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03929 (AR)Qum& 0.929 P.O. BOX 1504 Building 49-980 Coachella Drive 78-105 CALLE ESTADO Address LA QUINTA, CALIFORNIA 92253 - Owner Erich ouerMailin- BUILDING: TYPE CONST. OCC. GRP. Address 1802 Regency HoweA.P.617-540-010 • -Number - CityJZip64112 Tel. Kansas City , Legal Description M Contractor Project Description Room addition Dan Edgar Address 40825 Yucca Lane City lZip Tel. Bermuda Dunes 92201 345--4048 State Lic. City & Classif. 357278 Lic. # � � Sq. Ft. 192 No. • No. Dw. Arch., Engr., Size "Stories Units Designer New ❑ Add ❑ Alter O Repair ❑ Demolition ❑ Address Tel. City Zip 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. ;t 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, 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) 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 (8500). O 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 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.) 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.) O 1 am exempt under Sec. B. & P.C. for this reason Dale 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 O Copy is filed with the city. O Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATIONINSURANCE (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 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. 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 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 City, State, Zip Estimated Valuation $12,748 f<i1 3 t7 4!1 A446 tb.s, f - _r.h ., PERMIT AMOUNT Plan Chk. Dep. vltJ • np BY: Plan Chk. Bal. • Const. Mech. Electrical • Plumbing S.M.I. •� Grading 5/11/88 Driveway Enc. Date Permit Infrastructure Validation: TOTAL REMARKS WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE f<i1 3 t7 4!1 A446 tb.s, f - _r.h ., Hzt 1V L9 ] AtgtftL f. 1W.40 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 5/11/88 Issued by: Date Permit Validated by: Validation: WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE CONSTRUCTION ESTIMATE : NO.. I ELECTRICAL FEES ' NO. I PLUMBING FEES Z:.Y• r, .. IST FL SO Fl (p 'UNITS UNDERGROUND YARD SPKLR SYSTEM 2ND FL SO FT. a SLAB GRADE ROUGH PLUMB MOBILEHOME SVC. BAR SINK POR SO FT. gr STORAGE TANK FORMS- GAR SO. FT. Cl POWER OUTLET ROOF DRAINS DUCT WORK DRAINAGE PIPING CAR P. SO FT. q GAS (ROUGH) WALL SO. FT. a- DRINKING FOUNTAIN OTHER APP.IEOUIP. REINF. STEEL URINAL SO. FT. ra TEMP. POLE ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES FINAL INSP. WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTONDISH) APPLIANCE DRYER $ GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LUMBER GR. LAUNDRYTRAY AIR HANDLING UNIT CFM FRAMING 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. g- c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID 1 V. c SEWAGE DISPOSAL SO.FT.GARis.Yc HOUSE SEWER SPARK ARRESTOR, GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMITEF--j 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 APP.IEOUIP. 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 L/�'✓"'� ' J REMARKS: .� VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR, GAR. FIREWALL .a a. ` LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT, OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL RECEIVED OCT 1 1984 CITY OF LA QUINTA COMMUNITY DEVELOPMENT DEPT P 04 AAJ VV --- P-ow�-- q q! C'eac��llR a s— �esl.��w�i �c 9ZZs3 DESERT SANDS UNIFIED SCHOOL DISTRICT 82-879 Highway 111 Indio, CA 922�r OC€ HENT CANNOT OLH, DJPL'CATED. CERTIFICATE OF SCHOOL FACILITY FEE WAIVER This is to certify that developer of DATE: Ar Y - which is located at , within this school dl5trict, is not required to pay schoo4--facili.ty fees pursuant to the authority generated by Government Code Section 53080. Building permit for the project indicated above may now be issued by your jurisdiction..F VALUATION INDICATED ON BUILDING PERMIT EXCEEDS $20,000, THIS WAIVER I VOID AND A SCHOOL FACILITIES FEE MUST BE PAID PRIOR TO ISSUANCE OF BUILDING PERMIT. or DESERT SANDS UNIFIK SCHOOL DISTRICT White -Building Department Yellow -Facilities Planning Pink -Developer (10)-38