10413 (AR)Building
e.trt.o.. 50027 OAXACA
T -&t - u
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Owner
DAVENPORT
Mailing
Address SAME
City Zip Tel.
I. LA QUINTA. 92253 564-3400
Contractor
GALLIEN CONSTRUCTION
Address
52811 AVENIDA VILLA
City lZip Tel.:
State Lic. City
& Classif. 577184 Lic. # 1.502
Arch., Engr.,
Designer
Address Tel.
City (Zip ( State I
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
of ec
SIG ATURE S DATE
r
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, after, 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
the provisions of the Contractor's License Law, Chapter 9 (commencing- with Section 7000) of
Division3 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 rive hundred dollars.($500).
❑ I, as owner of the property, 0r 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 safe. 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
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 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 t bject to the, orkers' Compensation
Laws of California.
jj ` )
Date' ! I_ f.%Owner f— �,%7 /.>.�' —� �/ t L4•
NOTICE TO APPLICANT: If, biter making this Certificate or 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 it 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. 10413
JILDING: TYPE CONST. OCC: GRP.
P. Number '.5
gal Description ROOM EXPANSION
Sq. Ft.
Size
Description 10 X 14 ADDITION
No.
Stories
No. Dw.
Units
New ❑ Add. ❑ Alter ❑ Repair ❑ 'Demolition ❑
IEstimated Valuation $7,210
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
AMOUNT
$64.35
c S �
99.03
}5.00
19.90
7.30
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
1ST 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. SO. Ff.
ROUGH WIRING.
DRAINAGE PIPING
WALL SO. FT.
FOUND. REINF.
DRINKING FOUNTAIN.
SO. FT. ®
METER LOOP
URINAL
ESTIMATED CONSTRUCTION VALUATION $
REINF. STEEL
WATER PIPING
NOTE: Not to be used as property tax valuation
TEMP. POLE
FLOOR DRAIN
MECHANICAL FEES
GROUT
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
BOND BEAM
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
LUMBER GR.
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 ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ec
HOUSE SEWER
SPARK ARRESTOR
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
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.
FINAL INSP.
FRAMING (�
FINAL INSP.
ROOFING
L "Jn
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION .�Z
l
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
December_ 17,'1991
Mr. David*Davenport
1103,W. St. Andrews
Edmond OK 73Q34
RE: 50-027 Oaxaca_
Architectural Change Request
Dear Mr. Davenport,
.The:Architectural Committee. of Santa Rosa Cove as approved your
request for the bedroom expansion and rear patio extension subject .
to the following conditions:",
a) a,copy of the building permit must be submitted.
d. b) theone-time fee of $5.00 per square foot for the additional
I. roof, area and $1.00 per square foot for the wall and french door
area.
i c) the filter and, heating'system is to be moved into the garage
with assocated,.plumbing changes.
If you have any questions, please do not he'
ita"te to contact me.
Sincerely, D
Pat 4 ins, Property Manager
Santa Rosa Cove Association
i
y .
49-200 Mariposa
Palm. Desert, .California
' (619) 346-1161
FAX (619) 346-9918
1 '
Mailing address:
Post Office Box 12710
resort c o m m u n i• t•' y 'm a n a g e m e. n t Palm Desert, California 92255