04559 (SFD)��. P.O. BOX 1504
Building', 78-105 78-105 CALLE ESTADO
Address' y LA QUINTA, CALIFORNIA 92253
Owner , r
Dan Featheri gill
Mailing „
Address' •
Cityr,
p Tel.
-
Contractor
owner/Builder
Address
City Zip Tel.
• �4
State Lic. City
& Classif. Lic. #
Arch Engr.,
Designer
Address Tel. .
r +�
City Zip State
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
effect. I . .
iG-R TORE - DATE
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, 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
the provisions or 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 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 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
71'! .i fi t -{'"' .. • . ,... "»•- •�--- rte- . �'
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.
•r
vL 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 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.
04559
BUILDING: "TYPE CONST. OCC. GRP.
A.P. Number 773--244--006
Legal Description
Project Description Single Family nweilig5
Sq. Ft. No. No. Dw.
Size 1640 Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line
Ihereby 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 properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days. 9 1 1 / 8 9
1 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
WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY: FILE
Estimated Valuation0e0
PERMIT
AMOUNT
Plan Chk. Dep.
$260 04
Plan Chk. Bal.
$ 95,56
Const.
406.00
Mech.
36.00
Electrical
80.11
Plumbing
()0
12940
S.M.I.
6134
Grading
20.00
Driveway Enc.
20.,00 -
Infrastructure
2,025.34-
,,025R24TOTAL
TOTAL
r06:
REMARKS
Lith t r iEl 1�`Ei.�
icy^d:r Ui IQ
11V t.ttart i1
1101ffl.. .i 41;A 0.0J
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line
Ihereby 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 properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days. 9 1 1 / 8 9
1 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
WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY: FILE
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL SO Fl rp S
UNITS
COLL. AREA
GRADE/?zY
—4
ROUGH PLUMB
YARD SPKLR SYSTEM
2ND FL SO FT. @
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC
BAR SINK
POR SO FTCr
DUCT WORK
ROCK STORAGE
GAR SO. FT.
POWER OUTLET
ROOF DRAINS
HEA7 (FINAL)
DRAINAGE PIPING
CAR P. SO FT.
GAS (FINAL)
HEMP. POLE
WALL SO FT. C
DRINKING FOUNTAIN
SO. FT. B
WATER HEATER
URINAL
ESTIMATED CONSTRUCTION VALUATION j
FINAL INSP.
WATER PIPING
NOTE* Not to be used as property tax valuation
WATER SYSTEM
FLOOR DRAIN
MECHANICAL FEES
GRADING
cu. yd.
j plus xj
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTOXDISH)
APPLIANCE DRYER
ROOFING
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
�/�_
LAUNDRYTRAY
AIR HANDLING UNIT CFM
VENTILATION
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEM/PERM
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 V. c
SEWAGE DISPOSAL
SO.FT.GAR @ 3i4c
HOUSE SEWER
MESH
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
Q. ROUND PLUMBINP�-(454-
UNDERGROUND
A.C. UNIT
COLL. AREA
GRADE/?zY
—4
ROUGH PLUMB
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEA7 (FINAL)
OTHER APP.IEOUIP.
REINF. STEEL
GAS (FINAL)
HEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
j plus xj
=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
W
�/�_
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
GFINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
Desert Sands Unified School District
CERTIFICATION OF PAYMENT
OF
NOTICE: THIS DOC UPA, rib-ZoCtX99 3�,tlTY, FEES
BE DUPLICATED. cry
TO: City of La Quinta DATE:
Department of Community Development
78-105 Calle Estado
La Quinta, CA 92253
(OLAM)
This is to certify that ,•% ,[% l developer of (� i0i which is
located at within
this District, has paid schoo fa ility fees impos&b pursuant to the
au ori ge erate by Government C de Section 53080 in he amount of
gob'M . M� ( . � 3�
covering a total of / quare feet of ( ) residential or
( ) industrial/commercial development and that building permits for
this footage in this development may now be issued by your jurisdiction.
�o �IoO x 80%; zAtd-ow 6
)� n for SERT SA UNIFIED SCHOOL DISTRICT
White- Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer
(10)-37
O f R\
01A'�,a"�* ;;� 1 ` 0111f_E OF E. LEON SPAUGY
j AGRICUL�I URAL CONIMISSIONE11 coa•��sO JAMES O WALLACEu'ALL
AN ASS:SPAM C+N.c115SIONEP
WEIGHTS TS & MEASURES CLEMENT BE`VENISTE
V
'�},,� 49-613 Ilwy 86, Suite B-12
Coachella, CA 92236
q r 9 aq 619-342-8291
DATE % - 2 2 - fJ CASE M. BIZ S 0 7 2 2-A
DEVELOPER'S NAME:
ADDRESS:
TEL EPI IONE: --
Dear
Dear Developer: T/ /
.r
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 frau plant m3- terial listed, this office must be notified
immediately.
Thank you for protecting and preserving the Coachella Valley's pest -free environment.
Agricultural Canni.ssi a 's Office
cc: Indio and Riverside Office