06143 (SFD)Building
Address, 54-"5
Owner
Mailing
Address . F. 0. Boit 772
City Zip
Uftchesi .92236
« Contractor
41ex Torres
Address
n_ 362-4
City Falin Desert Zip 92260
& Classif.
Arch., Engr.,
Designer
Address'
550498
44a
P.Q. BOX 1504 N o . -914.3 .
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
`Kt w
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number 774-281-020
Tel. .. ,
32_4kI'8 Legal Description
Project Description SFD
399-53'90
City
Lic. #
el.
City Zip State
I I Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and.Professions Code, and my license i in full force and
effect. j j?fit * f'v� /
!'
SIGNATURE - I I DATE
' .i- O*NEWBUILDER DECLARATION
I hereby affirm that 1 am exempt from the Contractors License Law for the following
reason: (Sec.- 7031.5,Busimess and Professions Code: Any city or county which requires a'
permit to construct, after, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to Me a signed statement that he is licensed pursuant to
the provisions of the Contractors. 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 chillpenally of not more than this 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 sok/ 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 Ucense Law
does not apply to an. owner of property who builds or improves thereon, and who contracts for
such projects with a contractors) licensed pursuant to the Contractor's License Law.)
�y O -.I am exempt under Sec - B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that 1 have a certificate of consent to self -insure, or a certificate of
Workers Compensation Insurance, or a certjfied copy thereof. (Sec.:48 , Labor Code.)
Poky No.%!C X17+ XY-;- Vet �mp�„y S tF ! it k +'
91 Copy is filed with the city. ❑ Certified copy is hereby furnished.
CE ITIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need riot 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
=any person in any manner so as 4o become subject to the Workers' Compensation
Laws of California
Date
—Owner
NOTICE TO APPLICANT: 8, 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.)
Lenders Name
Lenders Address
This is a'building permit when property filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I cartity 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 hof this••city to' enter the 'above-.'
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
lot
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line wa
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: '
Sq. Ft. • 1578
Size
No. _
Stories -
No. Dw.
Units
New ❑ Add ❑
Alter ❑
Repair ❑ Demolition ❑
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
ra25ii.00"w
'' ;
Plan Chk.. Bal.
335.50 F
Const.
585.50 • • .
Mech.
619,01
Electrical
113..33
Plumbing
178,53
S.M.I.
6.16
Grading
", 20.00
Driveway Enc.
2040,
Infrastructure
TOTAL
$3,488.47
REMARKS
lot
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line wa
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
IST FL. SQ. FT. ® $
UNITS
LAB GRADE y
ROUGH PLUMB.
YARD SPRLR SYSTEM
2ND FL SO. FT.
STORAGE TANK
FORMS
A —61 SEPTIC TAN
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
FOUND. REINF.
GAS (ROUGH)
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
REINF. STEEL
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. SQ. FT. @
GROUT
WATER HEATER
WAIL SQ. FT.
SERVICE
DRINKING FOUNTAIN.
BOND BEAM
URINAL
SQ. FT.
GRADING
cu. yd.
$ plus x$
ESTIMATED CONSTRUCTION VALUATION $
LUMBER GR.
WATER PIPING
NOTE: Not to be used as property tax valuation
FRAMING / J/
FLOOR DRAIN
MECHANICAL FEES
ROOFING L
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTOXDISH)
APPLIANCE DRYER
FIRE ZONE ROOFING
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GAR. FIREWALL
LAUNDRY TRAY
AIR HANDLING UNIT CFM
INSULATION/SOUND
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.
SO. FT. RESID @ 11/. c
SEWAGE DISPOSAL
SQ.FT.GAR ® VAc
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
�OSETBACK y i�
GROUND PLUMBIN — '
UNDERGROUND
A.C. UNIT
COLL AREA
LAB GRADE y
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
A —61 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. 7 �!C l
FRAMING / J/
FINAL INSP.
ROOFING L
w
� l V
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING f 1iyU
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATOR'=SIINITIALS
GARDEN WALL FINAL
t
Desert Sands Unified School District
CERTIFICATION OF PAYMENT
OF,
SCHOOL FACILITY FEES
NOTICE: THIS DOC�if�BENT C e�
pp DD ANS!®T
TO: City 1B9 PAL61 �,11G 4TED�, DATE: d
Department of Community Development
78-105 Calle Estado
La Quinta, CA 92253
This is to ertifyt t
developer of which is
located at -5 , G 110), within
this District, has paid school facility ikes imposed pursuant to the
a th.o ' ty g era d by overnme t Code Sec io1 53080 in the.amount off/
covering a total of square feet of (/IQ residential or
( ) industrial/commercial development and that building permits for
this footage in this development may now be issued by your jurisdiction.
--305 O Y c�
Y
1517 g 0 � fo DESERT SANDS UNIFIED SCHOOL DISTRICT
White - Building Department • Yellow - Facilities Planning • Pink - Accounting 0 Gold - Developer
(10)-37
01/31/90 16:20 $ 619 724 5639 1st FIDELITY 04
G0jkQPE A; Y VVA PIS;!�?T t • . s 0`>
`' � � r~4 `+r �,,,� �• ' , �1+�,i ii1� + � d.. 6 .' .fit.+'
Recelved From: ote_11 i t -, I 1yj
Address: U ' 1 O 2-NUtu
tot(el , I. � .' �. ,;, Tract
to O LO ;1.'k! • -2 Q0 G.A. Code
7 Mater(e) —Jly�J�.Ui1° v ✓ u'l3 t)V ; SOQ,t7t�
>~r Servlcelel - -'"'� . 1 � (� •� S .,v � S�l�. V J
O Beck(low(s) '
U House Lateral(o) 4
U Detector Check(&)
L1 MotorSuroh.args•
SenitetlonCapacity charga . S ! S7Sly�,iCw , C'S
O W.S.SAC.
O Temporary Construotlon Motor,
Li Twn an Charge,
0 uncollected Aocount - Name
O Inspection Fee- Tract -
Foe -
O Plan Cheok Fees Water I Sewor -
Tract-
0
ract-O Bond Payment - A.D. - Bond , ....
/►esmt
O Cuslomer Depoelt
U Other
TOTAL
Remarks: -"t�i(a� ry /t.
' �:5: —� . ,_V'cA,l�lP- -� �d- . S� •� 8u5 � Yr�n
l7Copy to: y—.(n(p2�
Cash _ �. • .
Check
Money
Order
90
Water Service
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