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08589 (SFD)i P.O. BOX 1504 N o . Building 78-105 CALLE ESTADO Address 54-035 JDASAZ LA QUINTA, CALIFORNIA 92253 Mailing Address sav e„ Y.. rr n City p E " "ftel. Contractor Address Zip State Lic. City & Classif. Lic. # Arch., Engr., Designer h Address Tel. City Zip State Lic. # .LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 70 OO) of Division 3 of the Business and Professions Code, and my license is in full force and 'effect . SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following +bw,;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 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 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 of sale.) O 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.) O 1 am exempt under Sec. B. & P.C. for this reason ) Datefuer 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 1 WORKERS' COMPENSATION INSURANCE i (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 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. 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- ,L 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 ateMailing Address City, State, Zip BUILDING: TYPE CONST. OCC: GRP. A.P. Number A—Irk — �Tvrt Legal Description Project Description S.F.D. Sq. Ft. No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation 'PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. ' 259.09 Const. S " g . QQ Mech. S 5. S Electrical Plumbing S.M.I. Grading Driveway Enc. 2h, On Infrastructure 1 9TH preetne TOTAL (� 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. SO. FT. ® $ 2ND FL. SO. FT. POR. SO. FT. ® GAR. SO. FT. ® CAR P. SO. FT. WALL SO. FT. ® SO 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 SLAB GRADE7 FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER SEW R GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED DUCT WORK LAUNDRYTRAY AIR HANDLING UNIT CFM 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 ® 11/4 cSEWAGE DISPOSAL BOND BEAM SO.FT.GAR ® V40 HOUSE SEWER 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 PLUMBIN / NDERGROUND A.C. UNIT COLL. AREA SLAB GRADE7 ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEW R ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLEO0/w GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ -Plus-X$-=$ LUMBER GR. FINAL INSP.? 9� FRAMING FINAL INSP. ROOFING D�/��/� /0�/� REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHINGfby//(j 1111-31f,-'AoW MESH INSULATION/SOUND Z 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 Gannot Be Duplicated (619) 347-8631 Date 8/30/90 Type of Permit I La Quinta No. 110125 - Permit # Owner Name Max Reefer Log No. street See comments below City La Quinta zip 92253 Study Area 110 APN # Tract # Lot # Square Footage 14897 Type of Development Single Family Residence No. of units 0 Comments 54-055 ,TilarPz, 54-035 ,TilarPz and 54-015 ,TllarP7._ 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: EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of 1.58 X 897 or $ 7,73726 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 Max C. Reefer Telephone. 42.8.8215 Name on the check By John D. Brooks Associate Superintendent, Business Services Fee collected /ezempd by Joan Larson /J Payment Received , ... Signature Check No. 1039 Collector: Attach a copy of County or City plan check application form to District copy. Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting OUICE OF l� AGRICULI URAL COMMISSIONER AND WEIGI IIS & MEASURES CAI IN C. KAM114SKAS • A111110111Com folor)nm JAMES O. WALLACE �Ul1U tEM011 SIIiEEI, ptJOM 10 CLEME141 DE14VE141SIE AgfkuftalCommtttlonni 111VERS1UE. CAUrot IJIA 02501. Soolet 011e001 of we+ahls A Meol'ym (714) 767.2561 49613 Iligllway 06,Suite B12 Coachella, Ca. 92236 J ( 619) 342-0291 pc -Dm 711 `10 DATE'�� r CAS r. Iu. DMEMPER' S NNIC 1 M N Y a} �, ✓- ADDRESSe 'lE1,CP11 m t (� - Dear Developert USS After reviewing your Inlxlsceping plans, n11 plant noterital listed is not in violatiota of guaralltille laws yoverliilfy tllc Coachella Valley. if substAutiolts do occur amJ they differ fj:u,j plant nuterial listed, this office must be notified immdiately. 'Ihank you for protecting aiyJ preserving Ute Coachella Valley's pest -free envimmlent. Agr c ural'C:aitidtsi.oner 8 UELI.ce cc g Itxiio and Riverside of f ice LvC QJ r G