003143 (SPIN)F�
P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address 52-031 Ave ixUa Vel-asio LA QUINTA, CALIFORNIA 92253
Owner
Mailing
Address `
A11 T 4w,. (Nnt- tlrn8wa
City - -- - Zip - -- - Tel.
"MIM ua 94941 38'3-- SGS
Contractor
Address
BUILDING: TYPE CONST. OCG GRP.
A.P. Number
Legal Description
Project Description �A@C3? Z3t1JE�t$t�;.
,.
'City' _.
Zip
Tela
State Lic.
City
& Classif..
Lic. #
Sq. Ft.
No. No. Dw.
Size
.Stories. • .-Units
...Arch., Engr.;... ... ...
Designer
New,❑ Add -0,
Alter ❑ Repair ❑ .,. Demolition ❑
Address
Tel.
City
State
_ ..
JZip
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 "
1 hereby affirm that I am exempt from the Contractor's License Law for the following
Estimated Valuation
- reason: (Sec.. 703 (, 5,Business and . Professions Code: -Any city or. county which ,requires a •
• a I
'- PERMIT
- -
•�- 'AMOUNT "
+e• -
permit To construct, alter, Improve, demolish, or repair any structure, prior to :ifs issuance also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to
the provisions o/ the Contractor's License Law, Chapter 9 (commencing with Section 7000) of.
' `-Division 3 of the'Business and Professions Code, or'thaLh'e 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).'-
O 1, as owner of the property, or my employees with wagesastheir sole compensation, will
-
Plan Chk: Dep.
- - '
. .
Plan Chk.-Bal.
COr1St:
'
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
Mech.
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 burdenEIQCtrICal,
of proving that je 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
-Plumbing
,
-
S.M.I.
-
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) -
0 1 am exempt under Sec.. B. & R.-C7forthis reason
Grading
-
Driveway Enc.
Date " tFs1f( 7 owner %--•C
Infrastructure
v
WORKERS' COMPENSATION DECLARATION
G01..n,rA 4 1 T 4 r+»M
' 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
-0 Copy. is filed with. the city. O.Certified copy is hereby furnished.
TOTALED
—
' REMARKS
-
CERTIFICATE OF EXEMPTION FROM -
WORKERS' COMPENSATION INSURANCE
!; ' ;~0. j'.0 t! _ ,'�,;:}Jir-•.q:1q ,.. ?•
(This section need not be completed if the permit is for one'hundred dollars ($100). valuation
.• or less.) c '• - - . _ . • .. ..
I certify that in the performance of the work for which this -permit is issued, I shall not
1 01$ 41L. A tv f". oV
.-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 Exemptionyou 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.
ZONE: ' ' BY: -
Minimum Setback Distances:
Front Setback from Center Line
'
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
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 Street Setback from Center Line
Side Setback from Property Line
Lender's Name
!
FINAL DATE
INSPECTOR -
� i S
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.
Issued'by:
Validated by:
Date f f Permit
Signature of applicant Date
Mailing Address -
.Validation:
-
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
COLL. AREA
2ND FL. SQ. FT.
ROUGH PLUMB.
YARD SPKLR SYSTEM
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
CARP. SQ. FT.
DUCT WORK
DRAINAGE PIPING
WALL SQ. FT. @
GAS (ROUGH)
DRINKING FOUNTAIN
SQ FT ®
HEATING (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GAS (FINAL)
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER HEATER
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
WATER SYSTEM
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GRADING
cu. yd.
$ plus x$
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
SQ.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 FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
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 APPJEQUIP.
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.
FRAMING
FINAL INSP.
ROOFING
c
_ DSC
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING,
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL -
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
4 Cv uk�t,�Gv
78-105 CALLE _ESTAbo - LA QUINTA, CALIFORNIA 92253 - (619) 564-2246
June 10, 1987
Michael & Donna De Giorgio
422 Live Oak Drive
Mill Valley, CA 94941
Subject: Special -inspection att352 Q31tiAven daFVel sa co
Dear Mr. & Mrs. De Giorgio:
A special inspection was'conducted at 52-031 Avenida. Velasco on
this date. It appears that the rear family room area was added on
some time after the original structure was built. The garage also
appears to have been built after the,house was completed.* Although
there is no record of permits being issued for either addition, it
appears that both are structurally sound and in substantial
compliance'with current setback requirements and emergency egress
standards.
If you have any.further questions, please feel free to contact this
office
Very truly yours,r
Tom Hartung
Building Official;
TH:bja
LTRTH.061
MAILING ADDRESS P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253