12054 (SFD)Building
Address
Owner
i
P.O. BOX 1504
52--445 Bermudan LA QUINTA, CALIFORNIA 92253
S Development Company
mailing
Address P.O. Box 2657
City • Zip
Zia Quints., CA 92253
Conacorr
Sttracct06in no.meS
Address •
P.O. Bax 1657
city Quina, CA Z1p92253
Tel. '
564-5154
Tel.' 564-5154
& Classif. B1 642236 I Lic. #
Arch., Engr.;
Designer Studio 4^
Address Tel.
949, Uhlwrsity (910920-1159
City Zip State
Sam r Slto, Ck Lic. # '22044
I 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 licensees in full force and
effebtk
17
SIGNATURE 1 - 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 to a civil penalty of not more than five hundred dollars ($500).
❑ 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 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.)
❑ 1 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
❑ 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 ($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 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
No. 12054
BUILDING: TYPE CONST. OCC: GRP..-
A.P. Number 773.-27.5-020
Legal Description Lot 20 Black 103
Project Description SFD Plan 2
Sq. Ft.2722 No. No. Dw.
Size Stories Units
New ❑X Add ❑ Alter ❑ Repair ❑ Demolition ❑
Par:rtit 'doer. not include block walls or
pool.
Estimated Valuation
PERMIT
AMOUNT
Plan Chk.'Dep.
Plan Chk. Bal.
494.63
Const.
576.50
Mech.
62.00
Electrical
123.71
Plumbing
244.00
S.M.I.
8.60
Grading
20.00
Driveway Enc.
—0—
Infrastructure
l 0 913.47
Precise Pan
25.00
TOTAL
3,367.91
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:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
A.C. UNIT
y
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL. SQ. FT. @
BONDING
HEATING (ROUGH)
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
GH WIRING
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
FOUND. REINF.
GAS (ROUGH)
DRAINAGE PIPING
CAR P. SQ. FT. ®
HEATING (FINAL)
WALL SQ. FT. ®
REINF. STEEL
DRINKING FOUNTAIN
TEMP. POLE27,11
URINAL
SQ. FT. ®
GROUT
ESTIMATED CONSTRUCTION VALUATION $
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.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
LUMBER GR.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FRAMING�l y—��;LYS
LAUNDRYTRAY
AIR HANDLING UNIT CFM
�(ZHl (�2
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
FIREPLACE
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
-7
LATHING —13
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 Z/ PLUMBING ELECTRICAL HEATING 3 AIR GOND. SOLAR
SETBACKGROUND
PLUMBINGtlZT
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMSI 01V
SEWER _ZZ
GH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE27,11
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
$
GRADING
cu. yd.
plus x$
_$
LUMBER GR.
FINAL INSP.
a_57
FRAMING�l y—��;LYS
FINAL INSP. —1/40
g—�Q
�(ZHl (�2
/_ ,[jV�
140ROOFING
� VJ 1
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
-7
LATHING —13
MESH
INSULATIONISOUND6 Zq-93
FINISH GRADING
FINAL INSPECTION —
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
4
P.O. BOX 1504
No. 12054
Building 78-105 CALLE ESTADO
Address 52-445 Bermudas LA QUINTA, CALIFORNIA 92253
Owner
WES Development CompanyBUILDING:
TYPE CONST. OCC. GRP.
Mailing
Address P.O. BOX 1657
A.P.Number 773-275-020
_ City Zip Tel.
La uinta CA 92253 564-5154
Legal Description Lot
10 Block 103 .
' Contractor
Stockman Homes
Project Description SFD Plan 2
Address
P.O. Box 1657
City Zip Tel.
La Quinta, CA 92253 564-5154
State Lic. City
& Classif. Ell 642238 Lic. N 1534
Arch., Engr.,
Designer Studio 4
Sq. Ft.
Size 1471
No. No. Dw.
Stories Units
New IX Add ❑
Alter ❑ Repair ❑ Demolition O
Address Tel.
949 Universit (916)920-1159
Permit does
n include
CityZip State -
acramen O C Lic.q 22 44
001.
LICENSED CONTRACTOR'S DECLARATION
hereby affirm that 1 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
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, 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 laleged exemption. Any violation of Section 7031.5 by 'any applicant for a permt
subjects the applicant to a civil penalty or not more than five hundred dollars ($500).
O 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
Code: The Contractor's License Law does not apply to an owner of property who
builds or Iproves thereon and who does such work himself or through his own employees,
provided Mat such Improvements are not intended or offered for sale. ff. however, the building
' or ftrovement is sold within one year of completion, the owner -builder will have the burden
of proving Mat he did not build or improve for the purpose or sale.)
Estimated Valuation
PERMIT
'
AMOUNT
Plan Chk. Dep.
Pian Chk. Bal.
.
Const.Professions
576 50
Mech.
62 00
Electrical
Plumbing
O 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 Lew.)
❑ 1 am exempt under Sec. R. 8 P.C. for this reason
S.M.I.
Grading
Driveway Enc.
Infrastructure
1,91-4-47
Date owner
Precise Plan
25-00
WORKERS' COMPENSATION DECLARATION
hereby affirm that 1 have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3900. Labor Code.)
• Policy No. Company
O Copy is filed with the city. O Certified copy is hereby furnished.
TOTAL
311367-91
' CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
REMARKS
(This section need not be completed B 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: n, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply wfM such provisions or this permit shall be deemed revoked.
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, Civil Code.)
Side Setback from Property Line
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.
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.
FINAL DATE
Issued by:
Validated by:
INSPECTOR
Date Permit
Signature of applicant Date
Mailing Address
Validation:
City, State, Zip
FINANCE
t
f L1
I I I
I
OF
of 'Ila (Quinta
This. Certificate issued pursuant to the requirements of Section 306 of the Uniform Building!
Code certifying that at the time of issuance this structure was in compliance with the various.
the
'
ordinances of City regulating building construction or use. For the following:
I
j illi
;k
BUILDING ADDRESS 52-445 Avenida Bermudas
{
III�
ill
Single Family Dwelling 12054
Use Classification Bldg. Permit No.
'
R3VN
Group . Type Construction Fire Zone Use Zone SR
1 I
''
i
Stockman Homes P.O. Box 1657
Owner of Building Address
r
!
'
La Quinta CA 92253
City ' Lonnie Day
�I
Se tember 16 1993
Dote: P
-
�)
I I
Building Official
POST INA CONSPICUOUS PLACE
NAN N6
-