lot #: ! Square Footage 15.50
Type of Development . Single IFAriily Residence,. No. of Units 1
Comments
At the present time, the. Desert'+Sands Unified School; District, does not-collect fees on+:garages/carports„ covered
patios/walkways, residential additions under 500 square feet, detached'::accessorystructtuesorreplacement mobilehomes. It
has been determined the above-namedowneri .e'x-e— ;from,pay<ng school fees`at this time du'e to.ti a following reason:
r t t
• � ` 1. "
EXEMPTION N AP BL,
t
This certifies that school facility fees unposed ptarstiant to y Government Code 53080 x • in-the amount of
,{
2.05. X 1,550 's� or,$ 31177,50 a w< 'the;propertyaisted;above and that'building
permits and/or Certificates of Occupancy for'this square footage m,this proposed.project;may now be issued
Fees Paid By. CC/Vgq.Independent Bank ° Bill Howard . Telephone .340-2726
Naine:on thiihcck
By Dr. Doris Wilson-
Superintendent' *-
Fee collected /exempted,by ° Ellen Patnio t:. Payment Received 1'77.S0'
:'. Check No. 222503 .
Signature r j SL
�r
NOTICE:. Pursuant of Assembly; Bill 3087 (CHAP-546STATS .•1998) this;will serve ton yo„ u.at the 90 day approval period in:whicn you may; pmtest the fess orotI I payment.identifled
above will begin to run from; Ire date on which the'Owidmg or;instellatlon:pennit for this project is essued:oron which'they.are paid to the Distnd(s) or to another public entity'authorized to
collect them on the District(s)(s'),bepo,,°whicheveris'eanier.
I
.Collector: Attacli a copy of county or city"plan check application .form to `district copy, for all waovers.
Embossed Original- 'Building DeptJApplicant .N Copy,Applicant/Receipt Copy Accounting
c
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CALIFCM41A cC5Z��TION
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-774-243--ULO, 011_022 6 023
j.,,nua,ry 24. 1989
STATT OF C'�b?M�ES
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(i d' 3-1111 OT315
RC DISTRICT ,-PLANNING I2EVIFEW- FORM
This form is to be used by -Q, staff for reView of single family dwellings, in the RC (Cove Residential)
District, in order to determine theTapplicability. of compatibility: issues or,need to'require the f ling of Master
Design:Gu delines by the'applicant. It shall be`trar smitted,to"the�Building and Safety Department as your
correction list. Please attach additional explanations as necessary:
APPLICANT ' MUMBIL-, I•NC
SITE ADDRESS 54-46,5 Avenida ;Ramirez,
APN 774' - ' '243 -0 2 3' BIN. NO .`l <�.-. -CASE NO::' 2000-213
-
LEGAL: LOT 12 •,BLOCK 2gg - UNIT 26 S.C.@V.L.Q.
Y:
CHECKED`.BY: Start, Sawa DATE:
Inform the assigned Building' plan checker .uponi your. assignment•.to this case. The CDD Executive .
a . ire ?. r f F
Secretary maintains a logbook to track applications an&a-ssign case numbers'..
REQUIRED ITEM
Y
N"
COMMENT/CORRECTION
Compatibility Review
Case logged and number assigned.
, =
Verify legal and"APN infurnatiop
Consistent with MDG oi,i fiie'(as..•applicable
MDG filing tequired (5 filings since.9/3/98) '
x
Consistency with:street/surrounding area:
(y
Colors4
4
Materials
/' I
rr
Architecture
Other
Requirements:
LPIl�c1
.-
µ
rC -
QQ r.
OO
It
J
Certificate of Occupancy
City FL a Quints
Building and Saf0*D', epartment
This Certificate issued pursuant -to the requirements of Sectioii `109,of the Uni€orm. Building
certifying}ttiat, atthe'time of issuance, this, structure was in comp/lance with the "various ordinances
of the Cif re `u/atin bui%dm construction use. For: f/ie=fol%win
Y 9 g� g.. ;r 9�
`BUILDIN.G ADDRESS: 54-465 AVENIDA RAIVIIR'EZ
Use Classification: SM'",Bldg. Permit'No" •- 0004--1.87
OccugancysGroup: R 3'' Type of Construction: VN Land Use :Zone:. RC ;
` Owner of 'Building: MUMBIL, INC. Address: 74-990 JONIDRIVE # 2-D. \
City: PALM DESERT; "CA 762260
Y
By: STEVE- TRAXEL }
Date: 09-21-00
Building Official
POST IN A CONSPICUOUS PLACE `'Ol,