Loading...
15575 (RPL).44 P.O. BOX 1504 No. 15575 Address i4-820 Ave • Vallejo LA QUINTA, CALIFORNIA 92253 Owner David Ross ~14il.ler - Mailing BUILDING: TYPE CONST. OCC: GRP. Address P.O. Box 722 A.P. Number CLa II uit�tas Zip 92253 ITel.564-0273 Legal Description Contractor Project Description Pool Pacific Trades 3 side and frank Address yard seLbaCk reduction Same a roved per BSA 95-537 City Zip Tel.: State Lic. City & Classif. 8 4253$1 Lic. # 3 g55 Sq. Ft. No. No. Dw. Arch., Engr., Size Stories Units ti Designer New ❑ Add ❑ • Alter ❑ Repair ❑ Demolition ❑ ° Address Tel. City Zip State Lic. # rtLIC�NSED.CONTRACTOR'S DECLARATION I heritby of irm that;l am�lf ensed underiprovisions of chapt 9 (comme ' ing ywith Section 7000) o Dwi'Sion�3`of th' Business and Pro�fessi6ns Code, and ty licens ,n,foily0th e' and Iffect. - i `t i SWG ATURE DATE OWNER•BUILDER DECLARATION �y q I hereby affirm that I m exempt from the Contractor's License Law for the following Estimated Valuation $8•♦ 0.0i 0 . 00 reason: (Sec. 7031.5,Businass 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 file a signed statement that he is licensed pursuant to PERMIT AMOUNT the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of ' Division 3 of the.Business and Professions Code, or Mat. 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). ❑ I, as oner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. 64.35 do the work, and the structure is not intended or offered for sale. (Sec.' 7044, Buisness and Const. ©�' Professions Code: The Contractor's License Law does not apply to an owner of property who r builds or improves thereon and who does such work himself or through his own employees, Mech.r provided that such Improvements are not intended or offered /or sale. I/, however, the building 00 or Improvement is sold within one year o/ completion, the owner -builder will have the burden Electrical of proving that he did not build or improve for the purpose of sale.) 41,00 ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 27.60 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 S.M.I. such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading ❑ 1 am exempt u6der Sec B. & P.C. for this reason Driveway Enc. Date owner Infrastructure 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 p is filed with the city, ❑ Certified copy.is hereby furnished. TOTAL 259,35 CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE (This section neednotbe completed if the.permft is for one hundred dollars ($100) valuation or less.) f I certify that in the performance of the 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: n, after making this Certificate o/ Exemption you should become ZONE: BY: subject to the Workers' Compensation provisions or the Labor Code, you must forthwith Minimum Setback Distances: comply with such provisions or this permit shall be deemed revoked. Front Setback from Center Line Rear Setback from Rear Prop. Line WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND Side Street Setback from Center Line SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, Side Setback from Property Line DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. This -is a building permit when properly filled out, signed and validated, and is subject to FINAL DATE INSPECTOR 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`. Issued by: Date �PerMit-. 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.! Validated by: Signature of applicant Date I t Mailing Address Validation: AI Ir- A Q 1001 1 City, State, Zip •. """ Ld I By r CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBINU FEES 1ST FL. SO. FT. ® $ UNITS SLAB GRADE 2ND FL. S0. FT. 'BONDING YARD SPKLR SYSTEM a STORAGE TANK MOBILEHOME SVC. BAR SINK POR. S0. FT. ® ROCK STORAGE FOUND. REINF. GAR. SO. FT. ® POWER OUTLET ROOF DRAINS OTHER APPJEOUIP. REINF. STEEL DRAINAGE PIPING CAR P. SO. FT. WALL SO. FT. WATER HEATER DRINKING FOUNTAIN SO. FT. ® URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation LUMBER GR. FLOOR DRAIN MECHANICAL FEES FINAL INSP. WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM FIRE ZONE ROOFING 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 LATHING SO. FT. ®c IWATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR a 3/.c 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 PLUMB 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 APPJEOUIP. 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: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATI ONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL . INSPECTOR'S SIGNATURESJINITIALS GARDEN WALL FINAL MEMORANDUM CASE: 15-33% Location(s): Request(s): Your setback adjustment application is hereby approved, subject to the following conditions: .Conditions: 1. Obtain a building permit from the Building and Safety Department. 2. The other Zoning Code provisions shall be met. 3. If ground excavation is required, please contact Underground Service Alert (USA) at 1-800-422-4133. The service is free of charge provided. USA is given at. least two working days' notice. 4. Additional Conditions: After.review it was determined that: 1. This adjustment is consistent with the intent and purpose of . the Zoning Ordinance. 2. There are special circumstances applicable to the property, including such factors as size, shape, topography, location or surroundings that justify approval of the adjustment. These circumstances are: �, / , c: Building and Safety Department It CASE NO: CITY OF LA QUINTA FEE:' $100.-00 PLANNING & DEVELOPMENT DEPARTMENT APPLICATION FOR SETBACK ADJUSTMENT APPLICANT: Submit this form with two copies ,of a scaled site plan, drawn to adequately depict the nature .of the request. A nonrefundable fee of $100 is required when -the Application is submitted. Check must be make payable to the -"City of La Quinta". If the Applicant is not the owner of the property, a letter must be submitted by the owner authorizing the Applicant to execute this document in his behalf. PLEASE PRINT OR TYPE APPLICANT/CONTRACTOR: `A,C-`� �- C. 'TTLP0 t_5 DATE Z ) 9 CONTACT PERSON ( IF DIFFERENT) c��J�� �� 1� LR— PHONE SZ y- OZ73 MAILING ADDRESS: P fl Sid 1 ZZ l "`� C (Address) (City) (State) (Zip) OWNER'S NAME: J1!, i�k W � �\ vL- PHONE S`& y.- o2_13 MAILING ADDRESS: 5 a'41 Z_ (Address). (City) 1 (State) (Zip) STREET ADDRESS OF PROPERTY.: S� � �. V P'A \ t_ 6 LEGAL DESCRIPTION OF PROPERTY: LOT # TRACT ASSESSOR'S PARCEL NUMBER: ADJUSTMENT REQUESTED: 2 �`CQ �� S't Pr c� .� S -t K f v REASON FOR REQUEST: 1 / L � N/ �1r*�t�lr�k�tcit�k�ir*it�1r�Y***7k 7k 7k�k*�IC�Y*7k****�k�tyt�lrylt 7k�k**�k*�k*7k*�Ir7k*ylr�k*****�k�kYlr7k*ilrytyt7lr�lr�ir*****�It*�r�k JUSTIFICATION: No request for a Setback, Adjustment shall be granted unless it is determined that it is consistent with the intend and purpose of this Ordinance; that there are special -circumstances applicable to the property, including such factors as size, shape, topography, location or surroundings that justify the approval of the adjustment of the setback requirement, and that the adjustment will not be detrimental to the health, safety, and general welfare of the community or be detrimental to property in -the area of the parcel.for which the adjustment is requested. FORM.013/CS I \ \ Gt _ \ !. ty �1 Lai Cil Lit IV 0 DOC