9781 (SFD)P.O. BOX 1504 (� N 9781
Building7&105 CALLE ESTADO %
Addres50-905 Calle Palma LA QUINTA, CALIFORNIA 92253
Owner
B4 ian £s Lynda Merritt BUILDING: TYPE CONST. OCC: GRP.
Mailing
Address 79,555 Kingston A.P. Number
City ` JZip Tel
Bermuda aT)id99201 772-2077 Legal Description
Contractor Project Description
Brian erritt
Address '��
same
City Zip Tel.:
State Lic. BC$2 C27 C33, o
& Classif. ic. S Ft. No. No. Dw.
�� ° C2 2�b33 # Sle 26v/ Stories Units
' Arch:, Engr.,
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition'❑
Address Tel. Does not include block Paull or cool
City Zip State
Lic. # '
LICENSED CONTRACTOR'S DECLARATION
II tereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
\7A00) of.Division 3 of the Business and Professions Code and my;license is in full force and
ffect.
SIGNATURE G /o r DATE
OWNER•BUILDER DECLARATION Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following 150,308.80
reason: (Sec. 7031.5,Business and Professions Cade: .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 PERMITAMOUNT '
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section, 7000) of rr
Division 3'of the Business and Professions or that. he is exempt therefrom, and the bests •,�
for the alleged exemption. Any violation of,Section 7031.5 by any applicant for-'a-permit .Plan Chk.'Dep.
objects the applicant to a civil penalty of not more than five hundred dollars (S500). .
p I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. 697.48
97
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. } �Q -
- 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, ! '
-_-.prodded. that such improvements are not intended or offered /or sale. 1l, however, the building Mech. 89.50
or improvement is sold within one year of completion, the owner-builder will have the burden Electrical. '167. 45 -
- 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 contractorstto con- Plumbing M • 50
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. 15. 10
such projects with a contractor(s) licensed pursuant to-the Contractor's License Law.)
Grading 20. 0
O I am exempt under Sec. B. 8 P.C. for this reason
Driveway Enc. 20.00
Date owner Infrastructure 3282. 3 2
#q, in, Piibli.9 125.77
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 t • - _.
[YCopy is filed with the city. ❑ Certified copy is hereby furnished.'.
TOTAL 5429.12 9•dm
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
This section need not be completed B the r' r10,
( p permit is for one hundred dollars' (5100) valuation: � „�1�i..��.,ya..,,, e,.,i.• _ ndtiR < ,,,
or less.)
I certify that in the performance of thg work for which this permit is issued, I shall not
employ any parson 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 ZONE: BY:
subject 'to the Workers' Compensation provisions of the Labor Code, you must forthwith Minimum Setback Distances:
comply with such provisions or this permit shall be deemed revoked.
Front Setback from Center,Line'
Rear Setback from Rear Prop. Line •
CONSTRUCTION LENDING AGENCY Side Street Setback from Center Lin@
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.) Side Setback from Property Line
Lender's Name
Lender's Address FINAL DATE INSPECTOR
This is a building permit when property 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. Issued by: Date Permit
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. Validated by:
Signature of applicant Date
Mailing Address Validation:
City, State, Zip
J CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST 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.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
WATER SYSTEM
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GRADING
cu. yd.
$ -plus-x$
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FINAL INSP. ?f �(
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% c
SEWAGE DISPOSAL
SO.FT.GAR ® 3yc
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 I.-ILUMBING ELECTRICAL HEATING & AIR COND. SOLAR.
SETBACK
GROUND PLUMBING Q�
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS a
SEWER OR SEPTIC TANK9 nqj I fie
OUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
` 1
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ -plus-x$
_$
LUMBER GR.
FINAL INSP. ?f �(
FRAMING Q ��
FINAL INSP. 14q"31,? m
3 Qm
ROOFING � !� q �
� /�
l/
10
Lq
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
THING l telco
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION 0
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
DESERTI SANDS UNIFIED SCHOOL DISTRICT
82=879 Highway.111 r
NOTICE: "•; Indio.`CA 92201
s.
Document Cannot 'Be Duplicated
(619)347-8631
•..
F Date 7/8/911 ' Type of Permit I La` • uinta
'10707
No. t Permit #
Log' #
Owner Name BriaTi"Merritt
No. 50-905 street 'Calle'Paloma
city La` uinta'=i zIN� 92253 studArea'�'125
ti3' Q P , Y, '' ,!
APIC.#ti *t #
Trac " , Lot # s
qua
re Footage'2607"
t 0` a
Type of Development Single Family Residence •; ' No. of units 0
Comments New eon si irtinn
At the present time, the yDesert Sands Unified School',District does not collect fees on
garages/carports, coveredpatios/walkways; residential
-additions under 500 square feet,
detached accessory structures ror replacement mobilehomes. 'It has,,been determined
the above-named owner is exempt from paying school fees at thi's time due to the
following reason:
EXEMPTION SNOT APPLICABLE
This certifies that school.facility-fees'imposed:pursuarit to ` Government Code 53080
in the amount of1.58 X 0 'or`$ 4,119:06 r ,have been• paid to D.S U SD. for
the ro listedabove and that buil ' ' 4
p petty ' , dmg permits and/or Certificates of:0ocupancy for •
this square footage in this proposed project may.now,be issued:
- r
Fees Paid By Brian H. Merritt `Telephone; 24483_ 6 . .
Name on the check `
By James•E. Lively
_.
Assistant Superintendent, Business Services'
s ...1 J-
Fee collected /ese ' ted by""thleen Emmerlin -�
Payment -Received'
Signa f. Check `N61 1453
Collector: ch ,a opy f county or city j' L ' check application form to district copy for all waivers.
Embo§sed Original yBuildingµDept./Applicant- Copy _Applicant/R.eceipt Copy -Accounting
.9 4'•