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12040 (RER)L. P.O. BOX, 1504 Building 78955 SKYWARD LA QUIN Address A CALIFORNIA 92253 CLIPP OSTROM ' Mailing Address $,,moi$ City Zip Tel. LA QUINYA 92255 Const. Contractor RICK BOYS Address 44-759-RUBI1DOUX Cit �IND10 Zi k201 Tela 342-4158 State Lic. & Classif. B 559`.154 City Lic. # 186$ Arch., Engr., Designer SAHi Address Tel. City I Zip I 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 businessr_V`d P,rofesssion% Code, and my license is i full forcetartd effect. J _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 rile a signed statement that he is licensed pursuant to 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 civil penafty of not more than five hundred dollars ($500). O 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 of completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale.) O 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 WORKERS' COMPENSATION DECLARATION Ihereby 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. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATIONINSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less.) k 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 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 ate Mailing Address City, State, Zip BUILDING: TYPE CONST A.P. Number No. 12040 _OCC. GRP._—_ - Legal Description (Project Description REMODEL - Sq. Ft. 2�© No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ ,timated Valuation 2,800 BY: PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. $35 • 0, Const. 4.0-0 Mech. Electrical INSPECTOR Plumbing Date Permit S.M.I. .30 Grading Validation: Driveway Enc. Infrastructure TOTALS • -. 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 1ST'FL. ' SQ. FT. ® $ UNITS A.C. UNIT COLL. AREA SLAB GRADE Y ARD SPKLR SYSTEM 2ND FL. Sp. FT. p HEATING (ROUGH) MOBILEHOME SVC. BAR SINK POR. Sp. F7. ® ROUGH WIRING POWER OUTLET ROOF DRAINS GAR. SO. FT. ® GAS (ROUGH) METER LOOP DRAINAGE PIPING CAR P. SQ. FT. @ REINF. STEEL GAS (FINAL) WALL Sp. FT. DRINKING FOUNTAIN. URINAL SQ. FT. ® SERVICE ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP. WATER PIPING NOTE: Not to be used as property tax valuation WATER SYSTEM FLOOR DRAIN MECHANICAL FEES $ WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FRAMING GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED ROOFING 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 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 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. FRAMING FINAL INSP. ROOFING F/A�tt� [l / /y 3 L� �WAI 1 ` l %3 n ,� e /v� REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL oz) \ yI-z oN �LNI Q?J-� CITY LA UINTA pow. os �a6b IRaO'� ��)z BUILDING & SAFETY DEPARTMENT CONDITIONALLY AR "gip rt r\ ACCEPTED FOR CONST l!C�10 6 sTIjJECT "i0 INS"FttiLTIC'Pv AS ��F7. QSS S� WU� VI�Q.,y► AND ALL MIPPLiCABLE Coins ::`RAT 2/3 o�l3 BY 9467 A . ?• -r. V Larry Sloan, Pres. Karl Thompson, VP Howard Silverman Jerry Kurabtoff . Jerry Moon ii 3. STARLIGHT DUNES HOMEOWNERS ASSOCIATION c o J. & W Management Co. P.O. Box 1398 Palm Desert, C4 92261 g (619) 568-0349 p March 30, 1992 Mr. Cliff Ostrom { 78-955 Skyward Wa 1 kyw Y r La Quinta, CA 92253 Re: 78-955 Skyward Way, La Quinta, CA Dear Mr. Ostrom: The Architectural Control Committee of the Starlight Dunes Homeowners Association has reviewed the plans for the Remodel of the Garage at the above'address. The committee and the Board of Directors have approved the plans as submitted. This approval is not to be considered a Building Permit. All necessary permits and approvals must be obtained from the City of La Quinta before any construction begins. t a If you have any questions pl ase call me at (619) 568-0349. r JF I Sincerely �fvi� x uci �vu perty_ Mana �r I