05873 (SFD)4
P.O. BOX 1504 N o . 0587-3.
Building7&105 CALLE ESTADO
Addres53.-360 Ave Navarro LA QUINTA, CALIFORNIA 92253
Owner
Norm= Staraf€ice
Mailing � BUILDING: TYPE CONST. OCC: GRP.
Address P.O. Box 457 A.P..Number 774-095-007
City Zip Tel. •.
� yli lit
92349 'iIZ650 -3591 Legal Description
Contractor
Project Description a•'
Straffin Dev. Co.
Address
game
City Zip Tel.'
State Lic. City
& Classif. 539977' Lic. # Sq. Ft. 1417 No. No. Dw.
Arch., Engr.,
Size Stories Units
•� -
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
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
700 of,Division 3 of the Business and:Professio •Code, and my license is in full force and
effect. y
_SIGNATURE /' .+' DATE
OWNEWBUILDER DECLARATION Estimated Valuation. A
I hereby affirm that I am exempt from the Contractor's License Law for the following7E, 769 •a
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 kite a signed statement that hes licensed pursuant to PERMIT
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of AMOUNT
Division 3 of the Business and Professions Code, or that he is exempt Merehom, and the basis �f tt
for the alleged exemption. Any violationai
of Section 7031.5 1W ry applicant for a permit Plan Chk. Dep. 250.00
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. • 45
do the work, and the structure is not intended or offered for safe. (Sec. 7044, Buisness and Const.�� • J
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, MBCh
provided that such improvements are not intended or offered for sate. Il, however, the build.ing
or improvement is sold within one year of conptation, the owner -builder will have the burden Electrical
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- Plumbing •��
struct the project. (Sec. 7044, Business and Professions Code: The Contractors License Law
does not apply to an owner of property who builds or improves thereon, and who contracts for S.M.I. .0 JJ
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) ,' •�
❑ I am exeGrading
mpt under Sec. B. & P.C. for this reason
Driveway Enc. Zu -
Date Owner Infrastructure _ 3 400
'C.i tis.` it T35- 2-5.00
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.) M,�. ! (x•6 �' f U+
Policy No. Company It. ey% + i
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished:
TOTAL 2 3. 00
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars (5100) valuation
or less.) _
I certify that in the performance of the work for which this permit is issued, I shall not Y .4
employ anyperson in any manner so as to become subject to the Workers' Compensation
Laws of California. ixlkkf. 7z-;ilta A0.4 4 •P'70,-1r�
Date Owner a vrovrc ... ,,, < T
NOTICE TO APPLICANT: !f, after making this Cede of Exemption you should become ZONE: By'
subject to the Workers' Compensation provisions of the labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked. 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, Civ9Code.) Side Setback from Property Line
Lender's Name
Lenders Address FINAL DATE INSPECTOR
This is a building permit when properly filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 180 days.
I certify that 1 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
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
2ND FL. SO. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. I 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
ROUGH PLUMB.
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GAS (ROUGH)
LAUNDRY TRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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
S� J
FOND BEAM 7—CJ (
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1+/. c
SEWAGE DISPOSAL
FIRE ZONE ROOFING
SO.FT.GAR ® 3/ac
HOUSE SEWER
GAR. FIREWALL
THING
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 —
'V CCC
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR�SE�P K
H WIRING
DUCT WORK
ROCK STORAGE
FO D. REINF. lj vA5
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
S� J
FOND BEAM 7—CJ (
WATER SYSTEM
FINAL INSP.
N.
J�
GRADING
FINAL INSP. cu. yd.
$ ptus x$
REMARKS.
l•�
J
_$
LUMBER GR.
FRAMING
ROOFING
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
THING
MESH
XUGNSULATIONISOUND ��
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
`
GARDEN WALL FINAL
Desert Sands Unified School District
CERTIFICATION OF PAYMENT
OF
SCHOOL FACILITY FEES
NOTICE: THIS ®OCUmENT CANNOT
TO: City ofBlS Q:� KATE' DATE:
Department of Community Development
78-105 Calle Estado
La Quinta, CA 92253
W
�.
This is to cert' y that - Luca
developer of wwh,�ic,h/�
located at - — 6 wgnQkirt ��/�•�
this District, has paid school facility fees imposed pursuant to the
au o y gMrat y vernment o Sec ion 5 0 0 'n e amo nt o s
covering a total of square feet of (I ) res dential or
( ) industrial/commercial de elopment and that building permits for
this footage in this development may now be issued by yDur jurisdiction.
pC! D for DESERT SA S UNIFIES SCHOOL DISTRICT
White - Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer
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