11366 (SFD)` P.O. BOX 1504
Building 77_500 Calle Chillon 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner
Pwalden Evans
Address
City Zip Tel.
Contractor
Paulden Evans
Address
ity jZip Tel.:
State Lic. City
I Lic. # 2592
Arch., Engr.,
Designer Rajendra. Patel
Address Tel.
73.4/359--6954
City Zip State
Riverside 92504 Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am -I cT ensed under provisions of Chapter 9(commencing with Section
7000) of Division 3 o the Business an/d/#r/oJfessions Code, and my license is in full force and «�
effect. i�.C/sa ► ... ,,. f • �,C�r+L
SIGNATURE !� DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
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 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 or 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 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 contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec. B. & P.C. for this reason
Date Owner r `
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 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
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 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.
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
No. 11366
BUILDING: TYPE CONST. OCC: GRP.:
A.P. Number
Legal Description Istat 13
Project Description SFD
Sq. Ft. 1637
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Permit does .not include block walls
or po01
4
Estimated Valuation
94,081.10
PERMIT
AMOUNT
Plan Chk. Dep. v
250.00
Plan Chk. Bal.
27..54
Const.
61!.00
Mech.
49. UO
Electrical
%r,128.50
Plumbing
144.00
S.M.L
9.50
Grading
20.00
Driveway Enc.
.00
Infrastructure
2078.57
�tt��`?tt�•�lf f�-"'i f.`�'�17L iL"!�' ' � •'?�.1 b . 2 1 5 f
TOTAL
3568.11 331U. -11
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 from Property Line
FINAL DATE INSPECTOR
Issued by: Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES �\
IST FL. SO. FT. ® $
UNITS
ROUGH PLUMB. BONDING HEATING (ROUGH)
FORMS
SEWER OR SEPTIC TANK ROUGH WIRING
YARD SPKLR SYSTEM
2ND FL. SO. FT. ®
FOUND. REINF.
GAS (ROUGH) METER LOOP
HEATING (FINAL)
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
BOND BEAM
DRAINAGE PIPING
CAR P. I SO. FT. ®
_$
LUMBER GR.
WALL SO. FT. @
ROOFING
DRINKING FOUNTAIN,
SO FT ®
REMARKS:
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
SPARK ARRESTOR
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GAR. FIREWALL 0 G
LAUNDRY TRAY
AIR HANDLING UNIT CFM
LATHING
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1 Va c
SEWAGE DISPOSAL
SO.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 FEEPLUMB. FEE
STRUCTURE /PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
s
SETBACK
GROUND PLUMBIN 7 UNDERGROUND
A.C. UNIT
COLL. AREA
STORAGE TANK
SLAB GRADE
ROUGH PLUMB. BONDING HEATING (ROUGH)
FORMS
SEWER OR SEPTIC TANK ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH) METER LOOP
HEATING (FINAL)
OTHER APP./EOUIP.
REINF. STEEL
GAS (FINAL) TEMP. POLE
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP.
FINAL I SP. �)� G
o` /
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FRAMING ' X13
ROOFING
_
^3BT NIZICI-0
/Q
ITT `� ' f I t (6 7i -Lt%
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL 0 G
LATHING
AHD l 3
INSULATION/SOUND
FINISH GRADING
FINAL INSP CTION ����` Z
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIA S
GARDEN WALL FINAL
77-500 C a'l/ LL. o P.O. BOX 1504 APPLICATION ONLY
Building 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner
Paulden Evans BUILDING: TYPE CONST. OCC. GRP.
Mailing
Address A.P. Number
City Zip Tel. LOT -13.
Legal Description
Contractor Project Description FAST CORNER OF ' CALLE CHILLON
Otft!ER71m-�R
Addres1525 3rd STREET SUITE "F"
RIVERSIDE 92507 "?14/788-6780
State sic. �� ` City
8 Classif. I Lic. #
Arch., Engr.,
Designer (ARCH.) RAJENDRA PATEL
Address Tel.
(ENGR) JESUS TORRES 714/3691--`6954--
City
14/369=`6954"City Zip State
RIVERSIDE 92504 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 hereby affirm that I am exempt from the Contractor's License Law for the following
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 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
su ' cfs the applicant to a civil penalty of not more than live hundred dollars (5500).
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 i I, as owner o1 tIR "p y, am exclusively contracting with licensed contractors to con-
struct the pro'e�I. (Sec. 7 4, Business and Professions Code: The Contractor's License Law
does not appI fe an owner of properly who builds or improves thereon, and who contracts for
such projects ith a contra r(s) licensed pursuant to the SyllhBttor'S License Law.)
I'! I am exe t under ec. B. & P . r this reason
q
Date Owner
WORKERS' COMPENSATION DECLARATION
1 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
0 Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed it 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 'RAIM ()'—P '. nr-c=!., TM, T7
Lender's Address
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.
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
BUILDING DIVISION
_ .. r.:;`tai # d ,'� :' ^.•1 .� •�'l �l f1
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. ly
Size 1,617
New ❑ Add ❑
No. No. Dw.
Stories 1 Units
Alter ❑ Repairs❑ Demolition; d j
r
O �•
Estimated Valuation
q� '/. /0
16Q,000.0'
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
,
Const.
& 7, eV
Mech.
41 P, &V
Electrical
F'.5"o
Plumbing
,
S.M.I.
, S a
Grading
Driveway Enc.
In±astructure'V
Q 079, 57
357Z of,
jg,
r 10
TOTAL
--�
REMARKS
_ .. r.:;`tai # d ,'� :' ^.•1 .� •�'l �l f1
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:
-77
I'll klr'l7i-,4 i4J.",
11 7-'r L
J�j
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H3G-lnud L2:VT S2—TT-26,
J
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated (619) 347-8631
Date 111/10/921 Type of Permit I La Quinta
No. 111823 Permit #
Log #
Owner Name Paulden Evans
No. 77500 Street Calle Chillon
City La Quinta Zip 92253 Study Area 111
APN # I Tract # I J Lot # 0 Square Footage 11617
Type of Development I Single Family Residence No. of units
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 been 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 facility fees imposed pursuant to Government Code 53080
in the amount of 1.58 x 1617 or $ 2,554.86 have been paid to D.S.U.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 Paulden Evans Telephone
Name on the check
By James E. Lively
Assistant Superintendent, Business Services
Fee collected /exempted by Vickie J. Durrett
Payment Received
Signature Check No. 329
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/ Receipt Copy - Accounting
P.O. sox 1504
76105 CALLE ESTADO
LA OUINTA. CALIFORNIA 92257
Contractor it PAULDEN,EVANS Owner PAULDEN EVANS
Address Job Address
LA QUINTA, CA
La Quinta City License No.: .2597 Expires: DEC. 92 Bldg. Permit No.:
This form shall be posted on the job with the Buildinq Inspection Card and it
shall be the duty of the General Contractor or if Owner -Builder Permit, the owner
to see that all sub -contractors sign this card, giving his City of La Quinta
Business License Number, Contractors License Number and a current certificate
of Workman's Compensation Insurance Certificate when he starts the job: Failure
to comply may cause Building Inspectors to stop work, or complaints to be filed
against such contractors or owners.
CITY CONT.
SUB -CONTRACTORS NAME LIC. NO. EXPIRES LIC. NO. EXPIRES
.405293
358495
521931
DO NOT REMOVE THIS CARD
Before Final Building Inspection Will Be Made
C4 1 �r7 'J; �I- M44-1�.,,-
Grade i Excavate
2.
Pipelines
�3.
Cement -Foundations
4.
Cement Walks i Drives
5.
Asphalt Paving
6.
Framing
7•
Steel Structural -
Masonry.
9.
Plumbing JEF PLUMBING 1987
12/31/92
10.'
Lathing
ll.
Drywall
L2.
Plastering
13.
HVAC PAUL'S AIR 1014
12/31/92
14.
Electrical' LONG ELEC 559
12/31/92
L5.
Roofing
l6.
Sheet Metal
17.
Floors -All Types
18.
Glass - Glazing
19.
Insulation/Weatherstrip
20.
Sewage Disposal
21.
Painting/Decorating
22.
Tile
23.
Cabinets -Installations
24.
Ornamental Metal
25.
Fences/Blockwalls
26•
Landscaping
27.
Others
28.
.405293
358495
521931
DO NOT REMOVE THIS CARD
Before Final Building Inspection Will Be Made
C4 1 �r7 'J; �I- M44-1�.,,-
CITY OF LA QUITA
PLANNING & DEVELOPMENT DEPARTMENT
BulLWING DIVISION
CONDITIONALLY
ACCEPTED FOR CONSTRUCTION
SUBJECT TO INSTALLATION AS PER
POOL AREA TO BE FENCE.
BYMINIMuM 5 FT-HIH
ALL SEL
SoCHING.
SELF-CLOS'NG
AND-LA
AND ALL APPLICABLE C s
DiE
DATE W
- ---------
tLE CA S
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. ...... ....
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tel: a it
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7
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Ip
STATE LICENSE j,-0—
. AD STE. /6CITY
CATHEORAL CA 92234 (619) U4.4460
QQ
OL SPA
Orzo ...f.c I r I C Ar i o
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CODE ............. ....... 70 ............ %10L .............. GAL
...................................
GRA01I4G .... Yk Al AVA.r 10 )q
PRISED BOND SEAM ...... •FWAp
SWIM OUT...... .........
...FLAIL'S ...........................
SPA ..............
.......... misa
....................
OUT K L
DEEP Eno STEPS LOVE SEAT...
....... 6K ...............
.....
RAISED BOND BEAN.. ................................
SPA ............... SURI CII ...
ARG E
SUCTIONT P L U M El I N 0
A E TUR,
�.,INLETS
POOL S,Y=Ep ....FILL LNZ ..../..........
...
. ................. .........
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MAN DRAfN
PETU,7.li
............... m:SC . ................... :.,.,
GRA3 rRAILS0 H O I N a
OIV""*G P-OA,10 .......rV•SLID= ................
OTHERS ......
...............................
FILTER...... Q U
FILTERA-, IO,,q p_ATE 1,9f4 . .......
pwap . . .,I ....... G.P.1.4 ............
....................HP SLOI.-VER
HEATER
nE.-.107
8 CONTROL ................... I ..........
POOL L, 8 .... I .....
POOL -SPA LIGHT.-- - ...... .
..........
42 A?�Al*o:,
DIW;G 130A.41) .....................
CH'ORf.';ATOij vo ............. SLIDE ..... ...............
GA^!3 RAILS ............ .........................
........... ?.jISr ........
..........
som,,I OUT 0 U H I -r X
CEEP E,4D �T�*P*,*:.::.:
...... LOvE SEAT ... /V c>
............ SPA . 1,!*,'
GRAB,-jA;LS ...... / .....A. -
..........
...... CUP ANCHORS .....
RA:SEO SONO SEAM
SUF;CP,ARGE .......
.......... ....
Imsc, WEEP HOLE
................................
E . &kvp" C."".
...
COPING ....
,!;Sr ................................
....................................
.1 PLATER
OLOR
- � 4M ............ CLjP A,:"Cpo;;s. ^/A
Isr.... ...............
LECT ...... .Q....... I .............. ............
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.................................. ............
MAP PAGE
.................
.............................TRACT
.......................................
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OVED By
.................