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11715 (RER)Builin Address 54-625 Vallejo Owner Dale Westhevan Mailing ' Address 54-625 Vallejo City`- Zip ' Iia' City -Quint CA 92253 Contractor Aooress 48-100 Beverly fir. CityZip Palm Deser'�, Cir, J 92260 State Lic. & Classif. e-359248 Arch:; Engr., Designer Address City Zip State �-- Lic. # (DECLARATION of Chapter 9 (commencing with Code, and my Ilcenae Is in full fc P.O. BOX 1504 N O . 11715 78.105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 r Tel. Tel.: - 346-7767 City Lic. # 2549 Tel. ' I herebv affl of 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, akar, 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 t: subjects the applicant to a civil penalty of not more then'tive hundred dollars.($500). O I, as owner of the property, or my employees with wages as thelrsole compensation, will do the work, and the structure is not Intended or offered for sale: (Sec. 7044, Bulsness and Professions Code: The Contractor's: Llcense.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 bullding 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.) BUILDING: TYPE CONST. OCC: GRP.- A.P. Number Legal Description Project Description Fire Restoration ' Sq. Ft. No. No. Dw. Size- • Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ 'Demolition ❑ Itimated Valuation PERMIT Plan Chk. Dep. ' Plan Chk.'Bal. Const. Mech. Electrical $48,000>©O AMOUNT 0,1, 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 -wh'o contracts for Plumbing S. M. 1. 4. 013 - -such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) - - ❑ I am exempt under Sec. B.,& P.C. for this reason Grading _ Driveway Enc. Date owner Infrastructure WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or'a certlficate of. Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)' Policy No. Company .. �py Is flied with the city. O Certifled'copy is hereby furnished. * >� xY• ?' t t i ,, i "• 1 ra3r t TOTAL CERTIFICATE OF EXEMPTION FROM'. WORKERS' COMPENSATION INSURANCE - REMARKS (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 any pparson In any manner so as to become subject to the Workers' Compensation Laws of Callfornia. ' 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. -ZONE:- • BY: Minimum Setback Distances: - ' 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 FINAL DATE. Issued by; Validated by. INSPECTOR Date Permit j 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 Validation: City, State, Zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING.FEES 1ST FL. SQ. FT. ® $ UNITS A.C. UNIT 2ND FL. SQ. FT. SLAB GRADE YARD SPKLR SYSTEM POR. SQ. FT. ® MOBILEHOME SVC. BAR SINK GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS CARP. SQ. FT. DRAINAGE PIPING WALL SQ. FT. DUCT WORK DRINKING FOUNTAIN. t SO. FT. URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation REINF. STEEL FLOOR DRAIN MECHANICAL FEES GAS (FINAL) TEMP. POLE WATER SOFTENER VENT SYSTEM. FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FINAL INSP. LAUNDRY TRAY AIR HANDLING UNIT CFM KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR . r HP POLE, TEM/PERM " LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER. B.T.U. SQ. FT. ® c BATH TUB, REMARKS: SQ. FT. ®c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1+/. c SEWAGE DISPOSAL FIRE ZONE ROOFING SQ.FT.GAR ® 3/ec HOUSE SEWER FIREPLACE 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.(r �:- 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 APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE r GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM FINAL INSP FINAL INSP GRADING cu. yd. $ -Plus-X$-=$ LUMBER GR. ^ / FRAMING 1/` �/f CO ROOFING VENTILATION L n� � /_ , /� eo REMARKS: FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LA ING O MESH INSULATIONISOUND ?, FINISH GRADING FINAL INSPECTION G0 CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESlINITIALS GARDEN WALL FINAL , 4(4j. 78-105 CALLE ESTADO - LA QUINTA, CALIFORNIA 92253 - (619) 564-2246 FAX (619) 564-5617 December 23., 1992 ..Mr. Dan Westhaven 54.-625 Avenida Vallejo La Quinta, CA 92253 Dear Mr. Westhaven: Just a note to let you know what expectations the City of, La' Quinta has of you regarding the fire restoration at 54-625 Avenida Vallejo. Plans must be submitted prior to commencement of construction, (demolition excluded) and the home shall be returned, to. its original condition:' Additionally, we -request that.at minimum, a battery powered smoke detector be placed in each sleeping room in addition to the existing locations. If you have any,questions, please feel free.to contact me anytime. Sincerely, .BUILDING AND SAFETY DEPARTMENT Lonnie.Day Building Inspector LD:es LTRLD02 MAILING ADDRESS - P.O. BOX 1504 LA QUINTA, CALIFORNIA 92253