Loading...
15244 (PLBG)Ci/QNq� /�Vr� -a� �,.r2ecT yi9Q� P.O. BOX 1504 Building >z 78-495 CALLE TAMPICO Address '�Z" � Ave'. BeriitLti�FtS LA QUINTA, CALIFORNIA 92253 Owner k B. White Address SaML City LSI Qui nta r CA Contractor Econo Address 92253 CityZip Tel.: Falco Dessert, Ci 92261 346 -2793 State Lic.: ,,, `�nR6� City 342 & Classif.. Lic. # Arcn.,-tngr., Designer " Address Tel. . City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm tham licensed under provisions of Chapter 9 (commencing with Section 7000) of Divisjon 3 ,.ihe Ousiness and Professions Code, and my license is in full force and X OWNEWBUILDER DECLARATION I hereby affirm that I ap exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Bus6ress 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 or 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 penally of not more than rive hundred dollars (5500). O 1, 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 inproves thereon and who does such work himself or through his own employees, provided that such improvements are not intended or oNered.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 contractors) jicensed 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 the work for which this permit -is issued, I shall not =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 subjectto the Workers' Compensation provisions of the tabor Code, you must forthwith comply with such provisions or this permit shalt be deemed revoked. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. This is a building pernit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certify that.l 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. 150A A BUILDING: TYPE CONST. - OCC. GRP.: A.P. Number Legal Description Project Description Sewe Connect Sq. Ft. -Size No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $900.00 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing 30.00 S.M.I. Grading Driveway Enc. Infrastructure TOTAL 30.00 REMARKS ZONE: BY: Minimum Setback Distances: Front Setback frorfl Center Line Rear Setback f �In e r PProp. Line Side Street S b k from Center Line Side Setb4d m Pr p6 Q'Line_ FINAL DA CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBIWU FEES 1ST FL. SO. FT. ® $ UNITS COLL. AREA SLAB GRADE ROUGH PLUMB. YARD SPKLR SYSTEM 2ND FL. S0. FT. STORAGE TANK FORMS MOBILEHOME SVC. BAR SINK POR. SO. FT. ® ROCK STORAGE GAR. SO. FT. ® POWER OUTLET ROOF DRAINS HEATING (FINAL) DRAINAGE PIPING �- CAR P. SO. FT. ® GAS (FINAL) TEMP. POLE WALL SO. FT. ® DRINKING FOUNTAIN SO. FT. ® WATER HEATER URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation WATER SYSTEM FLOOR DRAIN MECHANICAL FEES x$ _$ WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED REMARKS: LAUNDRY TRAY AIR HANDLING UNIT CFM 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 SO. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR ® 3/ac HOUSE SEWER MESH 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 s HEATING (ROUGH) STORAGE TANK FORMS < SEW' ORS ( 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. f1n FINAL INSP. FRAMING FINAL INSP. /' �sl ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL r COACHELLA VALLEY WATER DISTRICT CASH RECEIPT DETAIL 1 •� C Received From:Vvi � Date* Address: (? `>> n •/ + el .1._ �� �. � � ! >es P : /'7t--C Account No. Lot(s) Tract :x Service Address �� � TTS/ r, r �We, L'4 .A. Code 7J i _ - ❑ Meter(s) $ ❑ Service(s) ❑ Backflow(s) ' ❑ House Lateral(s) ❑ DetectorCheck(s) ❑ Meter Surcharge 01 -Sanitation Capacity Charge �1 I �(�'s1 UJ ❑ W.S.B.F.C. ❑ Temporary Construction Meter ❑ Turn on Charge ❑ Uncollected Account - Name ❑ Inspection Fee - Tract - Fee ' ❑ Plan Check Fees Water I Sewer - Tract - ❑ Bond Payment- A.D. - Bond Assmt. ❑ Customer Deposit ❑ OVher " TOTAL $ Remarks: V"- k'— Ae It �+^ C o. y� SEf sh c i. �qopy to: 4 Cash Water Service Money Cashier- • Order (11199) 7 ECONO SEWER SERVICES P.O. Box 192 PALM DESERT, CALIFORNIA 92261 AM WHEV MR 45976 PHONE 328-7760 346-2793 TOTAL MATERIALS " TOTALLABOR PtEASE PAY FROM THIS INVOICE NO STATEMENT WILL BE MAILED ck CUSTOMER'S ORDER NO. PHONE TOTALAMOUN Signature CN HELPER STARTING DATE 21�11U BILL TO A ORDER TAKEN BY ADDRESS 4i� 'DAY WORK CITY CONTRACT 5a-Bz5 � EXTRA JOB NAME AND LOCATION - JOB PHONE URINIION OF WORK: eAYMEN_r_�X XfiR :�.S-N•EX 3 -0 -NN T -DAYS FROM DATETATE-OFcF RVICE 1%% PER MONTH CHARGE AFTER 30 DAYS completion PR= nH-2 nrEes Inc I hereby knowledge the satisfactory completion .I* Of work cram mm 01471, of the above described work r TOTAL MATERIALS TOTALLABOR PtEASE PAY FROM THIS INVOICE NO STATEMENT WILL BE MAILED TAX DATE COMPLETED WORK ORDERED BY TOTALAMOUN Signature CN No one home ❑ Total amou d-ue Total billing to for above work or be mailed after completion PR= nH-2 nrEes Inc I hereby knowledge the satisfactory completion .I* Of work cram mm 01471, of the above described work r y c"eD`e'sert SandsRUnified School District .RNs rUk�P §, u Cou�vuvVv b FICATION OF PAYMENT OF SCHOOL FACILITY FEES ify� (r" TO: City of La Quinta DATE: Department of Community Development 78-105 Calle Estado La Quinta, CA 92253 This is to certify that developer of L which is located at_10 �_ �`��� yL�� within this District, has paid school facility fees imposed pursuant to the authority genera t by vernment Code S ctim 53080 in the amount $ (� R� covering a total of square fe2Y o ( resident al or ( ) industrial/commercial development and that building permits for this footage in this development may now be issued by your jurisdiction. for DESERT SAA'S' FIED L DISTRICT White - Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer (10)-37 Building Address Owner Tit�t " - i P.O. BOX 1504 APPLICATION ONLY 78-105 CALLE ESTADO— LA OUINTA, CALIFORNIA 92253 I Mailing Address BUILDING: TYPE CONST. OCC. GRP. A.P. Number `7 % 1 —.3 3 r ---. 0.1 � Legal Description Lot # 5 Blk. 149 MB 018/092 Santa City Zip Tel. Project Description Carmelita Valle La Quinta Unit 15 One Fmdly Resident Contractor Aaner/3iilder Address . f Focal 448 S. Calle Encilia Rd. City Zip Tel.. Palm Sprinqs 92262 320 4638 State Lic. City &,Classif. - ' Lic. # Sq. Ft. 1348 No. One No. Dw. One Size Stories Units Arch., Engr., Designer Jams A. Boulwaft New)EJ Add ❑ Alter ❑ Repair ❑ -Demolition ❑ Address Tel. _- 2J)4;v,4 Alicia Pkwy. 714-830-1405 City Zip State Mi .,cin - yi in (' .. 92691 Lic. #(,^ 6442 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 Contractors License Law for the following reason: (Sec. 7031.5,Business 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 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 penafty of not more than rive hundred dollars.(E500). ❑ 1, 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.) Estimated Valuation �� 74, Zq3 01 PERMIT AMOUNT Plan Chk. Dep. 17 , p a Plan Chk. Bal. 44 Const. 0 Mech. Electricalp Plumbing 0 49 D 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 S.M.I. 'L Grading a Driveway Enc. C) Date Owner Infrastructure 33. / 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 O Copy is filed with the city. ❑ Certified copy is hereby furnished. TOTAL REMARKS CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE Al`)R 4 Q3) 411 70AQ 4 ?—(17--f:2R 4 11 (This section need not be completed if the permit is for one hundred dollars (8100) 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. i 0 CASH i TOTAL_ i 275.00 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 7 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 �. Lenders 'Name Lenders 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. FINAL DATE INSPECTOR Issued. by: Date Permit Validated by: Signature of applicant— Date Mailing Address Validation: City, State, Zlp BUILDING DIVISION CONSTRUCTION ESTIMATE GROUND PLUMBING NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ SLAB GRADE UNITS BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK YARD SPKLR SYSTEOZ FOUND. REINF. 2ND FL. SO. FT. METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) �j 20— MOBILEHOME SVC. GROUT BAR SINK SERVICE POR. SO. FT. ® BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ GAR. a SO. FT. ® �� d POWER OUTLET FINAL INSP. ROOF DRAINS FINAL INSP. ROOFING DRAINAGE PIPING REMARKS: CAR P. SQ. FT. ® VENTILATION WALLSO. FT. ® G FIREPLACE DRINKING FOUNTAIN SO FT ® SPARK ARRESTOR URINAL GAR. FIREWALL ESTIMATED CONSTRUCTION VALUATION $ 7W 0 LATHING WATER PIPING 21— NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES FINISH GRADING WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN CERT. OCC. WASH ER(AUTO)(DISH) APPLIANCE DRYER INSPECTOR'S SIGNATURES/INITIALS GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED GARDEN WALL FINAL 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. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL v SO.FT.GAR ® 3/ac HOUSE SEWER GAS PIPING PERMIT FEE to ... PERMIT FEE Ov PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE 36-°= 31/ s� 355 — 7 50 S• ZZ STRUCTURE PLUMBING ELE��� 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 REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL