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09180 (PAT)Building Address 79. Owner Mailing Address SAME City i LA QUINTA,CA Contractor Address . . 4 P.O. BOX 1504 N o , fl9180 78-105 CALLE ESTADO 01 • LA QUINTA, CALIFORNIA 92253 ENCLOSE PATIO — REMODEL BUILDING: TYPE CONST. OCC: GRP. A.P. Number Zip Tel. 92253 Zip ` State Lic. I City ' & Classif. Lic. # Arch., Engr., Designer P Address Tel. City I Zip I State 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 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 of not more than five hundred dollars ($500). as owner of the property, or my employees with wages as their sole compensation, will o 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 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 I does not apply to an owner or 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 i Date- -Owner / -T %✓ y.r �- 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. 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 any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Owner RT.' PUBLIC INS • NOTICE TO APPLICANT. If, after making this Certificate or 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 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 Legal Description Project Description - ENCLOSE PATIO & ENLARGE BATIROOM AND MASTER BEDROOM Sq. Ft. No. No. Dw. Size . '� Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $30,841.00 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing ,�Fa 13.00 S.M.I. i~,. '` 2.17 Grading ��'�#:'" 4.1J-:' Driveway Eno. " Infrastructure Leas acctpa d—Permit fO9169 134.07 TOTAL Balauee +stile 363.25 REMARKS. ?'•tY.tF.1C{f�r•.�+1..F.+li�,P.T:S4Koi�`�f ...�4Q:�: q-f^o !:'1'. �•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: T CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS SLAB GRADE 2ND FL. SO. FT. ® BONDING YARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. SO. FT. ® GAS (ROUGH) DRAINAGE PIPING WALL SO. FT. OTHER APP.IEOUIP. DRINKING FOUNTAIN, SO. FT. ® TEMP. POLE URINAL ESTIMATED CONSTRUCTION VALUATION $ GROUT WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SYSTEM WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED 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 ® 1+/a c SEWAGE DISPOSAL GAR. FIREWALL SO.FT.GAR ® 3/ac HOUSE SEWER LATHING GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PPL.CK.Fd CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING 3 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 APP.IEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ 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 DESERT SANDS UNIFIED SCHOOL DISTRICT 82-879 Highway 111 NOTICE: Indio, CA 92201 Document Cannot Be Duplicated (619) 347-8631 Date 1/29/91 1 Type of Permit I La Quinta No. 110394 Permit # Log # Owner Name Tadros Tadros No. 78-170 street Calle Cadiz City La Quinta zip 92253 Study Area 115 APN # I I Tract # I Lot # Square Footage 1632 Type of Development Residential Addition I No. of units Comments F.nelnca nntin Rr anlnrara hnt.hrnnm nnri mnctar harlrnnm 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 FE -5 8-1 X ® or $ 998.56 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 Tadros A. Tadros/Elaine Tadros Name on the check Richard M..Beck Director, Facilities Planning & Development Telephone .i iZ� �r s: , Fee collected /eze pted by Shelley D. Bennett Payment V.6'ceived, �" y Signature �' Check No .1658 Collector: Attach a copy of County or City plan check application form to District cony: Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting i 4 P.O. BOX 1504 APPLICATION ONLY Building�7 7&105 CALLE ESTA50— CFS C AddresLA QUINTA, CALIFORNIA 92253 Q Owner — — _7_7— e - f- I_ BUILDING: TYPE CONST:' Mailing Q Address 7� A.P. Number. C}ty Zip Tel. 2_212 Legal Description Contractor ` Project Description;'' /! ddress n� / -- City Zip TeJ� ' �G o y State Lic. City Lic. # Sq. -Ft. �(� % No. No. Dw. Size / i Stories Units Arch. mgr., Desig r New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. ' o City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION 1A'er�p�( affirm that I am licensed under provisions of"Cha _' 9 (commencing with Section 7000) iff D}vision 3 of the Business and Professions Code, ani my license is in full force and effect. It-_ S G rQ R DAT \ OWN -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the. following reason: (Sec. 7031.5,Buslness and. Professionsp.Code:-Any city,or county, which requires a permit to construct, aftef,'fTOrove, degtotish 45' -?Pair any stiuctureXpri—to its issuance also requires the applicant"for Such'-peWW toyfle�a `sfgrfed statement the; 1 i licensed pursuant to the provisions of the Contractor's License Law, Chapter 8 (.0mmencing with Section 7000) of Division 3 of the Business and Professions Code° or that.he Is exempt therefrom, and the basis for t�alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit snub acts the applicant to a civil'pehalty of not more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will o°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 orImprovement i's 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 contractor(s) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt undti&c l i ! 2r I13.18 P.C. for thiereason .i. .� ter_. •y/ QQ ,, �'""'''�,�Yti its .- :� �— i �: `'i •° Date—_Z -Owner .0 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 it 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 tg become subject to th Workers' Co nsation Law of California. ' �Dat� E TAPPLICANT. Owner r`� NOTICE TO If, after making ,this Certificate of Exemptio 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.) Lenders..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 car illy 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 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 ate•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: 3tim ted Valuation �M O l/4 , PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical $' r Plumbing S.M.I. Grading -Driveway Enc. Infrastructure TOTAL 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 Permit Validated by: Validation: CONSTRUCTION ESTIMATE GROUND PLUMBING NO. ELECTRICAL FEES NO. PLUMBING FEES $ 3 40 BONDING UNITS STORAGE TANK FORMS SEWER OR SEPTIC TANK 1ST FL. SQ. FT. ® DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) 2ND FL. SO. FT. ® REINF. STEEL GAS (FINAL) TEMP. POLE YARD SPKLR SYSTEM GROUT WATER HEATER q q O O MOBILEHOME SVC. BOND BEAM BAR SINK POR. SO. FT. ® =$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. GAR. SQ. FT. @ ROOFING POWER OUTLET ROOF DRAINS CAR P. SO. FT. DRAINAGE PIPING WALL SQ. FT. FIREPLACE DRINKING FOUNTAIN SPARK ARRESTOR SO FT ® GAR. FIREWALL URINAL ESTIMATED CONSTRUCTION VALUATION- $ MESH WATER PIPING INSULATION/SOUND NOTE: Not to be used as property tax valuation FINISH GRADING FLOOR DRAIN MECHANICAL FEES CERT. OCC. WATER SOFTENER FENCE FINAL VENT SYSTEM FAN EVAP.COOL HOOD INSPECTOR'S SIGNATURESIINITIALS SIGN WASHER(AUTO)(DISH) GARDEN WALL FINAL APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED 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. SO. FT. RESID ® 11/4 c A0ToI SEWAGE DISPOSAL SO.FT.GAR ® 3/ac HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE A4T— PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.0 .FEE CONST. FEE ELECT. FEE SMI FEE PL MB. FEE 3Pa� 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 INSULATION/SOUND FINISH GRADING r FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL