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06228 (SFD)4 P.O. BOX 1504 N o • Building 78-105 CALLE ESTADO Address 54-475 Juarez LA QUINTA, CALIFORNIA 92253 Mailing' Address " City Zip Contractor Address ty State Lic. I City & Classif. Lic. # Arch., Engr., Designer Address Tel. CityI Zip I State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7(100)ffect of Division 3 of the Business and Professions Code, and my license is in full force and e SIGNATURE DATE OWNEWBUILDER DECLARATION I hereby affirm that I am exempt from the Contractors License Law for the following reason: (Sec. 7031.5,6usimess 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 app6caut for such permit to rite a signed statement that he is licensed pursuant to the provisions of the Contractors 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 civi penalty of not more than rive 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 krproves 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-bugder will have the burden of proving that he did not build improve or prove for the purpose of sale.) ❑ 1, 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 appy 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 Workers 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 IS 100) valuation or less.) I certify that in the performance of thg work for which this permit is issued, I shall not employ any penton 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 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.) Lender's Name Lender's Address This is abuilding permit when properly filled out, signed and validated, and is subject to expiration it work thereunder is suspended for 180 days. I certity that 1 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 06228 BUILDING: TYPE CONST. OCC: GRP. A.P. Number 774-232-012 & 024 Legal Description Project Description••• Sq. Ft. No. No. Dw. Size 1512 Stories Units New ❑ • Add ❑ Alter ❑ Repair ❑ Demolition ❑ Lot lily adiiist n:t 4 itx£rastmeture £ep Estimated Valuation $78,591 PERMIT AMOUNT Plan Chk. Dep. s2si.ii Plan Chk. Bal. Front Setback from Center Line Const. Rear Setback from Rear Prop. Line Mech. Side Street Setback from Center Line Electrical Side Setback from Property Line Plumbing FINAL DATE S.M.I. Grading $ 5.39 Driveway Enc. Validated by: Infrastructure 851.54 Validation: TOTAL $1,117.03 REMARKS QVLiOV —LS�JA-7 f) X ..VU 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 .8/29/89 Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL SQ. FT. ® $ UNITS ` COLL. AREA Leo LAB GRADE YARD SPKLR SYSTEM 2ND FL SQ. FT. BONDING HEATING (ROUGH) MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® ROUGH WIRING GAR. SO. FT. ® POWER OUTLET ROOF DRAINS GAS (ROUGH) DRAINAGE PIPING CAR P. SO. FT. ® HEATING (FINAL) OTHER APP.IEQUIP. WALL SQ. FT. ® GAS (FINAL) DRINKING FOUNTAIN SO FT ® URINAL ESTIMATED CONSTRUCTION VALUATION $ GROUT WATER PIPING NOTE: Not to be used as property tax valuation SERVICE FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GRADING cu. yd. plus x$ GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM I I IKITCHEN 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 SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR ® Vic HOUSE SEWER GAR. FIREWALL 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 PLUMBI 1-4Irz UNDERGROUND A.C. UNIT COLL. AREA Leo LAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE 4tOUND. REINF ? — 111 GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IEQUIP. 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. /�/J/g 4AERAMING /v-" ( - (Fj FINAL INSP. RO FING - Yv AI REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL HING MESH U INSULATION/SOUND/&? —649 FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL t Desert Sands Unified School District CERTIFICATION OF PAYMENT OF r s ® � SCHOOL FACILITY FEES � p'� ^Ulfty'r Q �j �DATE: ��O 1 TO: City of La'QuPi� � Department of Communiti De4velopment 78-105 Calle Estado La Quinta, CA 92253 This is to certify that R�-tw (4 .developer of which is located at , within this District, has paid school facil' y fees imposed pursuant to the authorit_ gene ate by Gov rnment Code S tion 5 080 in the a ou t of S 0 , covering a,total of square feet of ( ) res e i 1r `73/J-0 ( ) industrial/commercial development and that building permits for this footage in this development may now be issued by your jurisdiction. :f% Q 1k, p � mo�� for DESERT SANDS -UNIFIED SCHOOL DISTRICT White - Building Department 0 Yellow - Facilities Planning • Pink - Accounting • Gold - Developer (10)-37 P m Date: COACHELLA VALLEY WATER DISTRICT N2 25649 CASH RECEIPT DETAIL Received From:/ 4/1 i i .^,r//•' Address: `-+�! 1/x/"2/ l�/) r si��=/r .ix r'! /� A", Account No. /�� `� �— a'l Lot(.) ❑ Meter(s) Q ❑ Service(s) ❑ Backflow(s) ❑ House Lateral(s) ❑ DetectorCheck(s) ❑ Meter Surcharge L�Sanitation Capacity Charge ' ❑ W.S.B.F.C. ❑ Temporary Construction Meter ❑ Turn on Charge ❑ Uncollected Account - Name ❑ Inspection Fee - Tract - Fee - ❑ Plan Check Fees Water I Sewer - Tract - ❑ Bond Payment - A.D. - Bond Assmt. n rQfnmar nPnn Clt ❑ Other Remarks ❑Copy to: Cash Check Money Order 4, TOTAL Water Service Cashier. '--CVWD-438 (8188) _ _ Date: COACHELLA VALLEY WATER DISTRICT CASH RECEIPT DETAIL Received From: vt0 �1 I 1,ci u+ ri Address: Account No. LB l� ! ,/ j - /3 Lot(s) -�O Meter(s) 191 Services) ❑ Backflow(s) ❑ House Lateral(s) ❑ DetectorCheck(s) ❑ Meter Surcharge ❑ Sanitation Capacity Charge ❑ W.S.B.F.C. ❑ Temporary Construction Meter ❑ Turn on Charge ❑ Uncollected Account - Name ❑ Inspection Fee - Tract - Fee - ❑ Plan Check Fees Water I Sewer - Tract - ❑ Bond Payment - A.D. - Bond Assmt. ❑ Customer Deposit ❑ Other Tract �G G.A. Code N° 253.75 /, TOTAL $ 6 a' •S . v ✓ Remarks: �P/ i// C� liiJ ( CC -4--v_,5- Z/ - / % 5✓ ❑Copy to: Cash Check s � Water Service G Money Order ,.` • „> Cashier x _� CV•, WD,438 (8/88) 1)I I11 -E or AGRIC:UL I URAL CUMMISSIUMLIt ANO WI:IGI I IS &. IALASURES 49-613 IINy 116, Hulte 11-12 'Conthello, CA 92236 619-342-0291 E. LE0)1+ SI'AI;r,Y (O'.tVl� illl'.(n )n�1r.5 v WMAU �}N}ia�t �yr.�•.0}}n��(n CEEMENI V.NVEMSIE Suan • � 1 CASE Iu.J14 q'1— �u'F i� oR MniC �' '� VEVCLAI'L'li' 5 (W1�(` i� 4� 13 c Iti r tijA I' h l�l)UItE5S 1 `; ® 2 S i9ot tear 1)eveloperi 11Eter reviewlny your 1a11(1sct�I)I.I1(1 I)lans, t(nl �)lEllit ac ellatvalley.erial If suLslitu 10119 violation Of: yuarantLle ll)+vs t�uvallt ly er �o�c do occur E�IId they dItter [run Itlallt material listed, tills v[[ice must be 1lvti) ied jinllediately. 'i•1)a1Jc you Lor protectbly mid pieserviny the Coachella valley's lest -11: a envlM11l1ent- �' Ayri ltural C nt s lo-iier s UL [ice cc, ludio mid Itiverslde u[[ice '��SIDE C,0 APPROVED ��' R Y: DATE: v Al. G