13200 (RER)P.O. BOX 1504
Address 78-025 Coronados Circle LA QUINTA, CALIFORNIA 92253
pne
V !iarandis
BUILDING: TYPE CONST
Mailing
Address Same
A.P. Number•.
City_ Zip T
el.
La Quinta, CA 92.253 Legal Description_
Contractor Project Description
Barb].er Construction
74653 Yucca Trail
Cityp Tela
Palm Desert, Zi92260 341-•_:D�
State Lic. City
& Classif. B 452696 LicC#`
Arch- Engr.,
Designer X. Wasif Design Consultai�t
Address Tel.
P.O. Box 3126 345-1688
City Zip State
Pals Deaert '�, (:& 92260 Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am I'icensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full fore nd
ieffee . T �. fc-v
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
i Division 3 of the Business and Professions Code, or thathe 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 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 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 or completion, the owner -builder will have the burden
os
f 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-
truct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
oes not apply to an owner of property who builds or improves thereon, and who contracts for
uch 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
O Copy is filed with the city. O Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
+4t WORKERS' COMPENSATION INSURANCE
I ^(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.)
i I certify that in the performance of thg work for which this permit is issued, I shall not
I employ any person in any manner so as to become subject to the Workers' Compensation
i Laws of California: i r yr
Date � -" _,/' Owner
NOTICE TO APPLICANT., If, alter making this Certificate of Exemption you should become
I subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
icomply 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
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
Remodel
N0. 1.3240
OCC. GRP.
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
Issued by:_
Validated by:
Validation:
t
INSPECTOR
Permit
Sq. Ft. 94.5
Size
No.
Stories
No. Dw.
Units
New Ela :;" Add 0--L:-Alter EIRepair
Ofy ,'Demolition ❑
r
W_
jY
AUG 0 51993
I
•
By
Estimated Valuation
M t
`^ '
$7,068.60
t1
;_ � t
PERMIT .,
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
•sem '
Const.
Mech.
Electrical
18.31
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
2
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
Issued by:_
Validated by:
Validation:
t
INSPECTOR
Permit
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
UNITS
SLAB GRADE 6
i
BONDING
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
GAS (ROUGH)
METER LOOP
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. I SQ. FT. ®
GROUT
WATER HEATER
WALL SQ. FT. ®
FINAL INSP.
DRINKING FOUNTAIN
BOND BEAM
WATER SYSTEM
URINAL
SO. FT. ®
=$
LUMBER GR.
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP. `lam ��
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
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
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
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/4c
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 FEE PLUMB. FEE
STRUCTURE / PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE 6
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP. `lam ��
FRAMING 40
[[
FINAL INSP.
ROOFING
LQ
xg
_
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALI-q-,.9 j_
LATHING —?—Gr'3 Lr�
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
7/'Y
M
132s-igit
139V-03`
13Vti!0 r
C %I�TY O F LA QU I NTA
Contractor < Address ;7yds-? _X,C /y
Owner ,��/ ,�j%�/��v,�%S Job Address
This form shall be posted on the job with the Building Inspection Card at all times in a
conspicuous place. It is. the responsibility of the General Contractor or the Owner/Builder
to monitor the sub -contractors that are on this list are the same persons performing the
work. Any changes of this list must be approved by the City of La Quinta Department of
Building and Safety prior to work being performed by a changed sub -contractor. Failure to
comply will result in a stoppage of work and/or the voidance of building permit.
TRADE
SUB—CONTRACTOR NAME
CONTRACTOR'S
LICENSE NO.
WORKMAN COMP.
NO. ON FILE
CITY BUSINESS
LICENSE NO.
GRADE/
EXCAVATE
PIPELINES
CEMENT/
FOUNDATIONSnttt6.f�tJ�yx�1�
L O/v✓T.
w bNL
INSULATION
SEWAGE DISP
PAINTING/
DECORATING
/L(3 C S v ,v
��Z�
TILE
CABINETS/
INSTALLATION
pp
ORNAMENTAL
METAL
FENCES/
BLOCK WALLS
LANDSCAPING
OTHERS
a
=ST_ANDS HOMEOWNERS ASSOC=AT=ON- NO 1
........................................................................................
P. O. Box 1271 La Quinta CA 92253 :
April 22, 1993
Building and Permit Department
CITY OF LA QUINTA
P. 0. Box 1504
La Quinta CA 92253
RE: EVELYN BRANDIS Residence
78025 Coronados Circle
Gentlemen:
The Architectural Committee of Islands Homeowners.Association No. 1 ;
has reviewed the plans submitted by Joel Barbier for alterations to
• residence referenced above.
These plans meet the criteria setforth in the Association CC&Rs, and
the Committee, therefore,. has no objectiou�to these changes.
If you have auy.questions,. please contact the office:- 564-2177
and someone.on the Committee will get back to you.
Sincerely,
THE ARCHITECTURAL COMMITTEE
• Edwin F. Steen =
President
EFS/at