08427 (SFD)Building
Address
VA�.2fa{p
Owner
Tt��.eralr 11iLne+in►
Mailing
Address
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City ... ,r..�.. IP
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Contractor
Raenr.,.s �txY1S3 �>r
Address '
City lZip
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P.O. BOX 1504 No. 0842-T
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253L (���
.V
BUILDING: TYPE CONST. OCC: GRP.
Tel.
State Lic. I City
& Classif. Lic. #
Arch., Engr.,
Designer
Address Tel.
CityI 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 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 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 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. 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
Date Owner
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 furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' -COMPENSATION INSURANCE
(This section need not be completed it 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: It, 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 Address
City, State, Zip
.P. Number 774-212.-W? & 023
Legal Description
Project Description S*F*D+
Sq. Ft. No.
Size 13 Stories
New C:kg Add ❑ Alter ❑
b--vim46h =sSIA�..,.
No. Dw.
Units
Repair ❑ Demolition ❑
mmatea valuation
PERMIT
AMOUNT
Plan Chk. Dep.
230.00
Plan Chk. Bal.
320.01
Const.
6".00
Mech.
99.50
Electrical
143,01
Plumbing
148.50
S. M. 1.
7.49
Grading
2
Driveway Enc.
20.00
Infrastructure -
2,278.84
MIA In Iic
laceft
17.01
AI+ f3
TOTAL
3,708.36
REMARKS
Y,� j ( es2[
v.I 1. S�i! 15 �.fii
qy yy *yp r�r tyy
Y�'A �l ASA%�N ���.�3";✓i� ���
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 390 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE-
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. @ $
UNITS
A.C. UNIT
2ND FL. S0. FT.
SLAB GRADE
YARD SPKLR SYSTEM
ROUGH PL MB.
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. @
STORAGE TANK
FORMS �`
GAR. SO, FT. @
POWER OUTLET
ROOF DRAINS
DUCTWORK
DRAINAGE PIPING
CAR P. SO. FT. @
GAS (ROUGH)
WALL SO. FT. @
DRINKING FOUNTAIN.
SO FT @
REINF. STEEL
URINAL
ESTIMATED CONSTRUCTION VALUATION $
TEMP. POLE
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
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GRADING
cu. yd.
$ Plus—X$—=$
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
j
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 1 Vac
SEWAGE DISPOSAL
SO.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 PLUMBI
NDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PL MB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS �`
SEWER
ROUGH WIRING.
DUCTWORK
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP.-�Q —7/
GRADING
cu. yd.
$ Plus—X$—=$
LUMBER GR.
FRAMING (�/l
FINAL INSP.
ROOFING4&0_
to I/&
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING /a �O
MESH
INSULATION/SOUND a
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
-
J*
IIIAIL to
".01tw court
:-terk&Ontario
*ban.
owswissm 96
I i: 7414,
son
is -above
all
ILL
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P
SPAC T -MIS ume oan 1616 i L."
Dorii.vwnary Iftnol'" to 1.....
xacriptillutij an (till value of
❑ Computed oil full value "===.loll
re"saining thereon of time Of 0010.
....... ......... . 4, a
❑
If .....
Unint-orintreted ores City ofl&.JOANAV.17� ...
xiS 7-N 2 6-il-l'f
-22015 Grant Deed
its 'row No. 10
1MM form hIrnixilhed by OmIW Coad Tftb COMPartY
3.4ft A VALUABLE CONSIDERATION, receipt of which Is hereby acknowledged.
E. BUBER, a single woman
Kkteby 16RANT(S) to
-01AN0, a married man as his sole and separate property
- des trilsed real property in the
Riverside state of California:
Lots 11 and 12 in Block 284, Santa Carmelite at Vale La Quints, unit No. 26,
:,.aa per map recorded in book 20, page 50 of Maps, Records of Riverside County,
Or CA I
�L'tmmry or 'ss.
1990 bilf. tae. the undet.
ojpo& a Netary Nellie in end for said Coal"If and State. perionally
Joan 11, Blaber
known to MO
I& ba the pitirtint— whom now I robseribodl to the within
.112ill
a
3-1
PC* NOTARY SCAL ON STAMP
Title Order No. fs, row \0.
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MAIL TAX 9T&T%M2NTS As CIPICC-20 A11110VE
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This Certificate. issued 'pursuant to the requirements of Section 306 of. -the Uniform Building!
Code certifying that at the time of issuance this structure was in compliance with the .various
ordinances of the City regulating building construction or use. For the following: f
BUILDING ADDRESS
54-235 Avenida Vallejo.,
Use Classification SFD Bidg. PermitANo. 08427
Group R3 Type Construction VN —,Fire Zone - Use Zone SR`
Oviner of ,Building Frank Diana . Address R. O. Box 5132
City " La~ Quinta, CA' 92253 = *' Mark Harold. M
• • ��� ���� �.�;,�,,,, _ `� By; ,
DMay 10 1991.
ote} v
Building Official-
POST IN A'OONSVI000Us PLACE