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9447 (RPL)44 P.O. BOX 1504 No. 9447 Building78-105 CALLE ESTADO Address 52-695 Bermudas LA QUINTA, CALIFORNIA 92253 Esperanza Torres BUILDING: TYPE CONST. OCC: GRP. Mailing Address same A.P. Number City Lat�uinta rlpTel- 92253 Legal Description Project Description ONLY Contractor Western PoolsPOOL Address P. a. Box 1047 City Indio Zip 92291 Tel.: 347-5959 State Lic. City & Classif- C53 348768 Lic. # 1151. Sq. Ft. No. No. Dw. Size Stories Units Arch., Engr., Designer- - New ❑ Add ❑ Alter ❑ Repair ❑ -Demolition ❑ Address Tel. City Zip State Lic. # • LICENSED CONTRACTOR'S DECLARATION 17n, reby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Prrofessions Code, and my license is in full force and effect. ,lSIGNATURE 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, after, 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 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 or not more than rive 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 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 Nat such kmprovements,are not intended or offered for safe. 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 or 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.) O 1 am exempt under Sec. B. & P.C. for this reason Estimated Valuation 7 = 500.00 PERMIT AMOUNT Plan Chk. Dep. , Plan Chk. BBI. C ,��y1 9y 6 `7t ..7 Const. 99 . 00 Mech. 27.00 Electrical 30.00 Plumbing 21.00 S.M.I. .56 Grading 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 Workers Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No Company [XCopy is filed with the city. ❑ Certified copy is hereby furnished. _ + 1f�1J i. �^ "� lJ6l :l X'•" 1 4 ' �l�i� T i $ TOTAL 141'.91 CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE REMARKS +, (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: ft, after making this Certificate of Exemption you should become subject ,lo the Workers' Compensation provisions of the Labor Code, you must forthwith comply with 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 FINAL DATE INSPECTOR 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. 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. 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 COLL. AREA 2ND FL. SO. FT. ROUGH PLUMB. YARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. SO. FT. DUCT WORK DRAINAGE PIPING WALL SO. FT. GAS (ROUGH) DRINKING FOUNTAIN. SO FT ® HEATING (FINAL) URINAL ESTIMATED CONSTRUCTION VALUATION $ GAS (FINAL) WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER HEATER WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER WATER SYSTEM GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED GRADING cu. yd. $ plus x$ 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 FIRE ZONE ROOFING: SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/. c SEWAGE DISPOSAL SO.FT.GAR ® 3/ac 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 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 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 /✓� (� Q 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 T4hf 4 a9boL Building Address Owner {fIFP_AA/ZA O. Tnr2iZCS Address City Contractor - Address _ �!J Zip Zip ` Tel. ' ( Legal Description °f ,�nc.k �S� G{A•t t f,i Project Description f'//F7 State Lic.///+++ City & Classif. �!"�FQ 47�D A 1 Lic. # /f/a-/ Arch., Engr., I Designer Address Tel. CityI Zip I State I Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under ovlsions of Chapter 9 (commencing with Section 7000) of Division 3 oylhe Business ander fesslons Code, and my license is in full force and effect. ///!/ SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby afflrm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Bu8 iness and Professions Code: Any city or county which requires a permit to construct, atter, 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 the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) or Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis for the alleged exemption. Any violation or Section 7031.5 by 'any applicant for a permit subjects the applicant to a civil 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 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 or 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 orimprovement 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 or 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. ti P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION 1 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 O 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 parson in any manner so as to become subject to the Workers' Compensation lbws 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 it 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 DIVISION 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: Sq. Ft.+� p Size /M •�/J No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation U 7 PERMIT AMOUNT Plan Chk. Dep. _ Plan Chk. Bal. Const. 6Z Mech.. Electrical Z. 3-3 Plumbing , fp S.M.I. Grading 20— Driveway Enc. 210 — I frastructure 0�6 Y.02. 2 • • `t0 TOTAL --� REMARKS CRs -) sn PQJA Ai -09-9i t(1 i0 _ _CASH I TUTAL I 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 IST FL. SQ. FT. ® $ SLAB GRADE UNITS BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK YARD SPKLR SYSTEM FOUND. REINF. 2ND FL. SQ. FT. @ METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE MOBILEHOME SVC. GROUT BAR SINK SERVICE POR. SO. FT. ® BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ GAR. SO. FT. ® POWER OUTLET FINAL INSP. ROOF DRAINS FINAL INSP. ROOFING DRAINAGE PIPING REMARKS: CAR P. SQ. FT. @ VENTILATION WALL SO. FT: FIREPLACE DRINKING FOUNTAIN SPARK ARRESTOR URINAL GAR. FIREWALL SQ. FT. ® LATHING ESTIMATED CONSTRUCTION VALUATION $ MESH WATER PIPING �+ NOTE: Not to be used as property tax valuation FINISH GRADING FLOOR DRAIN MECHANICAL FEES CERT. OCC. WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN INSPECTOR'S SIGNATURES/INITIALS WASH ER(AUTO)(DISH) APPLIANCE DRYER GARDEN WALL FINAL GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY. AIR HANDLING UNIT CFM KITCHEN SINK A 2 ABSORPTION SYSTEM. B.T.U. TEMP USE PERMIT SVC WATER CLOSET 2 COMPRESSOR HP POLE, TEMIPERM ai LAVATORY ^ HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SQ. FT. ® c BATH TUB 2 r SQ. FT. ® c WATER HEATER 7 529 MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER GAS PIPING PERMIT FEE / PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.F 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 SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. 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 INSULATIONISOUND FINISH GRADING 1 FINAL INSPECTION CERT. OCC. FENCE FINAL 1 INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL DESERT SANDS UNIFIED SCHOOL DISTRICT 82-879 Highway 111 NOTICE: Indio, CA 92201 Document Cannot Be Duplicated (619) 347-8631 Date 1/14/91 1 Type of Permit I La Quinta No. 110370 Permit # Log # Owner Name Esperanza O. Torres No. 52695 street Avenida Bermudas city La Quinta zip 92253 Study Area 112 APN # 773-305-022-1 Tract # Lot # Square Footage 11738 Type of Development Single Family Residence No. of units 0 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 accessory structures or replacement mobilehomes. It has been determined the above-named owner is exempt from paying school fees at this time due to the following reason: EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of 1.58 X 1738 or $ 2,746.04 have been paid to D.S.0 S.D. for the property listed above and that building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued. Fees Paid By Alex O. Torres Name on the check By Richard M. Beck Director, Facilities Planning & Development Telephone Fee collected /exempted by Shelley D. Bennett Payment Received '= as,.4� z4 Signaturezim Chuck No. 1674 Collector: Attach a copy of County or City plan check application form to'District- copy. Embossed Original- Building DeptJApplicant Copy - Applicant/Receipt Copy- Accounting