06874 (SFD)Building
Address 52-025 Berilmulas
Owner
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Address
City Zip Tel.
Contractor
No. 06874
JILDING: TYPE CONST. - OCC: GRP.
P. Number »3-235-013
Legal Description
Project Description 3FD
City
Zip
Tela
State Lic. 398519
& Classif.
City
Lic. #
17)7
Sq. Ft.
No. No. Dw.
Size
Stories Units
Arch., Engr.,
Designer
New ❑ Add ❑
Alter ❑ Repair ❑ 'Demolition ❑
Address
Tel.
City
Zip
State
Lic. #
C`
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am'licensed under provisions of Chapter 9 (commencing with Section
70(!p) of Division y3Of the Busineswand Professions Code, and my license is infull forceand
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
Estimated Valuation
�9s755
PERMIT
AMOUNT
permit to construct. after, 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 vitiation of Section 7031.5 by 'any applicant for a permit
subjects the applicant to a avB penalty of not more than rive hundred dollars ($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will
Plan Chk. Dep.
$250.00
Plan Chk. Bal.
270.28
Const.
2.50
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
Mech.
53.50
builds or irproves thereon and who does such work himself or through his own employees,
provided that suchrrprovemments are not intended or offered for sale. If, however, the building
or improvement is sod within one year of completion, the owner -builder will have the burden
of proving that he did not build or inprove 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 of property who builds or improves thereon, and who contracts for
Electrical
118.36
Plumbing
157.50
S.M.I.
6.58
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec B. & P.C. for this reason
Grading
20.00
Driveway Enc.
20.04
Date Owner
Infrastructure
2,0171.2
WORKERS' COMPENSATION DECLARATION
I hereby affirm that 1 have a certificate of consent to self -insure, or a certificate of
Workers Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
O Copy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL
$3,579.98
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.
REMARKS
xvt- JaH 1 I U f t:i_ 3 J'2`'7
Date Owner
NOTICE TO APPLICANT: U, after mating 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 Oft permit shall be deemed revoked. a
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Cita code.)
Side Setback from Property Line
Lenders Name
FINAL DATE
INSPECTOR
1,t !�
s /
Lenders 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.
1 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.
Issued by:
Validated by:
Date Permit
Signature of applicant Date
Mailing Address
Validation:
City, State, zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL SO. FT. ® $
UNITS
SLAB GRADE 1
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL SQ. FT. g
FORMS
SEW
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
GAS (ROUGH)
METER LOOP
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. SQ. FT.
GROUT
WATER HEATER
WALL SO. FT.
FINAL INSP.
DRINKING FOUNTAIN
SQ FT ®
WATER SYSTEM
URINAL
ESTIMATED CONSTRUCTION VALUATION $
=$
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP. 6 7 0
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
VENTILATION
LAUNDRYTRAY
AIR HANDLING UNIT CFM
FIRE ZONE ROOFING,
KITCHEN 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
LATHING
SQ. FT. ® c
WATER HEATER
MAX HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/4c
HOUSE SEWER
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 1�1ROUND
PLUMBING2//3 (pQ
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE 1
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEW
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.y% O
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. 6 7 0
FRAMING / 90
FINAL INSP.
ROOFING 3 /� �O
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
OF
SCHOOL FACILITY FEES
TO: City of La Quinta DATE:
Department of Community Development
CLU
tLaAJ
UDit
78-105 Calle Estado
La Quinta, CA 92253 NOTICE: THIS ®OCUR1ENT CANNOT
BE DUPLICATED
This is to certify t at - c, ,
developer of which is
located at - (/ within
this District, has paid school facility fees imposed pursuan to the
authority generated by G ernment Code Sec iost 53080 in the am;
nt of
covering a total of square feet.of ( ) re idential or
( ) industrial/commercial development and that building permits for
this footage in this development may now be issued by your jurisdiction.
`V
cc 712 r /
for DESERT SANDS UNIFIED SCHOOL DISTRICT
White - Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer
(10)-37
49613 Highway 86, Suite B12
Coachella, Ca. 92236
A '� t 1 (619) 342-8291 g0
� zi CASE No. (� -
DATE
DEVEIAPER' S NAME: Y . ` {M e C' "IAA
ADDRESS: q(;) -,s( t /0 � !`cam ; "1 10'
D2
C 'ice '_ 1✓ C C r�
TELEPHONE:
Dear Developer:
After reviewing your landscaping plans, all plant material listed is not in
violation of quarantine laws governing the Coachella Valley. If substitutions
do occur and they differ from plant material listed, this office must be notified
immediately.
Thank you for protecting and preserving the Coachella Valley's pest -free environment.
Agric al Carmissioner's Office
cc: Indio and Riverside Office
7,ffi
e,
OFFICE OF
o'
'
AGRICULTURAL COMMISSIONER
e
V
'
AND
�''� �•'
WEIGHTS & MEASURES CALVIN C. KAMINSKAS
JAMES O. WALLACE
4080 LEMON STREET, ROOM 19 Assistant Commissioner
Agricultural Commissioner
RIVERSIDE, CALIFORNIA 92501 CLEMENT BENVENISTE
Director of Weights & MeasuresSealer
(714) 787-2561
49613 Highway 86, Suite B12
Coachella, Ca. 92236
A '� t 1 (619) 342-8291 g0
� zi CASE No. (� -
DATE
DEVEIAPER' S NAME: Y . ` {M e C' "IAA
ADDRESS: q(;) -,s( t /0 � !`cam ; "1 10'
D2
C 'ice '_ 1✓ C C r�
TELEPHONE:
Dear Developer:
After reviewing your landscaping plans, all plant material listed is not in
violation of quarantine laws governing the Coachella Valley. If substitutions
do occur and they differ from plant material listed, this office must be notified
immediately.
Thank you for protecting and preserving the Coachella Valley's pest -free environment.
Agric al Carmissioner's Office
cc: Indio and Riverside Office