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11094 (AR)P.O. BOX 1504 N o . 11094 Building 78-105 52-397 Velasco LA QUINTAC Address CALIFORNIA 92253 Owner ftxxVAxnnx Daniel Varner Mailing BUILDING: TYPE CONST. OCC: GRP. Address same A.P. Number City Zip Tel. . LaQuinta 92253 564-0745 Legal Description Contractor Project Description fawner /Bll] Zi��'� Address $2flort Addition City lZip, Tel.: State Lic.I City & Classif. Lic. # Arcn.; Lngr., Designer Address Tel. City ( Zip ( State 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 Contractors License Law for the following reason:. (Sec. 7031.5,Business 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 rife a signed statement that he is licensed pursuant to 1 the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) or 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'clvil penalty of not more than five hundred dodars.(E500). Ni 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. ff, however, the building or improvement is sold within one year of completion, the owner -budder 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 exempfunder Sec. I B. & P.C. for this reason �f{� fir- )g Date V Ownei"'� f !%.v11 �.f 52-4-7 vox r• %J. 4 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 fumished.. , 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 thg work for which this permit is issued, I shall not employ any person in a anner.so'as to become subject to'the Workers' Compensation Laws of California. / 'Date—'Owner .r�i' , .:w:"" i / !.✓" E? rr=3.. .. NOTICE TOAPPLICANT: If„ after making this Certificate of Exemption you shouts become'" subject to the Worker's 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 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 Sq. Ft. 270 No. No. Dw. Size -Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ . 15 W :timated Valuation 13.905.00 PERMIT AMOUNT ri Plan Chk. Dep. Plan Chk. Bal. 99.45. Const. 144.00 Mech. Electrical Plumbing S.M.I. 1.40 Grading Driveway Enc. Infrastructure 6142i AP 14 TOTAL 244. 5 ` REMARKS r 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. SQ. FT. ® $ UNITS SLAB GRADE 2ND FL. SQ. FT. BONDING YARD SPKLR SYSTEM POR. SQ. FT. ® MOBILEHOME SVC. BAR SINK GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS CAR P. SQ. FT. GAS (ROUGH) DRAINAGE PIPING WALL SQ. FT. OTHER APPJEQUIP. DRINKING FOUNTAIN. SQ FT ® TEMP. POLE URINAL ESTIMATED CONSTRUCTION VALUATION $ GROUT WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN t MECHANICAL FEES WATER SYSTEM 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 KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER. B.T.U. SQ. FT. ® c BATH TUB SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL GAR. FIREWALL SQ.FT.GAR ® 3/ac HOUSE SEWER LATHING GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE ___JCONST. FEE JELECT.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 REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION - CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS jGARD,EN WALL FINAL I 4 4.Q" P.O. BOX 1504 N o . 11094 Building 78-105 52-397 Velasco LA QUINTACALLE DO Address CALIFORNIACAL FORN92253 Owner RnHx51Hxnsx Daniel Varner Mailing BUILDING: TYPE CONST. OCC: GRP. Address same A.P. Number City Zip Tel. LaQuinta 92253 554-0745 Legal Description Contractor Project Description Owner/Builder - Address Room Addition City Zip Tel.: State Lic. City & Classif. Lic. # Sq. Ft. 270 No. No. Dw. Arch., Engr., Size Stories Units Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State 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 Estimated Valuation I hereby affirm that I am exempt from the Contractor's License Law for the following 13,905.00 reason: (Sec. 7031.5,Business and Professions 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 PERMIT AMOUNT the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) or 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 Plan Chk. Dep. sGbjects the applicant to a civil penalty or not more than rive hundred dollars ($500). as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. 99.45 do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. 144.00 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 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 S.M.1. 1 4n such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading ❑ I am exempt under Sec. t B. 8 P.C. for this reason - J Driveway Enc. Date Owner //rn/1 / t� .`bs�� f) n /1 /% �1 Infrastructure v 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 'A0 C, t`rk; ri`? ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. 4 TOTAL 2441.18.5 - CERTIFICATE 44, 8.5CERTIFICATE 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.) I certify that in the performance of the work for which this permit is issued, I shall not employ anyperson in any manner so as to become subject tothe rah Laws of California. Date - NOTICE NOTICE TO APPLICANT)", PPLICANalter making this Certificate or 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 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 if 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 state laws relating to building construction, and hereby authorize representatives -of this city to enter the above-. mentioned property for Inspection purposes. Validated by: Signature of applicant Date Mailing Address Validation: City, State, Zip APPLICANT .,.w-.r........•�-••..-..���•,`..rr�9Kt� rr:�u � s.,��•-.aH�rv'��.. •.r�* s�,,,r.,�. �+•� r--••-;Y,.r-•F�y�.°.'�!'w-r'.r� »;+�t_ Y�,•Y•�ir:Y.:� r�r•;:y-c�,_-�';,.^,�v;�# "" ri•� S' ,r .', M ,Ci .g attr^,. .VG`S.'., ..'tia .r,,•. F.i. j`a sg2a :As.}...; s - ♦- . s.'w • .. V DE�1/LAN 3 "'iECK,RE S , ......................::::. ...............:.:.:..: ' OF Return check to requestor - Mail check - 4 ' Name / Title of person requesting check r Department individual is associated with: Y 4 Check Payable to: Amount: .a -e (Vendor NOT � as- -S 2 2 �% i/�l��,CLr� C�i Account Number: �=3 S�Ur� -.G �.�-- D9/,7 7� • TAd re - .., .2 0 U Check description and .invoice number: - • �„ ' - . �,' { .r .w 9VL % 9- 7�q G' o `r, �• • �.' -� •.. •. ,,��,. ,- } fig tg.! � _.♦ • +{ - ' t ce,ouolvz 4 78-105 CALLE ESTADO — LA QUINTA, CALIFORNIA 92253 - (619Y 564-2246 FAX .(619) 564-5617 May 26, 1993 Daniel Varner - 52 -391 Velasco La Quintal CA 92253 Dear Mr. Varner: It has come to the attention of the City of La Quinta Department 6f Building and Safety that your building permit number 11094 at 52- 397 Velasco has expired.. According to the Uniform Building Code,.Section 303(d), no further work shall -be performed on the above permitted job -site until anew permit has been issued or an extension granted. An extension of this permit can be requested. in writing within 14 -days of the date of this letter. If a final inspection has, not been requested due to ,an oversight by either yourself or your contractor, please schedule that final inspection within 14 -days to..resolve this matter. Failure to do so will result in further action by the City. Please contact me at your earliest convenience. We appreciate your immediate attention to this matter. Sincerely, BUILDING AND SAFETY DEPARTMENT Lonnie Day Building Inspector kt Attachment MAILING ADDRESS P.O. BOX 1504 LA QUINTA, CALIFORNIA 92253 T44f 4 4a QUM& 78-105 CALLE ESTADO — LA QUINTA, CALIFORNIA 92253 - (619) 564-2246 FAX (619) 564-5617 August 8, 1992 Mr. Daniel Varner 52-397 Avenida_ Velasco La Quinta, CA 92253 RE: Check 12912 52-397 Avenida Velasco .Building permit #11094 - room addition Dear Mr. Varner: Enclosed is a check for the reimbursement of the building permit fee that was voided. The amount equals 80% of the permit fee.. Thank you. BUILDING AND SAFETY DEPARTMENT � Mark HVarold Building Inspector II Enclosure: Check MH: es LTRMH01 MAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253