11332 (SFD)Building r
Address"' Navarra
Owner
David Ross miller
Mailing
Address Q. Oe BOX 722
44 )
P.O. BOX 1504 6' t ' �� N 0 .
78-105 CALLS
LA QUINTA, CALIFORNIAORNIA 92M f
Cit Zip Tel.
Ea Quinta 92253
Contractor
Pacific Traces Dev.
-Address
same
State Lic. City
& Classif. B 425381 1 Lic. # . 1955
Designer
Address Tel.
;ity IZip I State
Lic. #
M that
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 -s in full force and
effect.
\ OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's Lirense Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
permit to construct, after, 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
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).
❑ 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 contractors) licensed pursuant to the Contractor's License Law.)
0.1 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
WorkePs Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
4 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 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
This is a building permit when property 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
11332
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number,
Legal Description trot 14 Block, 251
Project Description SFZ+
as'"rilfuF7f�:t;ti#s:7"t1�Y i`rYt+a."<3.S ,i?
.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. 1372
Size
No.
Stories
No. Dw.
Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition, ❑
Permit does
not include
block wall
or pool
Estimated Valuation
93, 034-.-60
PERMIT
AMOUNT
Plan Chk. Dep. `
257.70
Plan Chk. Bal.
241.78
Const.
567.50
Mech. _
55.50
Electrical
121.82
Plumbing
141.00
S.M.I.
8.40
Grading
20.'00
Driveway Enc.
00
Infrastructure
1830.03
TOTAL
3236.03
2986.03
REMARKS
as'"rilfuF7f�:t;ti#s:7"t1�Y i`rYt+a."<3.S ,i?
.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- SQ. FT. ®
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. SQ. 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
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEQUIP.
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
FRAMING V �A�
`�Yl
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
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 PLUMBING '00flao
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE a
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
/y
FOUND. REINF. (71l/
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP.�6 2
FINAL INSP.O/
es
GRADING
//
�7 cu. yd.
$ plus x$
_$
LUMBER GR.
FRAMING V �A�
`�Yl
ROOFING / G�
[ I/
��,/V,
W "4' /V! O� �V/� "Y/
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
I G Q
MESH
INSULATIONISOUND 1(9
FINISH GRADING
r
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 9/14/92 Type of Permit La Quinta
No. 111714 Permit #
Log #
Owner Name David Ross Miller
No. 53900 street Navarro
city La Quinta zip 92253 Study Ares 110
APN # I Tract # I Lot # Square Footage 11372
Type of Development I Single Family Residence No. of units, 0
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 be -3n 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 fatality fees imposed pursuant to Government Code 53080
in the amount of 1.58 X 11.372 or $ 2,167.76 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 David Ross Miller Telephone
Name on the check
By James E. Lively
Assistant Superintendent, Business Services
Fee collected /exempted by Shelley D. Bennett,
Payment Recei-ved* '
Signature �0e j, 'Chec'-No. 307;,1 ✓
Collector: Attach a copy of county or city plan check application form to district capy.for all wai:.4eis'
Embossed Original- Building Dept:/Applicant Copy - ApplicanYReceipt Copy - Accountings �,
COACHELLA VALLEY WATER DISTRICT
. 40
CASH RECEIPT DETAIL'
Received From: 1)
Date: f �'
Address:" !.a `� �n�' �....:�.
1 ' �...:
r.. �; Lk it..
% i.
Account No. I ,� i : lr. i
1 - • v "��
i
Lot(s)
Tracf
-�� C"
Service Address .,yC 4"•
f'< i C,
:k
G.A. Coce
Ln <eter(s) - 4
g
--Ifl-Sarvice(s)-
❑ Backflow(s)
❑ House Lateral(s)"
❑ Detector Check(s)
❑ Meter Surcharge
Q-3M61tation Capacity Charge
' ❑ W.S.B.F.C.
❑ Temporary Construction Meter
f, >. ❑ Turn on Charge'
❑ Uncollected Account - Name
O Inspection Fee- Tract -
Fee
❑ Plan Check Fees Water / Sewer -•
Tract -
❑ Bond Payment - A.D. - Bond
Assmt.
❑ Customer Deposit
❑ Other
g r` L.
TOTAL
Remarks:
❑Copy to:
Cash
A L
Water Service .
Check
Money
/ '�
Cashier
Order
} ..Y..
CVWD-438(11189)
AV
OF
E}
m
z5afJON jj*11i*
U . itbt*n� anb t t ktun
This Certificate issued pursuant, to the requirements of Section 306 of the Uniform' Building
Code certifying that at the time of issuance this structure was in compliance with the various
ordinances of the City regulating building construction or use. For the following;
BUILDING ADDRESS 53-920 AVENIDA NAVARRO
Use Classification SINGLE FAMILY DWELLING Bldg. Permit No.. 11332
Group R3 Type Construction VN Fire Zone Use Zone SR
Owner of Building DAVID MILLER Address P 0 BOX 722
City LA QUINTA, CA 92253 By, LONNIE DAY
t.. Dots; NOVEMBER 20,
.1992
Building Official
POST IN A CONSPICUOUS PLACE