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13609 (PLBG)P.O. BOX 1504 Building 78-105 CALLE ESTADO Address 51-570 AV IDA VA LEJO LA QUINTA, CALIFORNIA 92253 Owner Mailing Address 52-670 AVENIDA VALLEJO City Zip Tel. LA' QLIN, TA 1 92253 Contractor owner/builder Address Zip State Lic..City & Classif. Lic. # Arch.; Engr., Designer Address Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that 1 am licensed under,provisions of Chapter 9 (commencing with Section 70 130) of Division 3 of_the:Business and -Professions Code, and my license is in full force and effect.- 81GNATURE - 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 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 five hundred dollars ($500). ' ItI as owner of the property, or my employees with wages as their sole compensation, will she 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.) ❑ 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 �� }}}} t• 1a h � �r 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. 0 Certified copy is hereby furnished. 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 mploy any person in any manner so as.to become subject to the-Wofkers')'Compensation 'Laws of California: { S •AG f• { Date I ! f: Owner ?i+ : i I �r� 4 +1 s G'�� :✓moi NOTICE TO APPLICANT: If, after; -making this Certificate of Exemption you should become subject tos 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 Address City, State, Zip N o . 13609 BUILDING: TYPE CONST. OCC: GRP. A.P. Number Legal Description sever -connect Project Description Sq. Ft. Size New ❑ No. 'Stories Add ❑ ' Alter ❑ No. Dw. " m Units Repair ❑ Demolition ❑ IEstimated Valuation $1e000.00 PERMIT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing .S.M.I. Grading Driveway Enc. AMOUNT Infrastructure 1A pM� TOTAL REMARKS r ZONE: BY: Minimum Setback Distances:- ` Front Setback'from Center Line Rear Setback from Rear Prop. Line Side Street Setback fri,(i C,, ter Line Side Setback from �r�p'//6t Line=1� ' 1 < FINAL DATE I .PEOTOR V Issued by: Date ✓ //�j r{� Validated by: l99 Validation: �\ t CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES A.C. UNIT ' SLAB GRADE 1ST FL. SQ. FT. ® $ UNITS __1 -1 ^' r FORMS YARD SPKLR SYSTEM 2ND FL. SQ. FT. DUCT WORK ROCKSTORAGE FOUND. REINF. MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® OTHER APPJEQUIP. REINF. STEEL GAS (FINAL) POWER OUTLET ROOF DRAINS GAR. SQ. FT. ® GROUT I SERVICE FINAL INSP. DRAINAGE PIPING CAR P. SO. FT. ® WATER SYSTEM WALL SQ. FT. =$ DRINKING FOUNTAIN. FINAL INSP. URINAL SQ. FT. ® ROOFING ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES VENTILATION WATER SOFTENER VENT SYSTEM FAN EVAP.COOL' HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYEFI FIREPLACE 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 SQ.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 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 ROCKSTORAGE 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 SIGNATLRES/INITIALS GARDEN WALL FINAL 71 COACHELLA VALLEY WATER DISTRICT CASH RECEIPT DETAIL q 6 Q Received From: �� ,�� jK 14 0 Date:— Address: ate: Address: 1. � i _ � � • w i Lot(s) Account No. �_ s) Tract v n Service Address Z• G.A. Code } ❑ Meter(s) $ ❑ Service(s) ❑ Backflow(s) ❑ House Lateral(s) ❑ DetectorCheck(s) ❑ Meter Surcharge QY fiitation Capacity Charge Lg ❑ W.S.B.F.C. ❑ Temporary Construction Meter ❑ Turn on Charge ❑ Uncollected Account - Name . • ❑ Inspection Fee - Tract - Fee - ❑ Plan Check Fees Water I Sewer - Tract - 0 Bond Payment - A.D. - Bond Assmt. ❑ Customer Deposit ; ❑ Other y 4 TOTAL Remarks: ❑Copy to: !CashWaterServiceheck a ;oney:Cashierrder - ;; D 38(11189) r. � • '... _. .. _ - it - - 78-495 CALLE TAMPICO — LA QUINTA, CALIFORNIA 92253 – (760) 777-7000 -FAX (760) 777-7101 TDD (760)':777-1227 December 18, 1997 • ` Daniel Clark 51-670 Avenida Vallejo ' - La Quinta, CA., 92253 w RE::Sewer Permit #13609. The purpose of this letter is to" inform you that your Sewer Permit #13609; for the project at 1 51-670 Avenida Vallejo, has expired. In accordance with 094 UBC section 106.4.4; no further work may be performed until a new permit has'.been.issued.: Please contact Daniel P. Crawford Jr., Building`Inspector I, at (760) 777-7012_to obtain any informationyou need regarding a new permit and/or any required inspections. Should you :choose not to complete the' project, we would then have to pursue any or all of the following r` actions: 1) Abatement of the project through'the City Attorney's Office and Code Compliance Division. 2) Notice of non -conforming structure placed upon property profile.: y >3) Action filed with Contractor State License Board. Optional if Owner/Builder. Please contact us atyour earliest convenience prior to 10 working days to. resolve this issue;and for. any questions you may`have. Sincerely; Mark Harold Buildin Safety Manager' 71 Daniel.P. Crawford' Jr. - �I Building Inspector I f cc: file dpc• - = V �� .. ' " MAILING'ADDRESS P.O. BOX1504 - LA QUINTA, CALIFORNIA 912253 ��