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06741 (SFD)Buildin Address 53-42511er=das Owner Marion L. White, Mailing Address City Zip Contractor Address City Zip P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Tel. _ State Lic. I City & Classif. Lic. # Arch., Engr., Designer Irvin Dealga Assoc _ ..� New,O,, _ , Add ❑ Address Tel. 555 Cajon, #D _.. .. City Zip State Redlands Lic. # LICENSED CONTRACTOR'S DECLARATION 1 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. 7031.5,6usiness 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 Inge 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 penally of not more than fwe hundred dollars ($500). ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do the wodr, and the structure is not intended or offered for sale. (Sec. 7044, Suisness 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. d, 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.) ❑ [,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 contrector(s) licensed pursuant to the Contractor's License Law.) No. 06741 LDING:.TYPE CONST. OCC: GRP. ..Number. - 774-095-020 Legal Description ` Project Description SFD Sq. Ft. 14M No. No. Dw. Size Stories Units ❑ 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION 1 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. 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 (E100) 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: g, 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 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civa Code.) Lenders Name Lenders Address This is abuilding permit when property filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 100 days. I certify that I have read this application and state that the above information is correct. 1 agree to comply with all city and county ordinances and state laws relating to building construction, and herepy authorize representatives of this city to enter the above-, mentioned property for inspection purposes. Signature of applicant Date Mailing Addr' City, State, Zip Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. $250-00 Plan Chk. Bal. $ 252.07 Const. 590.00 Mech. 53.501 Electrical 109." Plumbing 157.50 S.M.I. 6.23 Grading 20.00 Driveway Enc. 20.00 Infrastructure 1,875.25 A-4 .mit 'jsrc'. `7dt�-'.d —?ANM-1 3H -moi TOTAL $3,334.45 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 12%12/89 Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ UNITS SLAB GRADE /� / ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL SO. FT. 0 FORMS O SEW K ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SO. FT. ® GAS (ROUGH) METER LOOP HEATING (FINAL) POWER OUTLET ROOF DRAINS GAR. SO. FT. ® TEMP. POLE 7 GROUT DRAINAGE PIPING CAR P. I SO. FT. FINAL INSP. WALL SO. FT. WATER SYSTEM DRINKING FOUNTAIN. GRADING cu. yd. $ plus x$ =$ URINAL SO FT ® FRAMING7 2 S ! (J FINAL INSP. ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation REMARKS: FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTOXDISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM SPARK ARRESTOR 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 INSULATIONISOUND SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1Vi c SEWAGE DISPOSAL SO.FT.GAR ® V4c 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 6 Z'? ! XIBIN Yllf UNDERGROUND A.C. UNIT COLL AREA SLAB GRADE /� / ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS O SEW K ROUGH WIRING DUCT WORK ROCKSTORAGE FOUND. REINF. O GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE 7 GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM FINAL INSP. �a 1/ 9t7 GRADING cu. yd. $ plus x$ =$ LUMBER GR. FRAMING7 2 S ! (J FINAL INSP. ROOFING7 REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL A LATHING 1)JVA/ MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL 4 10 P.O. BOX 1504 APPLICATION ONLY Building � -G ��� r-, 10A, CALL ORNIAESTAD9 Address l) QUINTA, CALIFORNIA 92253 Y v 114--1LJI N `. ' v ' I I I `-' BUILDING: TYPE CONST. OCC. GRP. Mailing Address A.P. Number % % 6-n 9aa ;Lo City zi T.I. =� Legal Description Project Description Contractor AC-)EN—L. Address City Z�> , ,._ TeLIQ _ State Lic. City & Classif. Lic. # Sq. Ft. No. No. Dw. Size Stories Units Arch., Engr., Designer I BVI N Q0-;: >(� t-6 iSSC_� , New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. 555 1�3TC_ 0 City zip State p_ r' jets, Lic. # 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 affirin that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,8uslness and Professions Code: Any city or county which requires a Estimated Valuation PERMIT AMOUNT 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 afleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit subjects the applicant to a civilpenalty 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 Contractors 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 arpro ement is sold within one year of completion, the owner -builder will have the burden of pro Nat he did not build or improve for the purpose of sale.) - - Plan Chk. Dep. , dvO Plan Chk. Bal. Const. Mech. Electrical Plumbing 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 prqpertytvhoor improves thereon, and who contracts for such projects with a contractor(s) lrcens ursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec JLB. r'3 C. for this reason S.M.I. Grading Driveway Enc. Date /9 _5�--21 Owner Infrastructure l�Ft OL .rl v 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 c'i pp REMARKSn n iri 9-09-A9f 0 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 anyperson in any manner so as to become subject to the Workers' Compensation Laws of California. 16 --- CASH S 2 !:a Date Owner NOTICE TO APPLICANT, 11, 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 Code.) Side Setback from Property Line Lender's Name FINAL DATE Issued by: Validated by: INSPECTOR Date Permit 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. Signature of applicant Date - Mailing Address Validation: City, State, Zip BUILDING DIVISION CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. $ UNITS SLAB GRADE ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL. SQ. FT. @ FORMS SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SO. FT. ® GAS (ROUGH) METER LOOP GAR. SO. FT. POWER OUTLET ROOF DRAINS ' GAS (FINAL) TEMP. POLE DRAINAGE PIPING CARP. SQ. FT. ® GROUT WATER HEATER WALL SQ. FT. ® - DRINKING FOUNTAIN BOND BEAM WATER SYSTEM URINAL SO. FT. @ =$ LUMBER GR. ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP. WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FIRE ZONE ROOFING LAUNDRYTRAY AIR HANDLING UNIT CFM FIREPLACE 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. SQ. FT. ® c BATH TUB SQ. FT. ®c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1I/. c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ic 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 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 w t II,E ur E. t.Egtt SPAI;r,Y /1GMCUL I MAL CUMMISSIONER `°•'1"W10.1'`" )AMCS o WALIACE AN L) A%StsrA.%l r;�r:r.nStn��trt WEIGI I I S b.. MUNSURES ILLOIEvf Itf",VEMSIE SUM 49-613 ihry 114, Illrlte 11-I2 'Cvuchelln, CA 92214 619-J�i 2-ll'19 l fJnrc f T�2 MVCtA1'l H' S IMEt AUDIMS �l rl,crl IU1dC t t ! y 5 Dear Wvelutnr1 CASC lu. After reviewing your landsct111fng IIla11►1, till ItiviR m3terlal listed is Ilol' 1.11 violation of yuaralttlne lows govett1111y 1112 Coacltella Valley. 11 substitutions do occur wid they dlEter ttun lriallt Material listed, this u[tice must be notified iaut�diately. . Thank you fur ptuLectLly and pieservinU the Cuachella Valley's "st-free envirvisimit. l; f r Ayi:�. ltuca Caui�ss�oiier n OUce cc1 Indio rand Riverside mice P.O. BOX 1504 APPLICATION ONLY Building105 CALLE ESTADO Address ,BtVLrAUtA QUINT& CALIFORNIA 92253 Owner P A I D DEC 0 5 &"-5 Aati�ess City Zig ITel. LDING: TYPE CONST. OCC. GRP, P. Number. -1-7 §=!Q9!50n04d^119, Description wnTractor G?a�_ Project Description Address City Z�� Te� State Lic. City & Classif. Lic- M Sq. Ft. �/�j' No. No. Dw. Arch., Engr., Size l0 O Stories Units Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address —.A-- \nQ GQ'rr r it Tel. C8y=r 1 P4k11'1C IZip ILictfi LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section =01 lkvision 3 of the Business and Professions Code, and my license is in full force and SIGNATURE DATE OwNEWBUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,1k+siress and Professions Code: Any cry or count' whidr reeves a permit to can trio afar, ivpow. demofsh. or repair any structure. prier to is issuance also requires the applicant for such perm to Ge a signed statement that he Is licensed pursuant to Me p,ovf bm of the Contractors License Law. Chapter 9 (meg with section 7000) of Division 3 of the lhsivess and PnVessions Code, or Nat, he Is exentuu thenalmm, aif the basis lbr the afeged excerption. Arty violation of Section 7031.5 by any applicant for a perm studliects the tppili to a cM pertafy of not more Man Ove fumed dofas (6500). O 1, as owner of the property, or my employees with wages as their sole compensatkm, will do the work, and the structure is not intended or offered for sale. (Sec. 7044, Oursoss and Professions Code: The CorMradors License Lew does not appy to an owner of property who builds or %Ip10►es thereon and who Ales such wort hinsed or through his own anpbyees. provided that such irprovements are not Intended or offered for sate. It, however. the iuildig or trrpro is sold wfihir one year d omPletion, the owner•Dumfder w4 have due Darden Of that he did not build or irprove for the purpose of sab.) , as owner of the property, am exclusively contracting with licensed contractors to con, sttuct the project (Sec. 7041, Business and Professors Code: The Contractor's License Law does not apply to an owner of property who buvfa or hpvov+eus Maroon. ad who cortracts for such pmleds with a contractor(s) licensed pursuant to the Contractor's License Law-) ❑ 1 am exempt under Sec ---------& 3 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 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. CERTIFICATE OF EUMPTION FROM WORKERS' COMPENSATION INSURANCE (IRAs section need not be completed t the permit is for ane hundred dofas (:100) vateOon or less.) I certify that in the performance of the work for which this permit is issued, I staff not employ tory Call= par�n In any manner so as to become subject to the Workers' Compensation laws of Bate owner N077CE TO APPLICANT: ff. after makig this Certificate of Exemption you should become su tject to the Rlrkers' Cairrpertsatlon provisbrs of Oro Labor Code. you must torthwtth Aonpy with such provlsions Of MTs permit shat be dsermed reveled. CONSTRUCTION LENDING AGENCY I Hereby aNrm that there is a construction lending agency for the performance of the work for which tfuls permit is issued. (Sec. 3097, CW Code.) Lender's 'Name Lenders Address This is a buil6rg permN when property filled out, signed and validated, and is subject to expiration it work thereunder is suspended for 180 days. 1 certify that 1 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 retating to building construction, and hereby authorize representatives of this city to enter the above- meMloned proposrty for Inspection purposes, 3g PERMIT AMOUNT Pian Chk. Dep. Q . ofD Plan Chk. Bal. Const. Mech. Electrical 0!5t.90 Plumbing r7 fta S.M.I. Grading -Zee o Driveway Enc. -A'7 _ C!1� Infrastructure G� AGA o7 3 � TOTAL %S : 00 REMARKS io 10 - --CASH i TOTAL i -215-00 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: Signature of applicant Date ling Add rr Validation: ON Zip Desert Sands Unified School District CERTIFICATION OF PAYMENT OF SCHOOL FACILITY FEES rTO. ,Ca c - � � L�Vf�--� DATE 4:� This is to certify that , f-xv--)V[ Clo developer of tCJV4. '�-Lj which is located at _ _ 11 _ , within this District, has paid school facility fees imposed pursuant to the $u orit rr r(t overnment Co e ctioyl 3080 in t �m unC of '� cov ring a total of square feet of { ) resibential or ( ) industrial/commerci 1 development and that buil ing permits for this footage in this development may now be issued by your jurisdiction. G� I:�q4i&4 h &MLO for DESERT SANDt UNIFJED SCHOOL DISTRICT White - Building Department B Yellow - Facilities Planning • Pink - Accounting • Gold - Developer (10)-37