09345 (SFD)r ' ' , • C&tyl i� ♦ tr
F P.O. BOX 1504 —No., _09345
45
Building 78-105 CALLE ESTADO
Address 52-905 Be3"I ud as LA QUINTA, CALIFORNIA 92253
iOwner
P �" i tTf1X fi��Xi BUILDING: ,TYPE CONST. OCC: GRP.
Mailing
F Address
A.P. Number
City Zip Tel. (�
Legal Description
Contractor Project, es rjption
Address • . ^
"iso_ cn Tfeeca A3 81 _
City Zip" ' Tel
13k^V-V-w4TA 01-3()l 14A-2010 I
i State Lic.- City f(/
& Classif. Lic. # tfi-F No. Dw.
3$ " Size Stories Units f
Arch., Engr.,
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
:. I hereby afffiin that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of.Di�v . isk4.h3.QLtLe Business and Professions Code, and my license is in full force and
effect° 1!
e.sIGNATURE ! — DATE
OWNER -BUILDER DECLARATION
Estimated ValuationI 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 QA -21 -4 nfj
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 PERMIT AMOUNT
the provisions o/ 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 Plan Chk. Dep. , so mf)
subjects the applicant to a civil penalty of not more than five hundred dollars (8500).
Bal.
O I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk.
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const.
M V « _ — —
Professions Code: The Contractor's License Law does not apply to an owner of property who i~'x1
builds or improves thereon and who does such work himself or through his 'own employees, .
provided that such improvements Mech
are not intended or offered for sale. If, however; the building y�
or improvement is sold within one year of completion, the owner -builder will have the burden a
of proving that he did not build or improve for the purpose of sale.) Electrical s 1*
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing A
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 S.M.I.
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
O I am exempt under Sec. B. 8 P.C. for this reason
Driveway Enc.
Date Owner Infrastructure 1AAC A4
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..
TOTAL - 359S.69 3245.69
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars (S100) 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 AOwner;`�
NOTICE CANT: "^^
i/;(aR`e'rNmaking-MJ eertiricate of Exemption you should become
subject to the Workers' Compensation provision --s 8f- 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
REMARKS
ZONE:
BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback frcm 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. SO. FT. ® $
UNITS
SLAB GRADE ^ 9�
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
FORMS
SEWER OR SEPTIC TANK
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. I SQ. FT. ®
OTHER APPJEQUIP.
DRAINAGE PIPING
WALL SO. FT. ®
TEMP. POLE
DRINKING FOUNTAIN
SQ. FT. ®
GROUT
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WAIER PIPING
NOTE: Not to be used as property tax valuation
WATER SYSTEM
FLOOR DRAIN
MECHANICAL FEES
_$
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH F_R(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, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/4c
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 8 AIR COND. SOLAR
SETBACK i _30 —f/ /
UND PLUMBINCf�
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE ^ 9�
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCKSTORAGE
FOUND. REINF. �_3� .9i //'�
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP. 9l�
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FRAMING 5��3�9/
FINAL INSP.Cj
0 1
ROOFING/�� ��
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING MWAI
MESH
INSULATION/SOUND S 9�
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
TA*h
P.O. BOX 1504 APPLICATION ONLY
Building/ n p� 7&105 CALLE ESTADO
ArfrlrPsa 1 /ST Q Ak X47 til/F .RPPAJM/ LA QUINTA, CALIFORNIA 92253
Owner Prtnn
MFl-A S/1-VER5rg-/iV
BUILDING: TYPE CONST.
A.P. Number
•
Legal Description
Project Description
OCC. GRP.
Mailing
)
City
Coritiactor
N C0057 RJCT 100
Address
gra AVE 2 -VJIDy
CityZip
Tel..
uD �F
220/
Oq 310 2 zg
State Lic.Q
& Classif. Z Y 3�4 2)
City
Lic. #
Sq. Ft.
/
No. No. Dw.
/
Size
Stories Units
Arch., Engr.,
/� p
Designer LrA s PAti 6. s i 6 w r��Dv 1
New ❑ Add ❑
-
Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
61q 320 12-1 I
oe
City
Zip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affir that I am li�cenedder provisions of Chapter 9 (commencing with Section
70f0�0c),ofDlv�si 3 of the Bd Professions Code, and my license is in full force nd
�1.�
SIG"rdRe 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) or
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 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
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.)
O 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
Estimated Valuation
/j
'7,C'7 21 J irf ]
f 6
PERMIT
'
-
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.�,.
Electrical
'�..
Plumbing
S.M.I.
i 2
Grading
Zp
Driveway Enc.
�•� ----
Date Ownerfrastructur
f
P f
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.)
0367b♦ _ ; A
Policy No. Company
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
B- V CASH i Tf TAL 1 275.00
TOTAL
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section neednotbe 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.
REMARKS
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.
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 Cade.)
Lender's Aame
FINAL DATE
Issued by:
Validated by:
Side Setback from Property Line
INSPECTOR
- Date Permit
+
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
Validation:
City, State, Zip
T r
BUILDING DIVISION
CONSTRUCTION ESTIMATE
GROUND PLUMBING
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. , SQ. FT. ® $
SLAB GRADE
UNITS -�
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
YARD SPKLR SYSTEM
DUCT WORK
2ND FL. SO. FT. ®
FOUND. REINF.
GAS (ROUGH)
METER LOOP
FEATING (FINAL)
1,10SO.
REINF. STEEL
MOBILEHOMESVC.
BAR SINK
POR. FT. ®
GROUT
WATER HEATER
SERVICE
FINAL INSP.
GAR. SQ. FT. ®
BOND BEAM
POWER OUTLET
ROOF DRAINS
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
DRAINAGE PIPING
FRAMING
CAR P. SQ. FT.
ROOFING
WALL SQ. FT. @
REMARKS:
DRINKING FOUNTAIN
SQ FT ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FIREPLACE
WATER PIPING
NOTE: Not to be used as property tax valuation
SPARK ARRESTOR
FLOOR DRAIN
GAR. FIREWALL
MECHANICAL FEES
LATHING
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
CERT. OCC.
KITCHEN SINK
FENCE FINAL
ABSORPTION SYSTEM. B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
GARDEN WALL FINAL 71
POLE,TEM)PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. ® c
BATH TUB
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
GAS PIPING
PERMIT FEE
FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
M ECH.FEE
PL.CK. F���PPEERMIT
CONST. FEE ELECT. FEE
SMI FEE
n;UjMB.
' .
,_ .
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
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
FEATING (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
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL 71
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated (619) 347-8631
Date 4/18/91
No. 10549
Owner Name
Type of Permit
Pamela Silverstein
No. 52905 street Avenida Bermudas
city La Quinta zip 92253
La Quinta
Permit #
Log # -
Study Area 112
APN # I Tract # I Lot # Square Footage 11714
Type of Development Single Family Residence No. of units
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 Fl—.58--1 X 1714 or $ 2,708.12 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 Pamela/Elsie Silverstein Telephone (
Name on the check
-5
Richard M. Beck
Director, Facilities Planning & Development
Fee collected /esmpted by Shells D. Bennett
S�
Payment Rec fivyed1 -_
Signaturer _
Check' Ivo. 513
Collector: Attach a copy of county or city plan check application form to district co -pi for all waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
tr : OFFICE OF
AGRICULTURAL COMMISSIONER
AND
WEIGHTS & MEASURES cnlvlN C. I<nMINSKns
JAMES O. WALLACE 4080 LEMON STREET, ROOM 19 As%hlonl Commisslornwr
Agrlculturof Commlistonar RIVERSIDE, CALIFORNIA 92501 CLEMENT BENVENISIE
greclor of Wefghts A Meoswes Sooler
(714) 787-2561
83-612.Ave.. 45, Suite 7
'Indio, CA 92201
` �o , i (619) 3421
BATE CASE
No. L o S A
DEVELOPER'S NAM 0A"L 61 L.\1 C—(?_STE'1 M
ADDRESS: 7 A VE L 7 _- u 0 Ll
17220
TELEPI IONS: (6 C) ` 2 .Z ..
Dear Developer: C �� F� v A 14 QU ti l o 10—
After
C
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 noEified
imnediately.
Thank you for protecting and preserving the Coachella Valley's pest -free environfTent.
A ultural Conmissioner s Office
cc: Indio and Riverside Office
If
�4 rvS u
30
�u.���,.uSG-
H Is b S 1 T -\\t^- S}
WM
Orr
4 4t
X%Lk i pztnj�g
Tiof 14a (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
ordinances of the City regulating building construction or use. For the following:
BUILDING ADDRESS 52-905 AVENIDA BERMUDAS
SINGLE FAMILY DWELLING 09345
Use Classification Bldg. Permit No.
Group ft3 Type Construction VN
Owner of Building PAMELA SILVERSTEIN
C 0 V Lki CA 9
Building Official.
Fire Zone Use Zone SR
Address 2177 E. BADILLO
By; LONNIE DAY
Dote; AUGUST 9, 1991
POST IN A CONSPICUOUS PLACE
....t ,. � . ... %. «J * ' y.; P.r �?'�i..�.-f .•set;,, _..