002437 (SFD)I
P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address 53-725 AvMiWa Nava To LA QUINTA, CALIFORNIA 92253
Owner
I*ak JobimIicoast.
Mailing
Address^�.
City Zip Tel.
' Inwa 92202
Contractor
Small
Address.
smm
Zip
BUILDING: TYPE CONST. OCC: GRP'
A.P. Number 774-134-021-
5"-2228,
74-134-02 .5"-2228. Legal Description IAS I?
Project Description Simile%*IV
State Lic.
& Classif: 39` 169
City
Lic. # 202
Sq. Ft: �� �
Size-
No. No. Dw.
Stories Units
Arch.,-Engr.;
Designer
New ❑xAdd ❑
Alter ❑ ' Repair ❑ Demolition ❑
Address
Tel.
City
Zip
State
LICENSED CONTRACTOR'S DECLARATION,
hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 o�fi^th�e'Business and Professions Code, and my license is in full force and
effect. w:'Wv.
SIGNATURE o. ' DATE
OWNER•BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
Estimated Valuation
�° 8P•
-, 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.
r requires the.applicant for such permit to file a signed statement that she 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 Lode, or that. he is'exempt therefrom, and the' basis..
for the alleged exemption. Any violation o/ Section 7031,5: by 'any applicant for a permit.
subjects the applicant to a civil'penalty of not more than five hundred dollars (8500).
❑ I, as owner of the property, or My employees with wages as their sole compensation, will
the work, and the structure is not intended or offered for sale. (Sec. 7044; Buisness and s
ProfessionCode: The Contractor's license, Law does not apply to an 'owner o/ property • who
PERMIT
_
- - AMOUNT
- -
Plan. Chk.. Dep. ,
Plan Chk. Bal.
-
320.10do
COf1St.f�
• �.
Mech.
.
31 ;.Q0
builds.oi improves thereon and who does such work himself or through his own employees, -/1
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.-.
o/proving that he, did not build or improve /or the purpose of sale:) ..
EleCtrlCal
- r
90.12
Plumbing
so,�
❑ 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 I am exempt under Sec. B: & P.C. for this reason -
S.M:I.
-'"
Grading(
Driveway Enc.
etii
' Date owner
Infrastructure
1.282.85
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
- O Copy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL
2.237.06
CERTIFICATE OF. EXEMPTION FROM
WORKERS' COM P ENSATIO N INSURANCE
REMARKS
-
(This section need not be completed if the permit is for one hundred dollars (S 100) valuation
..orless.) .. ... _. _ _..
I certify that in the performance of tha work for which this'permit is issued, I shall not
employ any person in any -manner so as to become-subjectto the -Workers' Compensation
Laws of California.
' Date Owner'
NOTICE TO APPLICANT: I/, after making this Certificate o/ Exemption you should become
'subject to the Workers' Compensation provisions o/ the Labor Code,- you -must forthwith
comply with such provisions or this permit shall be deemed revoked.
ZONE: BY:
Minimum Setback Distances: -
Front Setback. from. Center Line
Rear Setback from Rear Prop. Line
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.) - _
'
Side Street Setback from Center Line
Side Setback from Property Line
Lender's Name
FINAL DATE
-
INSPECTOR'
6-16
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.
agree to comply with all city and county ordinances and stateflaws relating to building
construction, and hereby authorize representatives of this city to enter the above,
mentioned property for inspection purposes. // Jj,
Signature of applicant r. i. ,'! /✓�a Date
Issued by:
Validated by:
Date Permit
Mailing Address — "
Validation:
A5897
7 1 2237,06 CK
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES 1
1ST FL. SQ. FT. ® $
UNITS
SLAB GRADE
2ND FL. SQ. FT. ®
YARD SPKLR SYSTEM
FOR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT. ®
ROCKSTORAGE
DRAINAGE PIPING
WALL SQ. FT. ®
DRINKING FOUNTAIN
SQ. FT. @
OTHER APPJEQUIP.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
T P. POLE 711
WATER PIPING
NOTE: Not to be used as property tax valuation
SERVICE
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
L
GRADING
cu. yd.
$ plus x$
_$
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL . FLOOR • SUSPENDED
af
`/
LAUNDRY TRAY
AIR HANDLING UNIT CFM
REMARKS:
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
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
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
ZX; RMS n /
/ (
/ P ER OR
ROUGH WIRING
DUCT WORK
ROCKSTORAGE
&eFOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
T P. POLE 711
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
L
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP.�
FRAMING l C/�
FINAL INSP.// / Q�/
R OFING k� i�'
D
af
`/
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
THING a — S,— }Z7
MESH
N61NSULATIONISOUNDr 1 �(
`` r
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
w11
L
o
—0
Desert Sands Unified School District,
y BERMUDA DUNES
RANCHO MIRAGE
82-879 HIGHWAY 111 O INDIO, CALIFORNIA 92201-5678 O If 19) 347-8631
INDIAN WELLS H
PALM DESERT a
JP LA OUINTA
►�C I NDIO .lam
•'
July 1, 1986
City of -Aa Quinta
Department of Community
Development
78-105 Calle Estado
La Quinta, CA 92253
Re:. Lot ll, BI 241,
Unit 23
Gentlemen:
The. developer of the
above referenced lot
has mitigated i-ts impacts
on our overcrowded schools by payment
of the amount of $628
per unit to be applied to the cost of
district educational
facilities made necessary by such new
development.
Sincerely,
John D. Brooks
Assistant Supe.ri.ntende.nt -'
Business Services
JDB/crm