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11216 (PLBG)Building 54770 RAMIREZ Address Owner JAMES LAIER Mailing Address SAME City Zip Tel. LA QUINTA 92253 Contractor RbBENS PLUMBING ' Address. AA—?AA ATIRMA UTgTA P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 City Zip Tel.: DESERT ROT 3 RINGS 92210 320-7318 State Lic. City & Classif. C36 610554 Lic: # 2387 ' Arch., Engr., Designer - PERMIT Address Tel. City Zip State for the alleged exemption: violation .of by applicant a permit subjects the applicant to a civil penalty'of not more than rive hundred dollars.($500).. Plan Chk. Bal.. Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 70 00) of Dlvi��i//ooff�. 3/of the Busingss and .P �ofess/ions Code; -and my license is in full force and ry effect. if,/Lfi'1. 4 L • lr-�f..t1�.ffF/" /"s�:9� �j No. 11216 LDING: TYPE CONST. OCC: GRP. P. Number Legal Description Project Description SEWER HOOKUP Sq. Ft. No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ -Demolition ❑ (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 mannei so.as to become subject to tfie,W,orkers' Compensation ' Laws of Californias ' ly/, Date 7,_-&) -X-Owner NOTICE TO APPLICANT:.If,Yalter 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. (Stec. 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 ZONE: BY: Minimum Setback Distances: Front Setback from Center Lin 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: OWNER -BUILDER DECLARATION' I hereby affirm that I am exempt from the Contractor's Lirense Law for the following Estimated Valuation $1,600 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 - PERMIT AMOUNT the provisions of the Contractor's License Law, Chapter .9 (commencing with Section 7000) of Division 3 of the Business and *Professlons- Code, or that. he is exempt therefrom, and the basis Any Section 7031.5 `any for Plan Cfk. Dep. - for the alleged exemption: violation .of by applicant a permit subjects the applicant to a civil penalty'of not more than rive hundred dollars.($500).. Plan Chk. Bal.. ❑ 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 of offered for sale. (Sec. 7044, t3uisness and Const.... 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, Mech. ' 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 Electrical of proving that he did not build or improve for the purpose, of sale.) O I, as owner of the property, am exclusively contracting with licensed contractors to con, Plumbing ee y 30.00 struct the project. (Sec. 7044, Business and Professions. Code: The Contractor's License Law does not apply to an owner or property who builds or improves thereon, and who contracts* for S.M.I. such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading ❑ I am exempt under Sec. B. 8 P.C. for this reason 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:) IN -1 } Policy No. Company sa rJ.it.jl7%u f '' ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. - TOTAL . $30.00 CERTIFICATE OF EXEMPTION FROM REMARK$ 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 mannei so.as to become subject to tfie,W,orkers' Compensation ' Laws of Californias ' ly/, Date 7,_-&) -X-Owner NOTICE TO APPLICANT:.If,Yalter 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. (Stec. 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 ZONE: BY: Minimum Setback Distances: Front Setback from Center Lin 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. r PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS SLAB GRADE 2ND FL. SO. FT. BONDING YARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. SQ. FT. GAS (ROUGH) DRAINAGE PIPING WALL SO. FT. OTHER APPJEOUIP. DRINKING FOUNTAIN. SO FT ® TEMP. POLE URINAL ESTIMATED CONSTRUCTION VALUATION $ GROUT WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES • WATER SYSTEM WATER SOFTENER VENT.SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP. 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, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER. B.T.U. SO. FT. ® c BATH TUB SO. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1% c SEWAGE DISPOSAL GAR. FIREWALL SO.FT.GAR ® 3Ac HOUSE SEWER LATHING 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 SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS AI EWER ORK ZOUGH e 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. 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 SIGNATURESIINITIALS GARDEN WALL FINAL t..� y;s` ... ... .,�. .._. - .. .f:T�`t'tsn*�ir�;:.'��.:�,`. �"7,�•,;Y��,.. •.:•- +";`:a:wwriW.� .y"y --"�•��'. 4 COACHELLA VALLEY WATER DISTRICT ' CASH RECEIPT DETAIL • r� `'6, Received From: Address: J'�� , • c , , } Account No. '�L� �3 1 `Ci- , 3 ) Tract Service Address _ G.A.Code r O Meter(s) t t '0 Services) 4�rk,s. + ❑ Backflow(8) - ^ + ;,' •' t ' "!.F� *ti ❑ HouseLateral(s) +' O Detector Check(s) ❑ MeterSurcharger �' • t , K; SanitationCapacity Charge 4 % dl3 . ' + ❑ _ W..S.B.F.C. (..• O Temporary Construction Meter ❑ Tum on Charge r, r . t-0 jficoltseted Acoount = Name r + r� * �.. •. rr •� i : , r'• ° x- ;' , a `,� 3 err Y `E �0;71ns.yp�eotiyon'Fee `Tract- ~ M g'J t .- kiL�1 i, iJ'- `^tw+G� f. .l 'Fee Ci , t*. , �• J f, '�.iR• 1a:.t^'7r.S`. }-•�.�,, - �� ,A :� _T _ , *' O Plan Check Fees Water /Sewer k- tJt Tract- �O "Bond Payment-A.D: - Bond Assmt. ' O Customer Deposit e �sP/��JI _ �i 4. 78-105 CALLE ESTADO - LA QUINTA, CALIFORNIA 92253,- (619) 564-2246 August 7, 1992 TO WHOM IT MAY CONCERN: Re: 54-770 Avenida Ramirez La Quinta, CA 92253 The above address was inspected and approved for sewer hookup on July 23, 1992 (please see enclosed permit). Sincerely, BUILDING/ AND SAFETY DEPARTMENT Ellie Shepherd Secretary LTRESO4 Enclosure: Permit #11216 MAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253