13828 (SFD)P.O. BOX 1504
Building 54-815 Ave. Vallejo LA QUIN 5 COAL CALIALLE FORNIA 92253
Address
-11- Mark Dorian
Address 66011 W. Pierson Blvd. `
City Zip Tel.
Desert got Spy Ings 92240 1 (619) 329 0740 Legal Description_
Contractor Project Description
Platinum Devolopmeent, Inc.
Addres
6bUfl W. Ptilirsonl Blvd.. Ste, B
No.
BUILDING: TYPE CONST. 'N OCC. GRP.:
A.P. Number 774"341-015
Desert Hot Sp ings 92240 (613)329--0740
State Lic. B 614096 City ��
& Classif. Lic. #
Arch., Engr.,
Designer Backer Engineering
=487 Hwy Ill Ste. 56 Tel(619) 324--021.
City Zip State
Cathedral Citi 92234 Lic. #
LICENSED CONTRACTOR'S DECLARATION
f I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
1000) of Division 3 of the Business and Professions Code, -,and my license is in full force and
SIGNATURE' / d DATE
y\OWNER-BUILDER DECLARATION
I hereby affirm that I amlexempt 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, atter, 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).
O 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 or completion, the owner -builder will have the burden
of proving that he did not build or Improve for the purpose of sale.)
❑ 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 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
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 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
YLaws of California:,/ i ✓'
Date •` '.Itl Owner, 't L
ROTICE YO APPLICANT: If, "after making Yis Certificate of Exemption you should become
subject to the Workers' Compensation pr visions 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
Lot 5 Block 311
SFD
13828
R3
Sq. Ft. 1658 No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Permit does
not include
block Qualls
or pool.
ZONE:
BY:
Minimum Setback
Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Estimated Valuation
$99,320.00
Side Setback from Property Line
PERMIT
AMOUNT
Plan Chk. Dep.
260.00
Plan Chk. Bal.
Date -Permit �1
/ /"6
289.88
Const.
639.50
Mech.
55.50
Electrical
131.01
Plumbing
144.00
.S.M.I.
-_ 9.93
Grading
20.00
Driveway Enc.
.00
Infrastructure
2,234.70
]Precise Plat
25.00
TOTAL
1 3,799.52
3,549.52
REMARKS
Validation:
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
INSPECTO , _,<.
Issued by:
Date -Permit �1
/ /"6
Validated
Validated by:
t
_V %n
Validation:
A4.
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
UNITS
SLAB GRADE L
Y r • " �.
BONDING
YARD SPKLR SYSTEM
2ND FL. SQ. FT. p
FORMS
SEWER -
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
GAS (ROUGH)
METER LOOP
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL) �� 9�
9
P POLE
DRAINAGE PIPING
CARP. -SQ. FT. ®
GROUT
WATER HEATER
WALL SQ. FT.
FINAL INSP.
DRINKING FOUNTAIN.
BOND BEAM
ja��a
WATER SYSTEM
/
URINAL
SQ FT ®
=$
LUMBER GR. I
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
ILAUNDRYTRAY
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 ® 11/4 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 L
ROUGH PLUMB.
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) �� 9�
9
P POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
ja��a
WATER SYSTEM
/
/ I
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR. I
FINAL INSP.
FRAMING (°111-? GD
FINAL INSP.
ROOFING - G
pW, _�„ D
nJ�J�� Cei
-C (!
� W 7 �Gcs7
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND/,V 3
FINISH GRADING
FINAL INSPECTION��
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated 619-775-3500 "
Date 8/9/94 Type of Permit La Quinta
No. 113001 1 Permit #
Log
Owner Name Mark Dorian
No. 54815 Street Avenida Vallejo
City La Quinta Zip 92253 Study Area 110
APN # Tract # Lot # 0 Square Footage 11658
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 1.65 , x 1658 or $ 2,735.70 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 Platinum 'Development Telephone
Name on the check
329-0740
4 '
By Dolores A. Ballesteros
Superintendent
Fee collected /exempted by Vickie J. Durrett
Payment Received
Signature LOW CVVU1
. Chec,iNo. 250
Collector: Attach a copy of county or city plan check application form to district copy --for all waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/ Receipt Copy -Accounting
COACHELLA VALLEY WATER DISTRICT
CASH RECEIPT DETAIL �'
Received From: 1
Address: i. 1) r _
Account No. it v)—'r� l 1 Lot(s) Tract_
Service Address �T �_ 1 JS �� r E� r . (i 1 L.ld G.A. Code
CLN(eter(s) — b a f+
C"ervice(s) -'
❑ Backflow(s)
❑ House Lateral(s)
❑ Detector Check(s)
❑ Meter Surcharge
["anitation Capacity Charge �• '�
❑ 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 -
❑ Bond Payment - A.D. - Bond
Assmt.
❑ Customer Deposit
❑ Other
TOTAL
Remarks: 0 C+t
vot lief
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6116
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QQpFESS/�N`I!
� #16833
��For;';
F C
1�
01
inspcuoas pl�,f� L7-• _b
arer,on,
tOLmonitor'tbe,sub,
L -cont•"44-1
list' bb- gppwmied tiy' they
tiork City4'f`
BoLiid_Di4 -and Safety jji�t!3 work bei-io" , performed by,-a.cbariged , 'iubL-��
ccop1j.-will result In ��!toppage. _.w -16 and/or the #aaidance'of building'
47 TRADE
SIM-CONTRACTMwOpjm
N C.,
omp
c=, BUSIMSS
L1czmSz P10-
NO' . ON FILE
LICENSE NO.
GRADE/
EXCAVATE'
PIPELINE'S
= ;: I
FOUNDATIONS
CEMENT/WALKS
& DRIVES
ASPHALT
1.�
FRAMING
C
STEEL/
77
STRUCTURAL
MASONRY
PLUMBI RG
Ict I
LATHING
DRYWALL
-vk
oe
2,
PLASTERING
HVAC
ELECTRICAL
ROOFING
SHEET METAL
FLOORS
Lt (I
GLASS/
GLAZING
INSULATION
ck,%
SEWAGE DISP
PAINTING/
DECORATING
TILE
CABINETS/
INSTALLATION
sea
ORNAMENTAL
METAL
FENCES/
A.
BLOCK WALLS
LANDSCAPING
r)� a
OTHERS