003316 (RER)contractor
Antony Sestich
Address .. .
4
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
City' . . . .. I
Zip.
Tel...
State Lic.
& Classif. 335932
Building
Address
77-224 Potrero
Owner
Tel.
SIGNATURE DATE
Anthov .Sest ick
Mailing
Estimated Valuation
Address
rN 14 A,1,7
City
Zip
contractor
Antony Sestich
Address .. .
4
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
City' . . . .. I
Zip.
Tel...
State Lic.
& Classif. 335932
City
Lic. #
'... Arch:- Engr.,
Designer
Address
Tel.
City Zip State
No. 0033,6
BUILDING: TYPE CONST. OCC.'GRP.•
A.P. Number
Legal Description Lots 11.. -12-. 13. 14. Bk. 272, _,
Project Description R#'madel, — B
�S-5€x.23 -No.Stories
No. Dw.
Size-'
Stories Units
'New ❑ Add 3j' Alter ❑: Repair ❑ .` Demolition ❑
_ ..
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
;► -►Y14! f" 8l
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following.
Estimated Valuation
• reason: (Sec. 7031,5,Business and Professions Coder 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 rile a signed statement that he is .licensed pursuant to
Front Setback from Center.Line
PERMIT
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
•r•
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
Plan Chk. Dep.
subjects the applicant to a civil penalty of not more than five'hundred dollars -($500).
' ❑.I, as owner of the property, or my employees with wages as their sole compensation, will
Plan Chk. Bal.
Const..
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
Mech. '
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 '
Electrical
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.)
Plumbing -
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
S.M.I. '
such projects -with a contractor(s) licensed pursuant to the Contractor's License Law.) ..
. 0 I am exempt under Sec. B. 8 P.C.- for this reason
Grading
Driveway Enc.
- Date Owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
j
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. O 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 the 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 permitwhen 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 ordinarices 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
HARD COPY
TOTAL
18,000
AMOUNT
S 83.52
128.50
17.00
15.00
26.00
1..23
REMARKS-
ZONE:'
;► -►Y14! f" 8l
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, / 17 /87 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBLNG FEES
1ST FL. SO. FT. ® $
2ND FL. SO. FT. ®
POR. SO. FT. ®
GAR. SO, FT, ®
CAR P. I SO. FT.
WALL SO. FT. ®
SO. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
-
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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
BOND BEAM
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
LUMBER GR.
SO.FT.GAR ® 3/ac
HOUSE SEWER
FRAMING
FINAL INSP.
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 %y
g
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EOUIP.
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
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
moi.
Desert Sands Unified School District
CERTIFICATION OF PAYMENT
OF
SCHOOL FACILITY FEES
TO: City of La Quinta DATE:
Department of Community Development
78-105 C 11 E t d
tAl
LA
IF' 7 ct�n
La Quinta, CA s92253 NOTICE: THIS DOCUMENT CANNOT
BE DUPLICATED.
This is to certify t at
developer of which is J�J
located at //• within
this District, has paid school facility fees imposed ursuan to the
authoi y generat b Gover ment C�$d Sec ' ost 5 080 in the amount of
covering a total o 4- � square feet of (' residential or
( ) industrial/commercial development and that building permits for
this footage in this development may now be issued by your jurisdiction:
for DESERT SANDS UNIFL D SCHOOL DISTRICT
White - Building Department f• Yellow - Facilities Planning • Pink - Accounting • Gold - Developer
f/ v (10)-37
'i