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12333 (MISC)c� P.O. BOX 1504 N o . Building 4$ 16 Via Mistad 78105CALLEESTADO Address LA QUINTA, CALIFORNIA 92253 Owner Jack & Thelma Geenandt ' BUILDING: TYPE CONST. OCC: GRP. Mailing Address Same City Zip Tel. La Quinta, GA 1 92253 568-9056 Contractor Gaylon Renison V2r-e&2' 1 Haystack toad CityZip Palm Desert, 92262 Tela 564--9056 State Lic. 6%2��� & Classif. City Lic. # Arch., Engr., Designer Address Tel. City (Zip ( State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section .j7000) of Division 3 of the Business and Professions Code, and my license is in full force and effact. - SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt 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, alter, 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 or not more than five 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 sold within one year of completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose or 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 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.) ❑ I 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 ❑ Copy is filed with the city. O 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 thp. work for which this permit is issued, I shall not _ employ any,person in any manner so asjto beqoine subject to the Workers' Compensation Laws o,Ca iforni 4� tr Date_ f _'All --Owner NOTICE TO APPLICANT: _If;- 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.) 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 P. Number 12333 Legal Description Project Description (2) glass blokk windows 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 INS Issued by:_ Validated t Validation: . W- Sq. Ft. Size No. Stories No. Dw. Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ - Estimated Valuation $500.00 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. 25.00 Mech. _ Electrical Plumbing .S.M.I. .07 Grading Driveway Enc. Infrastructure TOTAL 41.32 REMARKS 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 INS Issued by:_ Validated t Validation: . W- CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. p $ UNITS SLAB GRADE ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL. SQ. FT. FORMS SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK FOR. SQ. FT. ® GAS (ROUGH) METER LOOP GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS GAS (FINAL) TEMP. POLE DRAINAGE PIPING CAR P. SQ. FT. ® GROUT WATER HEATER WALL SQ. FT. FINAL INSP. DRINKING FOUNTAIN. BOND BEAM WATER SYSTEM URINAL SQ FT ® =$ LUMBER GR. ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP. WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. 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 LAUNDRYTRAY AIR HANDLING UNIT CFM r 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 SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1114 c SEWAGE DISPOSAL INSULATION/SOUND SQ.FT.GAR ® 3/4c HOUSE SEWER FINISH GRADING FINAL INSPECTIONki CERT. OCC. 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 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. FRAMING (� FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTIONki CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL MANAGEMENT�GROUP 68-895 Perez Road Suite 23 Cathedral City, CA 92234 ` (619) 324-5811 FAX (619) 324-1701 ,LAGUNA DE LA PAZ ARCHITECTURAL VARIANCE AUTHORIZATION a w i NAME Jack & Thelma Gernandt ADDRESS -'r4.8-545 Via Amistad Your :request -,for -Ar`ch'itectural Variance has been approved by the.Architectural Committee. Any changes requiring a Building permit must be obtained through the City and must pass any City inspection. All changes must comply with City and County Codes. k. SPECIAL NOTES Please submit copies of ally''" city permits and final"i:nspections upon receipt. c Thank you, Nancy Duane Account _Executiv_e 1. REGIONAL OFFICES Irvine • Rancho Cucamonga • San Clemente • South Bay • Coachella Valley • San Diego ARCHITECTURAL VARIANCE REQUEST Unit d :;_. Date Street Address Local Phone �/�-�5"�1!_y- Other Phone.jp 4�y/-%Oji To the Arc -h teetural Committee: We the undersigned owners, request your approval of the modifications proposed on the reverse side of this form. ;Att.arhed are .drawings of the work to be done;. types of material to be used are indicated on the drawings. We understand that building permits for home improvements are ,--�required by the City of La Quinta and that the cost of the permits and responsibility of obtaining permits and subsequent inspections will be borne by'us., tie -ackowledge_that all approved ehanges'in the original ' design will be it Four expense';'4tAat any damage to. or, irelocation of existing sprinkle"rj sji•stems, underground utilities, building structure and' exterior landscaping o; " other damage :esulting'trom"`eonsiru'ction of these permitted 3:. improvements gill be at our -.expense; and that maintenance of - --- -the peia+itted improvements +rill be at our -expense. Signature of all owners: 1��'/ J . ARCHITECTURAL VARIANCE REQUEST Unit d :;_. Date Street Address Local Phone �/�-�5"�1!_y- Other Phone.jp 4�y/-%Oji To the Arc -h teetural Committee: We the undersigned owners, request your approval of the modifications proposed on the reverse side of this form. ;Att.arhed are .drawings of the work to be done;. types of material to be used are indicated on the drawings. We understand that building permits for home improvements are ,--�required by the City of La Quinta and that the cost of the permits and responsibility of obtaining permits and subsequent inspections will be borne by'us., tie -ackowledge_that all approved ehanges'in the original ' design will be it Four expense';'4tAat any damage to. or, irelocation of existing sprinkle"rj sji•stems, underground utilities, building structure and' exterior landscaping o; " other damage :esulting'trom"`eonsiru'ction of these permitted 3:. improvements gill be at our -.expense; and that maintenance of - --- -the peia+itted improvements +rill be at our -expense. Signature of all owners: 1��'/ Please pr2vide as much detail as possible so t.ha*t the Committee may consider approval without delay! iEaa : &154L L C 7- t- 7— If ri 0 Z - Fob — Ti� Z-- Ba 7—.;r -O --I 'CV- 7-1-j Z— ke-11 "V 0,:g The above proposal has been rev!cve-- by the A:=hLtectural Committee and las been: APPROVED REZECTED PENO:NG FURTHER INFORMATION Comments. z OATS: S Commit Committee Committee H b l is.2 T jG er '_Member