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