002529 (SFD)QUM&
-
P.O. BOX 1504 No. 002529
Building 78-105 CALLE ESTADO
Address 52-•140 RG:nst a Jinrm LA QUINTA, CALIFORNIA 92253
Owner
Mailing
M& C. TinG. BUILDING: TYPE CONST. OCC. GRP.
- - '
Address P.O.B= 20n 773-23.1.-007
., A.P. Number.,
City ZipTel.
p M 9-260 Legal Description lat 16
Contractor Project Description _qiy 10 f&.IV &1palim
RM
Address
P.O. Eft 3525
.. .City. PaIn -. Zip' - Tela ..
ie. ext 92263 346-3952
State Lie. City 1340
& Classif.� LieR575. # Sq. Ft. No. No. Dw.
..
Size . 447 - St
Arch., Engr.,ories Units
Designer New ISL- ID Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
City Zip State
_ .
Lie. # -
'
LICENSED CON TRACTOR'S -DECLARATION ,!!
• I under.provisions
hereby affirm that -1 am licensed; of Chapter 9 (commencing withtSectlon✓
7000) of Division 3•of the Business and�rProfessions Code;rand my lyic4e.r.ise is in 1611 foie ° nd���rr.
effect..rI. , %�^ ♦ ' 'Sb ti b?%/
SIGNATURES 0 F DATE
"
OWNER -BUILDER DECLARATIONS
I hereby affirm that I am exempt from the Contractorts License Law forthe following
Estimated VdlUdtlOn
70,469.90
_.reason: (Sec. 7031,5,Business andProfessions Code:,Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, -prior to its issuance also
'
a •-
.. requires the applicant for such permit to file a signed statement that he is licensed pursuant to
PERMIT AMOUNT
the provisions o/ the Contractor's License Law, Chapter 9 (commencing with Section 7000) o/
Division 3 o/ the Business and Pio/essions Code, or that he isexempt therefrom, and the basis
for the alleged exemption. Any violation o/ Section 7031.5 -by 'any applicant for a permit
-
Plan Chk. Dep. - 25w00
subjects the applicant to a civil penalty of not more than live hundred dollars (3500)' '• - ' -
O I,
Plan Chk. Bal. 42.80
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
Const. 346 00
•
builds or improves thereon and who does such work himself or through his own employees,
that improvements intended
Mech. Aet
28.00
provided such are not or offered for sale. If, however, the building
or improvement is sold within one year o/ completion, the owner -builder will have the burden
of proving that he did not build or improve for the purpose of sale.)
Electrical7 62
' w
0 1, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing
00
• slruct the project. (Sec. 7044, Business and Professions Code: -The Contractor's *License Law
does not apply to an owner o/ property who builds or improves thereon, and who contracts for
S•M•1. +
such projects with a contractor(s) licensed pursuant to the Contractor's -License Law.)'"
Grading
❑ I am exempt under Sec. B. & P.C. for this reason
20.00
Driveway Enc. 20.00
Date Owner
Infrastructure �.�J.Qr.
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
[I Copy is filed with the city. O Certified copy is hereby furnished.
TOTAL
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE '
REMARKS
(This section need not be completed if the permit is /or 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 Ownei "
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become
ZONE: BY:
' subject to the Workers' Compensation provisions o/ the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
-Minimum Setback Distances: -
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Ihereby affirm that there is a'construction lending agency for the performance of the
Side Street Setback from Center Line
work for which this permit is issued. (Sec. 3097, Civil. Code.)
Side Setback from Property Line
Lender's Name
Lender's AddressFINAL
This is a building permit when properly filled out, signed and validated, and is subject to
DATE INSPECTOR
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 andsstate laws relating to building
construction, and hereby authorize represe6tativ6sa of'this city to enter the above-
mentioned propertytor inspection purposes.'' ��``+F✓/� rr� )� f��
Validated by:
Signature of applicant. —�r✓_Fu Date 1 f C
Mailing Address l `yam?�
Validation:
City, State, Zip f
Ab153 8 7 2i 3 41 U
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SO, FT. ®
CAR P. SQ. FT.
WALL SO. FT. ®
SQ, 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
BONDING
FLOOR DRAIN
MECHANICAL FEES
, FORMS ,00�,411
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP./EQUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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.
SQ. FT. RESID ® 11/. c
SEWAGE DISPOSAL
�J(�
SQ.FT.GAR ® V4c
HOUSE SEWER
VENTILATION
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 I PLUMBING ELECTRICAL HEATING & AIR COND. - SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
LAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
, FORMS ,00�,411
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
ee
/ OUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
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. �P?
FRAMING
FINAL INSP.
ROOFINGJ%a��i l Z
�J(�
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
NSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
1 VII"J Jllil'IAI VII CJ/IMI I IALJ,
GARDEN WALL FINAL
IF
P.O. BOX 1330 PALMDALE, CALIFORNIA 93550
May 19, 1986
City of La-Quihta
P.O.Box 1504
La Quinta, Ca. 92253
Re: Building permit 52-140 Avenida Juarez
Dear Pam;
Due to conditions behond my controii°.I have not been
able to start construction on the above mentioned
parcel. I believe to the best of my knowledge that
I will be able to comence construction shortly.
I will greatly appreciate your patients concerning
this matter.
T k you 4
Chris Dvorak,r'
D&C ' Inc ..
'90
` °Fw x`986
OFp���NlM
ED
-0
y BERMUDA DUNES r
RANCHO MIRAGE
INDIAN WELLS ti
PALM DESERT
Jr LA OUINTA
INDIO y�
Desert Sands UAed School District
82-879 HIGHWAY 111 O INDIO, CALIFORNIA 92201.5678 • (619) 347-8631
August 5, 1986
City of La Quinta
Department of Community Development
78-105 Calle Estado
La Qui*nta, CA 92253
Re: 52-140 Avenida Juarez
Gentlemen:
The developer of the above referenced lot
has mitigated its impacts on our overcrowded schools by payment
of the amount of $628 per unit to be applied to the cost of
district educational facfli:ties made necessary'by such new
development.
Sincerely,
� L -ii. n
John D. Brooks
Assistant Supe.rintende.nt
Business Services
JDB/crm
09WO
78-105 CALLE ESTADO -- LA QUINTA, CALIFORNIA 92253 - (619) 564-2246
FAX (619) 564-5617
June 28,' 1991
To Whom,It May Concern:
The structure located at 52-140 Avenida Juarez will be located in a
"B" flood zone per the revised F.I.R.M. ( panels 060709-005 A and
0010 A) for La Quinta. This change will be effective August 13,
1991. The property is currently designated as zone AO (depth two
(2) feet).
If you have any questions, feel free to contact me.
Sincerely,"
B NG AN AFETY
Tom Hartung
Director of Building and Safety
TH/es
LTRTH30
MAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253