14023 (SFD)4 • V
P.O. BOX 1504 N o .
Building 78-105 CALLE ESTADO
Address 78-675 Star Flower Trail LA QUINTA, CALIFORNIA 92253
Ownelkoger 8nellenberger At Associates
Address 55-.695 Pebble Beach
City Zip Tel.
La Quinta, 92253 1(619)777-7767
Contractor
Sam
el:
State Lic. City
&Classif. B 488234 Lic.# 1$58
Arch.Des nergr Carlos Silas — Engineer
9
Ad JdW1t25 Charlesworth Dr. r419) 328-7271
City iiSi Zip State
Cathedra. Cit yr, CA 9223 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- 'i 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, 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) of
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 penalty of not more than rive 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. h 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.)
❑ 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
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's. ompensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Polici, o• Company
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed i1 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 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 �t
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
ateMailing Address
City, -State, Zip
14023
BUILDING: TYPE CONST. v10 OCC: GRP.
A.P. Number 604`252-018
Legal Description Lot 18 Tract 24208
" Pro'ect Descri tion SPI Plan 7
R3
1 P
Cactus Flower
Sq. Ft. 1867 No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation $114,706.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
580.2€1
Const.
692.00
Mech.
55.50
Electrical
142.45
Plumbing
144.00
.S.M.I.
11.47
Grading
20-00
Driveway Enc.
000
Infrastructure
21580.89
Arts in Public Places
36.77
N7-4.2
TOTAL
6 3.3 4
REMARKS
% rh ��•
iv
ZONE: BY:
Minimum Setback Distances: 1
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE
Issue by:
Validate by:
Validatio
_
7 I
INSPECTOR
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIJIG FEES
1ST FL. SQ. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. SQ. FT. @
t
FORMS I10
SEWER OR SEPTIC TAN
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. m
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
TEMP. POLE
DRAINAGE PIPING
CAR P. SQ. FT. ®
SERVICE
FINAL INSP.
WALL SQ. FT.
BOND BEAM
DRINKING FOUNTAIN.
GRADING
cu. yd.
$ plus x$
URINAL
SQ. FT. ®
FINAL INSP.
FRAMING 7
ESTIMATED CONSTRUCTION VALUATION $
ROOFING /
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
LAUNDRYTRAY
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.
SO. FT. ®c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
CERT. OCC.
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 j ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
t
FORMS I10
SEWER OR SEPTIC TAN
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 7
FINAL INSP.
ROOFING /
/ l
b/
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
p f�
LATHING �J / G '(
MESH q
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIG NATURESIN ITIALS
GARDEN WALL FINAL
T4 hFt. 4
78-495 CALLE TAMPICO = LA QUINTA, CALIFORNIA 92253 - (619) 777-7000
FAX (619) 777-7101
August 26, 1996
Ms. Jan Bishop 1
79-675 Star Flower Trail
La Quinta, Ca. 92253
Dear Ms.Bishop:
In June of 1996, I witnessed small cracks in the house slab at the above location. The
cracks appeared to be normal cracks found in concrete, that are associated with
temperature related shrinkage. I did notwitness any vertical displacement at the
cracks that could indicate.a more serious structural deficiency, and the possible
necessity of remedial measures.
Sincerely,
Tom Hartung
Director of Building Safety
Bruce Pelletier
Building Inspector I e
MAILING ADDRESS - P.O. BOX ;1504 - LA OUINTA, CALIFORNIA' 92253
'i
�a��I nye pJ�
T4 hFt. 4
78-495 CALLE TAMPICO = LA QUINTA, CALIFORNIA 92253 - (619) 777-7000
FAX (619) 777-7101
August 26, 1996
Ms. Jan Bishop 1
79-675 Star Flower Trail
La Quinta, Ca. 92253
Dear Ms.Bishop:
In June of 1996, I witnessed small cracks in the house slab at the above location. The
cracks appeared to be normal cracks found in concrete, that are associated with
temperature related shrinkage. I did notwitness any vertical displacement at the
cracks that could indicate.a more serious structural deficiency, and the possible
necessity of remedial measures.
Sincerely,
Tom Hartung
Director of Building Safety
Bruce Pelletier
Building Inspector I e
MAILING ADDRESS - P.O. BOX ;1504 - LA OUINTA, CALIFORNIA' 92253