11807 (SFD)44 4.
P.O: BOX 1504 N o .
Building-7�ti Valle 78-105 CALLE ESTADO:";'
Address 3 • LA QUINTA, CALIFORNIA 92253
Owner
14r. a Mrs. Palmer
Mailing
Address 2141 orange view Circle
City. Zip Tel.
Riverside, CA 9.2503 -
Contractor
Kleine By"aing Co.
Address
78710 Avenida 'La r6nda.
City-` ,.. F
ip Tela
La Q.xnta, CA 92253 5£4-3455
State'Lic. City
& Classif. ` B-390365 Lic. #
Arch.; Engr.,
,Designers:
Address % Tel.
City- T
ip State
Lic. #
IfCENSEb CONTRACTOR'S DECLARATION
I herebyy affirm that am IjbOn"sed under provisions of Chapter 9 (commencing with Section
7000) of,Division 3.of t eVsiness and Professions Code, and my license is in full force and
r
2.1807 4
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number 774.282-012-4 774-282`#13.2-8
Legal Description
Project Description 'SFD
Sq. Ft. 2242
Size
New 19,
No. No. Dw: w '
Stories Units:" >'
Add ❑ Alter ❑ Repair ❑ Demolition ❑
Permit includes black garden wall`.=
retaining walls. and '
obtained separately.
='
OWNER -BUILDER DECLARATION• I
Estimated Valuation
,I hereby affirm that I am exempt from the Contractor's License Law for the following
BY: `
reason: (Sec. 7031.5,Business and Professions Code: Any city orlcounty which requires a
` permit to construct,after, improve, demolish, or repair any structure, I prior to its Issuance also
requires the'applicant for such permit to file a signed statement thathe is licensed pursuant to
PERMIT
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
Plan Chk. Dep.
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
O I, as owner of the property, or my employees with wages as their sole compensation, will
Plan Chk. Bal.
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Const.
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
Mech.
s
mits .'tcs' be
, 4
• L
AMOUNT
2'50. Wir
or improvement is sold within one year of completion, the owner -builder will have the burden Electrical
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- Plumbing
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law -
does not apply to an owner of propertywhobuilds or improves thereon, and who contracts for S.M.I..'.13 • 1 E
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
Data 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
0 Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This'• section need not be completed if the permit is for pe hundred dollars ($100) valuation
or less.) � -
certify that in the performance;,of�hg�yora2 for•�Gvhich this iss"�ued hshall not
employ any pperson in any manner.=so as l eco6ie subject"to the Workers' Compensation
Laws of California.,
Date' `tOWner+_
NOTICE To.APPLICANT: If, after makingr-this Certificate of Exemption you should become
subject to the Workers' Compensation'; rovisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
Ihereby 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 t
This is a buildingpermit 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
Infrastructure _• ` • 1
its 4.E►iiUM c laces ra. 37
4 ^•3
TOTAL
REMARKS a
Permit tees reflect got merger., xnve>a;EiVes.
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 ==ij•_
FINAL DATE
I.N•S
Issued by:
Date
"rmit
Validated by:
j
UU I 1 I J
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FV3
1ST FL. SQ. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. SQ. FT. ®
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK r
FOR. SQ. FT. ®
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SQ. FT. ®
TEMP. POLE
I
GROUT
DRAINAGE PIPING
CAR P. SQ. FT. ®
FINAL INSP.
WALL SQ. FT.
WATER SYSTEM
DRINKING FOUNTAIN.
GRADING
CU. yd.
$ plus x$
_$
URINAL
SQ FT ®
FINAL INSP.
FRAMING
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD '
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FIRE ZONE ROOFING
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FIREPLACE
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1 % c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
FINAL INSPECTION
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
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
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:
ga2hd
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
T
I
'DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated (619) 347-8631
Date 418/93 Type of Permit La Quinta
No. 12133 Permit #
Log
Owner Name Mr. & Mrs. Palmer
No.
54-740 Street
Avenida
Vallejo
city
La Quinta
Zip
92253
Study Area 110
APN # 774-282-012-4 Tract # 11 1 Lot # 0 Square Footage 12242
Type of Development Single Family Residence No. of units .�
Comments
At the present time, the Desert Sands Unified School District does not collect fees on .
garages/ carports, covered patios/ walkways, residential additions under 500 square feet,,
detached. accessory structures or replacement mobilehomes. It has been determined'
the above-named owner is exempt, from paying school fees at this time due to the
following reason:
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to Government Code 53080
in the amount of 11M 1 x 2 242 or $ 3,542.36 have been paid to D.S.U.S.D..for
the property listed above and that building permits and/or Certificates of Occupancy for
this square footage in this.proposed project may now be issued.
Fees Paid By Bob Palmer Telephone 714-688-6530
Name on the check
By James F. Lively
Assistant Superintendent, Business Services
Fee collected /exempted by Vickie J. Durrett ,•� r -'
Payment ,Received l' .
Signature
Check N" 3505
Collector: Attach a copy of county or city plan check application form to district dopy icor all waivers.
Embossed Original- Building. Dept./Applicant Copy - Applicant/ Receipt `�; Copy - Ac' t ng
' (;fir Y F. •�`'�E
+•+rPAWkA WLT MUST it
I►ww.i7fU tfroereTtw hlTtas eM .1 �
t
CA 97M2
0704
ff4 ArIR Ito �10b611.16 Mier R., 11otle � '"i
.....r�u wet A96Ve
9►�.11Me Tee tfoeeRoeo•e ret
[RA1N�' DU
i� 'fir ��vt�..� ib.4wM dwr Aia A..re-14-7 Moder b. 6�..,1
08 ipdoe M r to" volt* of A. t e.'
, zA
�a ee� to" qIvo t%# atn.f R.O. t* tnvMIMvoA0 Mht I. of, w n+wt.l.e.R:..A...t.n.:.w......_i id_ w:.t.t..n:r ....:�..f:..u.:4..1..•.C.. 1�MpN.Jt,.
A
O .:I..sijTfM�l nit . CI' .111 .1...._.._.f.11„Q4lnc�._._..,...".,_.........................
......._... i. , •
f MR A lAblAILIt oav§ICCIt11'Inn. M41% of *hair a Ir,.1y ►!knn:r6de6a, -
Wild s_.%" Vol and ttAA M. Povee, huAbend end rfle as Ji+1At tenente '`
ltSltNT(9J to seAsr Qent Pelerr end Cerotrn R. Oo1e.r traetaee et the
letttier liiitty•Itn1t I • '
046116.1birw � «./► the
• Clip of to Quints'
R►Tr% Ie
/OF 1<tlerKde w ,¢
LA'ffl 1) IiAd la to Man 3DS'et ttott,ne. 7)1 Sento Cernrilte of 9e11 4.Qattiee, ; !'
od Ahewn !f #Up as fele to wvk 19 fRM one 06 of Moo, to the n►Ife. at ,
the CeeAtj rtderbr eE Aeld Ceeetj ' •
`Oete41 pr,
•-• :��' M. Ory . .•..
' .ODIRIIY eil.:_1t1YetA1AA_..:_._.__�"� .-`_� —--•�.+...__...._.. :�i
. faterrr_: i-' the ayr�.�!viMD! "
eve`►Nie►}.;ee��MOeu�wtAw6.v..MMhyre.i t" ., � 1.9? "Wen�or� e d
law? 04111
erwlj_ n wMTd+Ywwuelrve
wyw.1..nr.f/.iTTw�
,. •MeMwlo� •NeMIw*.wMhrN eNfiB11, .1,l •.
-.i filo tarJ:�leelwM.++i. llNetM11UA {.
.. 1 SIM N•►rv..�wre ��.
J `�ID '" hote�MuyhQtFdq�une6i,y
YAd 1t1 J!►A?iMEitft f11 Neon' fKMtbM T PhUAVWA I,INQ, tr Mn hAMri M ttteMM, f1A1LAAfMhlCT/IIAANL • � .
L :9 . LAI tt