11309 (SFD)P.O. BOX 1504
Building78-105 CALLE ESTADO.
Address 78-595 Sanita drive LA QUINTA' CALIFORNIA 92253 -
Owner
La Quint; 'sista Partnership
Mailing Box 227
Address P • O •
City Zip Tel.
La Qu? nta . 92253
Contractor
S mire
Address
City jZip
State Lic.
& Classif. 500316, B
City
Lic. #
Arch., Engr.,
Designer
Address
Tel.
City
lZip
State
I hereby -affirm that 1 am
300). of Division 3 of the
of
1646
! OWNER -BUILDER DECLARATION ' .1 .
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 clty,or county which the,
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 licensedpursuant 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). -
O l,.as owner of the r
property, or 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.)
❑ Vern 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
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.furn!shed.
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
NOTICE TO APPLICANT., If, 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 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
I
No. 11309
BUILDING: TYPE CONST. - OCC: GRP.
A.P. Number
Legal Description Lot 174
Project Description Pl a 3
Sq. Ft. No. No. Dw.
Size 2307 Stories' Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
stimated Valuation
123,308
Minimum Setback
PERMIT
AMOUNT
Plan Chk. Dep. .
Rear Setback from Rear Prop. Line
Plan Chk. Bal.
Side Setback from Property Line
Const. . .
FINAL DATE
723.50-
23.5titMech.
Mech.
Date Permit
60oQ0
Electrical
126.65
Plumbing
138.50
S.M.I.
8.69
Grading
Driveway Enc.
Infrastructure
2774.43
marts .1n Public
25.00
f1't'Y.i,''a'N (Y ! A 4 155z j
TOTAL
4455.36
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
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
COLL. AREA
2ND FL SO. FT.
ROUGH PLUMB.
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. @
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT.
DUCT WORK
DRAINAGE PIPING
WALL SO. FT.
GAS (ROUGH)
DRINKING FOUNTAIN.
SO FT ®
HEATING (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GAS (FINAL)
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER HEATER
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
WATER SYSTEM
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GRADING
d.
$ plus x$
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 Vi c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ic
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 /S
GROUND PLUMBING
ApNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE ?/Wxk2 //,-
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
y
SEWER 011^S afN
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
d.
$ plus x$
LUMBER GR.
FINAL INSP.
FRAMING G / ./
FINAL INSP.
ROOFING f0 Z./Ll
( L
/�%Ay✓-
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
��� /
LATHING"�"�/VYiy
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION-
NSPECTION
CERT.
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 9/21/92 1 Type of Permit I La Quinta
No. 11729 Permit #
Owner Name La Quinta Vista Partnership Log #
No.
city La Quinta zip 92253 Study Area
APN # Tract # Lot # Square Footage 12307
Type of Development Single Family Residence No. of units 1�
Comments
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 1.58 X ® or $ 3,645.06 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 Swan Development Co.
Name on the check
By James E. Lively
Assistant Superintendent, Business Services
Telephone
Fee collected /exempted by Shelley D. Bennett _
Payment Rec.iived 1, -
r
Signature ^heck No. 4j5
Collector: Attach a copy of county or city plan check application form to district copy dbr i..11 waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting