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05034 (SFD).d T P.O. BOX 1504 M o . Building 78-105 CALLE ESTADO Address 50-735 QuIrtCa LA QUINTA, CALIFORNIA 92253 Mailing Address 3s s+t City La Quinta Contractor Same Address State Lie. & Classif. Arch., Engr., Designer Address 487534 05034 1. A BUILDING: TYPE CONST. OCC: GRP.•- A A.P. Number 769-064-008 Tel. 92253 564-4832 Legal Description Project Description S.F.D. & Guest hon -se Tela City Lie. # Sq. Ft. 3350 No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Tel. 'Nall Included in permit City Zip State Lie. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7(100) of Division,3,pf.the,Business and Professions Code, and my license is in full force and effect. /or «Ar ' � SIGNATURE ' " DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractors License Law for the following reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a permit to construct, after, bnprove, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to 81e a signed statement that he is licensed pursuant to 1he•�provsions or the Contractor's License Law, Chapter 9 (commencing with Section 7000) or blvision 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis loc;the .alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit 'subjects. the applicant to a civit penalty of not more than five hundred dollars (E500). . 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 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 or completion, the owner -budder will have the burden of proving that he did not build or unprove for the purpose of sale.) ❑ 1, 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 or property who builds or bnproves 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 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 Cl 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 (8100) valuation or less.) I certify that in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California- Date-owner aliforniaDateowner NOTICE TO APPLICANT ff, alter 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 shaft be deemed revoked. CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, CivilCode.) Lenders Name Lenders Address This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 160 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 Estimated Valuation Rear Setback from Rear Prop. Line PERMIT AMOUNT Plan Chk. Dep. $250.00 Plan Chk. Bal. S 2f5. 10 Const. 635.50 Mech. 33 JI0 Electrical 122-82 Plumbing 147.00 S.M.I. 12.64 Grading 20.00 Driveway Enc. 20.00 Infrastructure 3,841.83 TOTAL 5 .3 81.8 3 / `317 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 2.122/80 Issued by: Date Permit Validated by: t Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ UNITS COLL. AREA 2ND FL SO. FT. YARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. SQ. FT. DUCTWORK DRAINAGE PIPING WALL SO. FT. DRINKING FOUNTAIN. SO FT ® HEATING (FINAL) URINAL ESTIMATED CONSTRUCTION VALUATION $ 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 GRADING cu. yd. $ plus x$ LAUNDRYTRAY 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 VENTILATION SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1+/a c SEWAGE DISPOSAL FIREPLACE SO.FT.GAR ® 3/ac HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PLCK.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 Q ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS ER OR SEPT GH WIRIN ,),� DUCTWORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (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. 2r' FRAMING ao7 FINAL INSP. ROOFING Tcf 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 CERTIFICATION OF PAYMENT . OF SCHOOL FACILITY FEES #V®a ✓/QY Do p T0: City of La Quinta� ��Py� DATE: Department of Co mu ity�D_ev�eTq menet °`� �T 78-105 Calle Estado ` La Quinta, CA 92253 KA kAt/,�� is-ao-g8 This is to cert' f that t'1 developer of � which is located at T within this District, has paid school facility fees imposed pur�iu&t to the au rit ge erat by Government Code Section 5 080 in the mount of I S ( 8�� cov ring a total of squar feet of ( ) re ident al or ( ) industrial/commercial development and that building permits for this footage in this development may now be i sued by your jurisdiction. �K7;1±y-�j I for DESERT SAN6j•UNIFI D SCHOOL DISTRICT White - Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer 110► -37 4 k Buena Engineers, Inc. 79-811. Country Club Drive, Suite 4 Berm, , 7n, 9 2201 - . (619) 345-1588 M-91131 Client lient d 40, Client Addressaw Noll Client Phone DATE I I S.//Lf/gj JOB NO. � Q; -*7)07-2-p( PROJECT kc)4 !Slf LOCATION REFERENCE CURVE CONTRACTOR OWNER WEATHER TEMP. >~o at AM 0 at PM PRESENT AT SITE 0 oke MAXIMUM MAXIMUM OPTIMUM NUMBER 56 5 0 CLIENT REPRESENTATIVE SIGNATURE FIELD REPORT' VA TECHNICIANS SIGNATURE FIELD TESTING REFERENCE CURVE TEST TEST LOCATION Lot MOISTURE DRY MAXIMUM MAXIMUM OPTIMUM NUMBER NO.. ELEVATION CONTENT DENSITY 'DRY DRY MOISTURE lbsiCu. ft. DENSITY DENSITY CONTENT % ibsicu. ft. % I U TI. 7 I„ F (� TI tS`, 1 l �, /-2 x REMARKS: r U c,', 7*36 1 L odsp c, 4: (-'A u i f houLe 0 0. S ->s -u •-e -it O',;qq ok (('7frF our r: .e 5()C?u. . ks� 'yCtLL-AA V3 56 5 0 CLIENT REPRESENTATIVE SIGNATURE FIELD REPORT' VA TECHNICIANS SIGNATURE