11642 (SFD)IN
ilding
dress 53-995 Cortez
finer
SVnercon leve
morn a ,y
Address 74940 Fier 3 l l
City Zip
Indian THellS. C,1 92210
Contractor
Synercon-Development
Address
City Zip
State Lic.
& Classif. B 337400
Arch., Engr.,
Designer
Address
City
T4ht 4 4v Q(4
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
No. 11642
BUILDING: TYPE CONST. - OCC: GRP.
A.P. Number 774-141-023
Tel.
564-6-0,291 legal, Description Lot ii Block IM 195
Project Description SFD
Tel.,
City � ,'
Lic. # 2279 Sq. Ft. 17 7 8 No.
1 Units w 1
Size
New Add ❑ Alter ❑ Repair ❑ Demolition ❑.
Tel. Permit races not include bock wall or
Zip ' State
Lic. #
LICENSED CONTRACTOR'S. DECLARATION
I hereby affirm that Lam 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-BUILDERDECLARATION
1 hereby affirm that I am exempt -from the Contractors License Law for the following
reason: (Sec. 7031.5,Suslness andProfessions Code: Any city or county which requires a
permit to construct,, atter, 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 iv(th Section 7000) of
Division 3.of the Business -and Professions, Code, or thaLhe Is exempt therefrom, and the basis
for the alleged exemption. Any violation of Section -7031.5 by 'any applicant for a permit
subjectethe 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 of offered for sale. (Sac: M44, 13uisness 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' employs",
provided Nat such Improvements are not :Intended or offered for 'sale. h, however,' the building
or Improvement is sold within one year of corfiplef on, the Einer -bulkier will have the burden
of proving. Marne did notbum-or Improve for the.purpose ofa".) -
❑ 1, 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.) -
❑ 1 am exempt under -Sec. B. &P.C. for this reason
n a
Date Owner ," , c ,� t :f �_ �_ f'e i
WORKERS' COMPENSATION DECLARATION'
I hereby affirm that I have a certificate of consent to 'Self -insure, or a certificate. of
Workers Compensation Insurance, ora certified copy thereof. (Sec. 3800„Labor Code.)
Policy No. Company
❑ Copy 19JIled 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 (5100) vakist on
or less.)
Lcertity that In the performance of thg work for which this permit is Issued, I shall,not
employ any pperaon In any manner so as to become subject the Workers' Compensation
Laws o1.Calif0 nfa.
Date�Owner
NOTICE TO APPLICANT._ it, eller making this Certificate of Exemption you should become
Subject t0 ,the Workers' Compensation 'Provisions of the Labor Code, you must tortnwLM,
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.)
Lenders Name
Lenders Address
This is a building permit when properly filled out, signed and validated, and is subjectAo
expiration It work thereunderls.suspended for 180 days.
I certify that I have read this application and.state that the above Information is correct.
I, agree to comply wlth•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 -
Mail Ing. Addr_esa
City, State, Zip
(Estimated Valuation $102,129.40
PERMIT- AMOUNT
Plan Ghk.bep,
250.00
Plan Chk. Bal.
294.06
COnst.
_.y.-
fir', 2.O A
Mech.
Electrical
7
Plumbing •
141.00
S.M.I.
10. 3
Grading
2 0 „ Q
Driveway Enc.
Infrastructure
2,259.66
Arts -in
Publ i c
25.013
[�3�.5;7
TOTAL
3,826.25
8.2
REMARKS
'
_I Ef1rJ b .ki'3J '.l':i nil rj'I:�=� 11,r, •` �.�..
- j:( :5; '
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. ® E
UNITS
A.C. UNIT
2ND Fl -SO. FT.
SLAB GRADE
YARD SPKLR SYSTEM
POR SO. FT a
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. @
POWER OUTLET
ROOFMRAINS
DRAINAGE PIPING
CAR P. SO. FT. ®
DUCTWORK
ROCKSTORAGE
WALL SO. FT.
DRINKING FOUNTAIN.
SO FT ®
URINAL
ESTIMATED CONSTRUCTION VALUATION S
REINF: STEEL
WATER PIPING
NOTE: Not to be used as property tax valuation
GAS (FINAL) TEMP. POLE
Ig
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM. FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
/]
a
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
VENTILATION
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T:U.
SO. FT. RESID a 1+A c
SEWAGE DISPOSAL
SO.FT.GAR ® :%c
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PLCK.FEE
OONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE / PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR'
SETBACK
GROUND PLUMBING jj: UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER ROUGH WIRING.
DUCTWORK
ROCKSTORAGE
FOUND. REINF.�zl/
GAS (ROUGH) METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF: STEEL
GAS (FINAL) TEMP. POLE
Ig
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
/]
a
GRADING
—cu. yd.
plus xs
=$
LUMBER GR.
FINAL INSP.w'
FRAMING
FINAL INSP. L�/f
ROOFING
gcd
/ y-1
�C — / ` �,j(r ( �J
D'
Pro P
[ (/ �•SI(
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
T I NG [
MESH
INSULATION/SOUND 51;p
FINISH GRADING
FINAL INSPECTION 3
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 12/8/92 I Type of Permit I La. Quinta
Ivo. 11886 Permit #
Log
Owner Name Synercon Development Corporation
No. 53995 Street Cortez
City La Quinta. Zip 92253 Study Area 111
APN # I I Tract # I J Lot # 0 Square Footage 11778
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 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 1778 or $ 2,809.24 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 Stuart Phelps Telephone
Name on the check
By lames E. Lively -
Assistant Superintendent, Business Services
Fee collected /exempted by Vickie J. Durrett
Payment Received
Signature (/ Check No.103
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.
. I — 4& IS 4* AALt gl'
(�tV
of
(19T rfs __
of �M �Uli�M
�uil�in� �nA S�'S�1�P��1 �Cl�i£�[IIlt
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 53-995 Cortez
Single.Family Dwelling 11642
Use Ciassifiootion Bldg.' Permit No.
Group, R3 Type Construction VN Fire Ione Use Zone SR
Owner of Building Synercon Development Address 74940 Hwv 111
City Indian Wells CA BY: Lonnie Day
Dote: March 25, 1993
Building Official
POST IN A OONeT1CY0Y! PIACI