04607 (SPIN)-------- --- ---� - ---------------- 4
- - __-- _------ --
`04607 4 Q"
P.O. BOX 1504
Building 78 073 Calle Barcell0n* LA OUINTA CALIFORNIA 92253
-. Address _
Mailing
Address
City Zip Tel.
Lt Ouinta 92.253
Contractor
Zip I Tel.
State Lic. I City
& Classif. Lic. #
Arch., Engr.,
Designer
Address Tel.
CityI Zip I 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
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,8usiness 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 thathe 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).
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.)
❑ 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 or 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. B. 8 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
❑ Copy is filed with the city. O 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 ($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 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
BUILDING: TYPE CONST. OCC. GRP.
A.P. Number 769-153-005, 0061 0140 015
Legal Description
Project Description pedal XnmpeGtion
Sq. Ft.
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
,,.0,,,,
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
apt-valiA.L .tuX3 p>z+. GY.: Tri y I)V.00
�:Yfit?:d�'k'�i4tfj.� S3'1�{l' ffAlhi�bl.i�ti,�+=t•,: r,r. i''s
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, PINK - APPLICANT, GREEN - BUILDING, GOL0ENf100 - ASSESSOR'S OFFICE, HARD COPY - FILE'.T -.
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES -
NO. PLUMBING FEES
ISI FL- SO FT (a $
UNITS
SLAB GRADE
ROUGH PLUMB
BONDING
YARD SPKLR SYSTEM
2ND FL SO FT. a
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR SO FT. a
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR SO. FT. Qt
TEMP. POLE
GROUT
DRAINAGE PIPING '
CAR P. SO FT. 0
FINAL INSP.
WALL SO. FT. (d
WATER SYSTEM
DRINKING FOUNTAIN
GRADING
cu. yd.
$ Plus x$
_$
URINAL
SO. FT. fd
FINAL INSP.
FRAMING
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
WASHER(AUTOXDISH)
APPLIANCE DRYER
FIRE ZONE ROOFING
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FIREPLACE
LAUNDRY TRAY
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.
SO. FT.'RESID (d' 1I c
SEWAGE DISPOSAL
SO.FT.GAR (g 3/4c
HOUSE SEWER
FINAL INSPECTION
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 8 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 APP.IEOUIP.
REINF. STEEL
GAS-IFINAL)
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
Y A729 s a
r
9 78-073 Calls
owner
�1ltl�>`tt
Mailing
Address
City La Q Lets Zip 42258
Address
City
State Lic.
& Classif.
Arch., Engr.,
Designer
Address
• r t*y+' r � �` � I
... P.O. �x 1.504r � . t ��. .• A � . � . �, .
78-105 CALLE ESTADO '7
6110" LA OUINTA,CAUFORNIA102253 ` ,�?�`jy�aA
BUILDING. TYPE CONST.��-_,:OCC.-GRP.
A.P. Number,
Tel. Legal Desollpth>fl : m ' rte.
roject Description :ipttiQtl>Psaiial!
4"!
Tel. t•~�
LIC. !
City I
Zip jState
j Lic. N
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that t am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the aualness and Professions Code, sad ray license is in full force and
effect.
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors LbaMs law for the following
reason: (Sec. 7031.6,eusiess and Profession# Odds: Any O.Y Of county width noise w
pemW to consUuct. after. stprovo, demoksn, or repair any structure, puler to fb lnrusnos also
#apneas tie app.canr for own permit to No a statamwd OW he i! .cern- plrixont to
Xe pro 10= a the Conrractora lAensa L sw, rarS a fooamanche with Section 7600) of
Division 9 of fns IlusMess and Professions Code. or &W he Is wsampt tnwabom. Andel# boaw
for the Moped exemption. Any violation of section 7031.6 by any applicant hw a pwnit. .
smtyects lite appacwnt to •ora pwWfy A/ rat mon men Are frnahedvfo4ra f=6001.
O I. as owner of the property, or my employees with wages as their sok compensation, will
Ztsshe wont, andode: the structure knot Intended or offered for sale. fSoc. 7044, eulanses and
Pro/s/orha CThe Oontracor's License law does not sopfy to so owner of property oft
&Ads or nlorov'es Y weon and who sop such work Massif or Mrough Air own wnplorees,
proOded that such improvements we not btwhded of offered for sofa. ff, however, ft bY.drig
or krprovement A sol w.nkn are rev rml cnrtplsdorn, the ownsrouader w1 have VW Aurdsn.
of provkg tilt M dd nbt lar d or krprdro for tis Papoae of oak.) .
❑ 1, as owner of the property, am exclusively contracting with licensed contractors io con-
struct the project. (Sec. 7044, eusksas and Professions Code: flue CohdrociOry !�i taw ,
dose net sshp%Y tO an owner of property WOW buds or krproy" dwoon, and Who Ifo#
such proNcte rkn • oontrauor(a) licensed pwamt to, time Contractor's License Law.) .
O Pam exempt under See- A, a P.C. for this reason
Date -LAOwner
WORKERS' COMPENSATION DECLARATION
V"rshCoin
pan etion Insurance e+iwifiedcop thoreoto. (Sec.. 3 . Cod@J* o
Policy No Corwpany
O Copy -is filed with the city. ❑ Certified oopy Is hereby tumhhed.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
Oft section need not be cornpkted X tie paras# is for ane hums rd 11A (8100) vatmoon
or fess.)
1 esrtlfy that to the pedWhanoe of the cork for which this permit is Issued, 1 OW not
employ any fpez In any manner so as to become subject to the Workers' Oompsnsation
Laws of CaUt eernmla.
Date miner
NOTICE TO APPLICANT: X, ane h:hMkp Lida CwlNtraoe of Eiwrpdm you slrmN boom is
srgeet to me ftrurs. Conpensaflon vrorklons of .de Labor Codeyou met kmrfAwaN
carpy wen such trpvAbns or itch perm. SAM be downed rooked.
Sq. Ft. No.
Size Stories
1
1*l0: Ow.. .
Units r 'R
New O Add O Alter O
Repair O Demolition L'
Side Setback from Property Line
Larders Name
Lender's Address
FINAL DATE
INSPECTOR
This is a building permit when properly tilled out, signed and validated, and Is susyasct to
expiration It work thereunder Is suspended for 180 days. a
10/4
I certify that I have road this application and state that the above Information is correct
issued by:
Estimated Valuation.
1 spree to comply with al ttyy and county ordinances and state laws (elating to bullding
PERMIT^`
aMouNT
Validated by:
Pian Chk. Dep.,
Signature of applicant n.t.
Plan Chk:.8a1:
Mailing Add reu -,
Validation:
",Const.
City, State, Zip
Mach.
Electrical
WHITE - FINANCE, PINK - APPLICANT, GREEN -.BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE
Plumbing
S.M.I.
Brading y
rl
eFdv@Way Enc.
+
thfmstructufe
R
TOTAL.
REMARKS
r
ZONE 'BY:
Minimum Siptback Distances:
front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
I lereoy affirm that there Is a construction lendingaps ncy for the performance of the
work for wMch this permit Is Issued. (Sec, 3097, CMGbde•1
Side Setback from Property Line
Larders Name
Lender's Address
FINAL DATE
INSPECTOR
This is a building permit when properly tilled out, signed and validated, and Is susyasct to
expiration It work thereunder Is suspended for 180 days. a
10/4
I certify that I have road this application and state that the above Information is correct
issued by:
Date 8 Permit
1 spree to comply with al ttyy and county ordinances and state laws (elating to bullding
construction, and hegtp. &u mortze reprosontatives of this city to enter the abovb
mentioned property f purposes.
Validated by:
Signature of applicant n.t.
Mailing Add reu -,
Validation:
City, State, Zip
WHITE - FINANCE, PINK - APPLICANT, GREEN -.BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE
TWT 4 4(Q a"
78-105 CALLE ESTADO - LA QUINTA, CALIFORNIA 92253 - (619) 564-2246
October 10, 1988
Mr. Feldman
78-073 Calle Barcelona
La Quinta, CA 92253
Dear Mr. Feldman:
A special inspection was conducted at the above address to
assist in determining the feasibility of converting a single
family dwelling into a restaurant. The following observations
were made:
1. Existing masonry walls and chimneys must be verified to
contain reinforcement steel in order to resist damage
from seismic activity.
2. Handicapped access to parking, dining, sanitary, and
outside facilities must be provided per the State
Building Code.
3. All exiting must be made to comply with the Uniform
Building Code.
4. An adequately sized sewage disposal system must be
installed to service the new use. Riverside County
Health Department will determine size and location.
5. Fire resistiveness of existing walls must be made to
comply for the new occupancy through construction or lot
line adjustments. This would appear to affect only the
existing pool house and not the main structure itself.
6. Light and ventilation shall be provided as outlined in
Section 605 of the Uniform Building Code.
The general items listed above should be addressed in the
design phase `of the project. A complete plan check will be
done at plan submittal to verify compliance with the applicable
codes.
BJ/LTRTHIVR LONG ADDRESS - P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253
Should you have any additional questions or need clarification,
please contact the undersigned.
very truly yours,
MURREL CRUMP
PLANNING DIRECTOR
Tom Hartung
Building Official
TH:bja
BJ/LTRTH.023