10264 (SFD)Building 52-370 JuarezAddress
Owner
tions Construction
P.O. BOX 1504 No. 10254
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Mailing
Address 54-360 Martinez
City Zip Tel.
La Quinta 1 92253 564.0793
Contractor
Address . „
City lZip
State Lic. , City
& Classif. > `613406 Lic. # 0105
Arch., Engr.,
Designer
Address Tel.
City I Zip I State
..,,. • Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that Iam licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business
s a nnd:Professions Code; and my license is in full force and
effect. i f .{ �. _ a^K 3 e✓ r+� _ :` 1,
SGNATt1REY' DATE
OWNER -BUILDER DECLARATION
1I ,hereby affirm that I am exempt from the Contractor's License Lawfor 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
requires the applicant for such permit to Ole a signed statement that he is licensed pursuant to
• the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 or 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).
❑ I, 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 or 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 or 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 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 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 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
11LDING: TYPE CONST. OCC: GRP.
P. Number 773-251-006
Description
Project Description SFEI
TOTAL tSSt2 ,. 4i.lC `ih .3orJ�.7:G a"
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:
Sq. Ft. 1557
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolitiori ❑
Permit doezd
not include block wall
or pool
Estimated Valuation
'95,619.50
PERMIT
AMOUNT—
MOUNT• ;Plan
PlanChk. Dep.
250.00
Plan Chk. Bal.
278.88
Const.
621.50
Mech.
49.00
Electrical
128.50
Plumbing
,160.50
S.M.I.
9.60
Grading
20.00
Driveway Enc.
20.00
Infrastructure
2020.34
TOTAL tSSt2 ,. 4i.lC `ih .3orJ�.7:G a"
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
1ST FL. SQ. FT. ® $
2ND FL SQ. FT.
POR. SQ. FT. ®
GAR. Sp. FT, ®
CAR P. SQ. FT.
WALL SQ. FT. ®
Sp 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
ROUGH PLUM
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GAS (ROUGH)
LAUNDRY TRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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
BOND BEAM
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ic
HOUSE SEWER
FINAL INSP.
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 9�
GROUND PLUMBING !� 7
DERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE �� /
ROUGH PLUM
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
S PTIC TANK
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APFJEQUIP.
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.
% 2 2
FRAMING //2`
�/
FINAL INSP.
ROOFING /
O
r I
O
1
b
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING 9CW) /
MESH
INSULATIONISOUND
�l
FINISH GRADING
FINAL INSPECTION -
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 11/4/91 Type of Permit I La Quinta
No: 10963 Permit # 110264
Owner Name Expectations Construction Log #
No. 52370 street Juarez
city La Quinta zip 92253 Study Area 112
APN # I Tract # I Lot # Square Footage 11557
Type of Development Single Family Residence No. of units
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:
This certifies that school facility fees imposed pursuant to Government Code 53080
in the amount of 11.58 1 X 11.557 1 or $ 2,460.06 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 Jim Snellenberger
Name on the check
Telephone 5644793
By James E. Lively �� i ri'•fr�
Assistant Superintendent, Business Services '~ r�`,
Fee collected /exempted by
^ r
Payment Received.
X
Signature Check ,l o.-0355
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
13
CALVIN C. KAMINSKAS + �►
Assistant Commissioner o ,
(714) 275.3000 '
4►i Is
OFFICE OF .
AGRICULTURAL COMMISSIONER
JAMES O. WALLACE, Commissloner
83-612 Avenue 45 Suite 7
Indio, CA 92201
(619) 342-8291
DAN RILEY
Sealer. Welghts & Measures
(714) 275.3030 .
DATEQllr� 02 9 q I CASE NO. �C IqL.S
—T
DEVELOPER'S NAME: �I M S,�i/3L ,�••=iy�s�G�� -
ADDRESS:
Lf� Ck' i- CA
TELEPf (ONE : ( ) S Q
Cof y G�oJc �P�fao 16117 &&3-f Co so N6 e4 is?/ &24a u4a.
3.2 9u"o cats— X41 Ma,Q&o cof3 &ock,sl ear,'
cellk 8/ork3 / MAAto Ldl 7
Dear Developer:
After reviewing your landscaping plans, all plant material listed is not in
violation of quarantine laws governing the Coachella Valley. If substitutions
do occur and they differ from plant material listed, this office must be notified
immediately.
Thank you for protecting and preserving the Coachella Valley's pest -free environment.
Agricultural Comnissio is Office
cc: Indio and Riverside
4080 LEMON STREET, ROOM 19, RIVERSIDE, CALIFORNIA 92501 — FAX (714) 275-3012
. is