08229 (SFD)4 aj•
t P.O. BOX 1504 No. 0822
Building 78-105 CALLE ESTADO
Address W965 Vallej�ai LA QUINTA, CALIFORNIA 92253
Owner
verm fteyiBUILDING: TYPE CONST. OCC: GRP.
Mailing,':
Address Q . ">• A 1 f � � A.P. Number 774-�4i1••E#i2 � f412
City Zip Tel.
qan Wl . gnot Legal Description
Contractor Project Description '. inalia Iralnitu rhmIl'it"
C. R"W1di' C0nStT`tiCtio?1 _
Address-'..
4MO.'Rosh Saae Com
CityZip
BY:
Tela
Front Setback from Center Line
,...
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
t
State<Lic.;=o;_,
City "
FINAL DATE
INSPECTOR
& Classif_
#1114
Sq. Ft.
'No. No. Dw.
4%157LIC.
Validation:
Sized
Stories Units
Arch., Engr:,;?"
Designer,; I �jE?
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
riQC
Address •
Tel.
wew
,. Aae3 6 nn -
m_ . .
City- .
. :.
Zip
State
Lic. #
Pool not
j
included.
,. -LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.
_SIGNATURE - DATE
OWNER -BUILDER DECLARATION,Estimated
Valuation
I hereby affirm that I am exempt from the Contractors License Law for the following
t �g�
$107 ` N
- reason:,(Sec. 7031.5,Business and Professions Code: Any city or county which requires a
i+
permit,lo construct, alter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to Nle a signed statement that he is licensed pursuant to
PERMIT
AMOUNT
the provisions o/ 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
/or .alleged Any Section 7031.5 'any for
Plan Chk. Dep.
the'exemption. violation o/ by applicant a permit
subjects the applicant to a civil penalty of not more than live hundred dollars ($500).
Plan Chk. Bal.
_
❑ 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
Const.
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,
Mech.
provided that'such improvements are not intended or offered for sale. I/, however, the building
or improvement is -sold within one year o/ completion, the owner -builder will have the burden
' Electrical
o/ proving that he did not build or Improve for the purpose of sale.j
'
❑ I, as owner of:the property, am exclusively contracting with licensed contractors to con-
Plumbing
} I
struct the. project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
ti^ does not apply to an owner o/ property who builds or improves thereon, and who contracts for
S.M.I.
MA
such^projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
.
Grading
9A
❑ I am exempt under Sec. B. & P.C. for this reason
Driveway Enc.;
Date owner
Infrastructure
2221.6 1
WORKERS' COMPENSATION DECLARATION
I hereby affirm that,l 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
❑ Copy is filed with the city. . ❑ Certified copy is hereby furnished.
TOTAL
CERTIFICATE OF EXEMPTION FROM
'
REMARKS.
WORKERS' COMPENSATION INSURANCE
(This section need not be completed it the permit is /or one hundred dollars ($100) valuation
_
or less.)'
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: ll, 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
+ 1 -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 it 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
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
INSPECTOR
Issued by:
Date Permit
Validated by:
Validation:
I,y.t-�{!Sf i� r. }'[M� �_ M1L +t tE-r .:,i �•,n'''i'�. .t'1,•"
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
r
2ND FL. SQ. FT. ®
YARD SPKLR SYSTEM,
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
ROUGH WIRING
DUCT WORK
DRAINAGE PIPING
CAR P. SQ. FT. ®
GAS (ROUGH)
METER LOOP
WALL SQ. FT.
OTHER APPJEQUIP.
DRINKING FOUNTAIN.
SQ FT ®
GAS (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
WATER HEATER
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
FRAMING Q p lg;rA
LAUNDRY TRAY
AIR HANDLING UNIT CFM
4
C/
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
GAR. FIREWALL
SQ.FT.GAR ® V4c
HOUSE SEWER
LATHING QAw
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 6
AOL
UND 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. 8 6 LD 7i_
`
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE �7 O
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP.
GRADING
. d.
cuy
$ plus x$
_$
LUMBER GR.
FRAMING Q p lg;rA
FINAL INSP.
ROOFING
4
C/
q i/ / �0��/�
�`/'/(//(//^�/
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING QAw
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC. V
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated
Date 7/16/90
No. 10033
Owner Name Vernon Embe
(619) 347-8631 ,
Type of Permit La' Quinta
Permit #
LOL, #
No. 54-%5 street Avenida Vallejo
city La Quinta Zip 92253 Study Area 110
APN # I Tract # 1 Lot # Square Footage 11845
Type of Development Single Family Residence No. of units 0
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 Govmnin6nt Code 53080
in the amount of 1.58 X 1845 or$ 2,915.10 have been Plaid to D.S.0 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 Contact: G. Reynolds Construction G Telephone
Name on the check
By John D. Brooks
Associate Superintendent, Business Services
-- r
Fee collected /exempted by y Shelley D. Bennett
n ^„
Ps,yixent�.�'E;�eived° �1=j
Signature
r`.Ch k No. 689007393
Collector: Attach a copy of County or City plan check application form to i'l stRiit copy.
Embossed Original- Building Dept./Applicant Copy - Applicant/P>eceipt Copy - Accounting
1! 17
>r , 'ply r { . S- ^cxr•7 tt - �_•-t1�t`}". Y n KdAr ..� •.'? 1 i11� i�'�yF J4 .���'++ ''!.�`�'-'
c: - }. •r �.4 lj t� • *��.v �� �sr�.i.rt^!�/ iy.r :� ` c;:. �~ i +.
COACHELLA VALLEY WATER aSTRICT ' '''i "
CASH RECEIPT DETAIL ' 1.
Received From: Date '�
Address: �� DG'-Cra !.E' t� r 10
r•
Account No. 606141" 3 t(a) M {�
Service Addnes' ',AA. Codis
' L9'�Mstar, J
A S
f- O Backflow(e)
O House Lateral(e)
❑ OetActor Check(s) . .. _ i • ' ; '
❑ Me rcharpe .. x c '�--
Sahltation Capacity Charge '' ` J s '' �•.� '� S 1
' O WS.B.F.C. Y "
O Temporary Construction Meter
O Tum on Charge f '
<+ "O Uncollected Account - Name
r O Inspectlon Fee - Tract - f >
Fee
❑ Plan Check Fees Water I Sewer -40,
Tract -
F r O Bond Payment - A.D. - tions, ; f
Assmt-
7 ❑ Customer Deposit
❑ Other
r�TOTAL ,y s
Remarks:
Fy. ❑Copy to: c *'
Cash ; c ,A WaterSeAd
rvlce
Check`>
r, •; MoneyCash
v: Order • . f i. -. ,•, '' ^".i' tt, i x� i - k.' ! - xVY�i1—i�a(11I�)
.� OFFICE OF
AGRICULTURAL COMMISSIONER
AND
WEIGHTS & MEASURES
CALVIN C. KnMlNsrcAs
JAMES O. WALLACE 4080 .LEMON SInEE1. ROOM 19 /bfhlonlcommissloner
AprWhoof Comml»bne!'CLEMENT BENVENISTE.
RIVERSIdE, CALIFORNIA 92501
odecta of welghh a Mwlues (714) 787 2561 SeO1e1 ;
4.9613 Highway 86, Suite B12
Coachella, Ca. 92236
(619 )i 342-8291
DATE >a ��. �O CASE NO. o Gam- CLp o� f
DEVELOPER'S NAMES
ADDRESS: �7 (2o S E SAS C7�
TELEP110NEt
Dear Developer:
After reviewing your landscaping plans, all plant naterial listed is not in
violation of quarantine -laws governing the Coachella Valley. If substitutions
do occur and they differ frfan plant material listed,. this office must be notified;'" _
immediately.
'Dank you for protecting and preserving the Coachella Valley's pest -free environment. • . ':
•i
12
� 7
! Indio
tural Ca s oner s Off ice
i
iCasa and Riverside Office
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