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08710 (SFD)Jz O - lo. AlECTA26D P.O. BOX 1504 N o . 08710 . Building S G% 78-105 CALLE ESTADO Address Vii! �,_ mt rAr+ tnt 'LA QUINTA, CALIFORNIA 92253 Owner R a�e'i1rc11 i lci-Tr �llcg flr�cs _ [' - BUILDING: TYPE CONST. OCC. GRP. Mailing Address P.O. ,o3z 13003 A.P. Number CityZip Tel. ,^ rA eApIr 225 771-1702 Legal Description i Contractor Project Description " Rancho CaDiStranO IOv. CO2:0. Address _wlrrsx-t� a. _,�w a� t+K cin sa City Zip Tela State Lic. City s & Classif. 597975 Lic. # Sq. Ft. No. No. Dw_ k Arch., Engr., Size Stories Units Designer rkna Groun Arch. New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. -- 6 Ciornarate LarAe 714/261-9262 City Zip State rid r1ock 1 40771 A Lic. # LICENSED 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 is in full force and effect: SIGNATURE DATE ' OWNER -BUILDER DECLARATION I herebyaffirm that I am exempt from the Contractor's License Law for the followingEstimated Valuation f •s reason: (se. 7031.5,Business and Professions Code: Any city or county which requires 31 +7. its 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 PERMIT AMOUNT 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 A for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit Plan Chk. Dep. 254, 60 - .4 subjects the applicant to a civil penalty of not more than five hundred dollars ($500). Plan Chk. Bal. O 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 Const. T 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, Mech. _ (� 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 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 . struot 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 S.M.I. such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading :i nin ❑ I am exempt under Sec. B. 8 P.C. for this reason Driveway Enc. Date 4T--- % `` 'bwner Infrastructure 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. TOTAL CERTIFICATE OF EXEMPTION FROM REMARKS %. WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less.) 5r f d? 6 }' V. +:F •• i �6 - -r' r,* I certify that in the performance of thg work for which this permit is issued, I shall not §1y `t k�4 a ` 0510 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 ZONE: BY: subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Minimum Setback Distances: comply with such provisions or this permit shall be deemed revoked. Front Setback from Center Line Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY Side Street Setback from ,Center Line 1 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.) Side Setback from Property Line Lender's Name Lender's 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 I 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 slate laws relating to building construction, and hereby authorize representatives -of this city to enter the above-. r, 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. SQ. FT. ® $ 2ND FL. SQ. FT. ® POR. SO. FT. ® GAR. SO. FT. ® CAR P. $Q. FT. WALL SO. FT. ® SQ, 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 GARBAGE DISPOSAL FURNACE UNIT WALL. FLOOR SUSPENDED FOUND. REINF. LAUNDRY TRAY AIR HANDLING UNIT CFM 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 1BATH 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 ROOFING k,K 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 SETBAC GROUND PLUMBING, 4�)l1NDERGROUNDI� /� A.C. UNIT COLL. AREA SLAB GRADE 0 ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS L©SEWER OR SEPTIC TANK/ ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE 3 / GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM �1 INSP. � FINAL INSP. ir 3 L GRADING cu. yd. $ —Plus—X$—=$ LUMBER GR. / y, FRAMING [ /—FINAL ROOFING k,K REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING �� a Lb MESH INSULATIONISOUND _l ( &P FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL L.2—Y INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL •RROwN PRINTING. INDIO 2700 7190 262022-C4 V 1 ' ot • 1GlGI�/ (lVlcv,s G U P.O. BOX 1504 APPLICATION ONLY Building / 78-105 CALLE ESTADO Address LOT (00 LA QUINTA, CALIFORNIA 92253 Owner BUILDING: TYPE CONST. OCC. GRP. Malting Address "?o 30 0 A.P. Number y Zip Tel. 1'" k5 9 7Z5_,5- 1773-/7,0-2- Legal Description" Contractor (Project Description Address Zipr'1'22� Tel 177-/70-L State Lic. City & Classif. S5` -7G2 7 5 Lic. # Arch., Engr., Designer Address I Tel. . Z in ' / i "1-) ZiA- 4— City City Zip State IZVI N S 97_-711,Lic. # LICENSED CONTRACTOR'S DECLARATION I hereb affirm that I am lic under provisions of Chapter 9 (commencing with Section 7000) of� 3 of t usI s nd Professio Code, and my li of in full force and effect. � —7 SIGNATURE cT�c !� DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Buslness 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 rile a signed statement that he is licensed pursuant to Me 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 rive hundred dollars ($500). ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do the wow;. and the struc;ura is not iaieade , o- ofiw j for =ale. ;Sec. 7044, Buisness and rYoifosslons Code: 7re Conuac:ar's tacei,se Lavv Does nc; appPy 10 3n 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. d, 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 Wild 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 Wilds 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 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 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 anyparson in any manner so as to become subject to the Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT., it, 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 thi�permitis ' d. (Sec. 0 i I C,ode.10Lender's Name�& 1—(L S� ` brLender's Address? . �c ./� to 10 fie` ��Q:r / This is a building permit when properly filled out, signed and validated, ar?d is subject toI expiration it work thereunder is suspended for 180 days. I certify that I have read this application and state that the above Information is correct. 1 agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatloe, ,of this city to enter the above-. mentioned property for�j Signature of applicant ,����X�� Date �Zb—/b 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 fron Property Line FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Mailing Address —I Validation: City, State, Zip�i���_ Sq. F . Size No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ 1 D Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. (const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure 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 fron Property Line FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Mailing Address —I Validation: City, State, Zip�i���_ 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 NOTAPPLICABLE This certifies that school facility fees imposed pursuant to Mitigation agreement in the amountof628.00 X 0 or$ 628.00 have been paid to D.S.0 S.D. for the property listed above and that building p Per't3' g permits and/or Certificates M_gAicy for this square footage in this proposed project may now be issued. Fees Paid By Rancho Capistrano Development Corp. Telephony � `5644,TQ5' s¢ Name on the check { e "= ; . xY 4 y _ By Richard M. Beck Director, Facilities Planning & Development Fee collecteAexempted by Carlene Ellenz J Pay_ Tent"Received . Signature Check No. 1.197 Collector: Attach a copy of County or City plan check application form to District copy. Embossed Original= Building Dept./Applicant Copy - ApplicanbTeceipt Copy - Accounting DESERT SANDS UNIFIED SCHOOL DISTRICT 82-879 Highway 111 NOTICE: Indio, CA 92201 Document Cannot Be'Duplicated (619)347-8631 Date 12/7/90 Type of Permit La Quihta No. 10312 Permit # Log # Owner Name Rancho Capistrano No. 50-910. Street Nectareo y City La Quinta zip 92253. Study Area' 117 APN # Tract # 124890 J Lot # Square Footage 1 Type of Development No. of unite Comments $62,9.00 per unit aG ner aerPPmPnt At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways; residential additions. under 500 square feet, detached accessory structures or replacement mobilehomes. It has been determined the above-named owner is exempt from paying school fees at this time due to the following reason: EXEMPTION NOTAPPLICABLE This certifies that school facility fees imposed pursuant to Mitigation agreement in the amountof628.00 X 0 or$ 628.00 have been paid to D.S.0 S.D. for the property listed above and that building p Per't3' g permits and/or Certificates M_gAicy for this square footage in this proposed project may now be issued. Fees Paid By Rancho Capistrano Development Corp. Telephony � `5644,TQ5' s¢ Name on the check { e "= ; . xY 4 y _ By Richard M. Beck Director, Facilities Planning & Development Fee collecteAexempted by Carlene Ellenz J Pay_ Tent"Received . Signature Check No. 1.197 Collector: Attach a copy of County or City plan check application form to District copy. Embossed Original= Building Dept./Applicant Copy - ApplicanbTeceipt Copy - Accounting