12029 (RER)1504
Building
G/✓�1:/� 78-1 50CALOLE ESTADO
Address 49-035 da S fircle LA QUINTA, CALIFORNIA 92253
Owner
Mailing
Address 49-035 Cedros Circle.
CityZip Tel.
%a. Quinta, CA 92253
Contractor
Craig Conklin Company
73-612 U 111. #7
City Zip Tel.
Dalun Desert, CN 92260 346-8905
State Lic. City
& Classif. 316634 Lic. # 203
Arch ; Engr.,
Designer
Address Tel.
City IiZip IState I
N Lic. #
I' LICENSED CONTIP'45TO<'i'S DECLARATION
I hereby affirp4tiat I am Iigensed.funderiprovisf�ns�,of Chapter 9 (commencing with Section
7000) of Division 3 o the Business and Professions Code, and my license is in full force and
effect. t
K
_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
j requires the applicant for such permit to file a signed statement that he is licensed pursuant to
I 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).
❑ 1, 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.)
❑ 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 under Sec. B. & P.C. for this reason
Date Owner
I
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.)
Poliic�cyy� No Company
8M 1 opy is filed with the city. ❑ Certified copy is hereby furnished.
1
CERTIFICATE OF EXEMPTION FROM
i 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 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
No. 12029
BUILDING: TYPE CONST. OCC: GRP.-.
A.P. Number
Legal Description
Project Description ReIO�Odel
Garage 38.5 s.i.. $716.11
Room 181 s.4.
Sq. Ft. No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition p
e",
stir -hated Valuation
$10,182.41 � .r
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
8_ '
Const.
126.00
Mech.
21,.00
Electrical
21.34
Plumbing
Date Permit
.S.M.I.
.77
Grading
Validation:
Driveway Enc.
Infrastructure
TOTAL
nig s r.1� :.oma �, 7 . �..:.. !• _ ., t `�
REMARKS
e,-, +raw -r: ar- rnti-: x ,aa•v r.
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
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
SLAB GRADE 41, V
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. SO. 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
CAR P. I SQ. FT. ®
GROUT
WATER HEATER
WALL SO. FT. ®
FINAL INSP.
DRINKING FOUNTAIN
SO. FT. ®
WATER SYSTEM
URINAL
ESTIMATED CONSTRUCTION VALUATION $
_$
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
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
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.
SQ. FT. ®c
BATH TUB
SO. FT. ®c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
FINISH GRADING
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 41, V
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"111
FINAL INSP.
FRAMING c./ q 3 G�
t
FINAL INSP.
ROOFIN
1
VENTILATION
J
/�-
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
THING C
INSULATION/SOUND 3
FINISH GRADING
FINAL INSPECTION IF— -13M
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
`
GARDEN WALL FINAL
2 SL.AND S HOMEOWNERS AS SOC =AT 2 ON NO- 1
.....................................................................................
P. 0. Box 1271 La Quinta CA 92253 :
March 24, 1993 :
Building & Safety Department
: CITY OF LA. QUINTA
P. 0. Box 1504
La Quinta CA 92253
: RE: Residence ANDY WILLIAMS
49-035 Cedros Circle
La Quinta CA 92253
Gentlemen:
: Please be advised that the Architectural Committee of Islands Home-
owners Association No. 1 -has reviewed the proposed residential changes
requested by Andy Williams and find them to met the criteria setforth
in the governing documents of this Association.
If you have any questions, please contact the Association office,
564-2177.
: Yours truly,
EDWIN STEEN
President
ES/at
,YY'A:V s .
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