07714 (SFD)4.14
11 A'
P.O. BOX 1504 N o . QT"> 14
Building78-105 CALLE ESTADO
Address 78-365,iiia Cal imita LA,QUINTA, CALIFORNIA 92253
Owner
Mailing
Address
City
_ RAE9rG
Contractor
Zip
r .. .
BUILDING: TYPE CONST. OCC: GRP.-
A.P. Number
Tel. Tract 23972
Legal Description
Project Description Phase I -A Lot 75
CERTIFICATE OF EXEMPTION FROM 1
WORKERS' COMPENSATION INSURANCE
REMARKSr�i3 t t 3 i5 . w.1 (yeg - %f DO �, ,
(This section need not be completed if the permit is for one hundied..dollars ($100) valuation
City f .'
Zip
Tela
I certify that in the performance of the work for which this permit is issued, I shall not
,
State Lic.
& Classif.
City
Lic. #
Sq. Ft. 2700 R
Size,
No. * 1 1,2 No. Dw.
Stories Units
Arch., Engr.,
Designer
New ❑ Add ❑
Alter ❑ Repair ❑ 'Demolition' ❑
Address
Tel.
Minimum Setback Distances:
Front Setback from Center Line
City
Zip
State
Lic. #
I hereby affirm that there is a construction lending agency for the performance of the
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 acid Professions Code, and my license is in full tftirce and
Side Setback from Property Line
-
Lender's Address
• SIGNATURE„Ff '+' �. -” +" `"' ,I`/"'-�'1r• ` DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors 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 30f 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).
❑ 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 o/ 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 o/ completion, the owner -builder will have the burden
of proving that he did not build or improve for the purpose o/ sale.)
O 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 o/ properly who builds or Improves thereon, and who contracts for
such projects with a contractor(s) licensedpursuant to the Contractor's License Law.)
❑ I am exempt under Sec. B. & P.C. for this reason
Estimated Valuation
expiration if work thereunder is suspended for 180 days.
. PERMIT
AMOUNT
'Plan Chk. Dep.
I agree to comply with all city and county ordinances and state laws relating to building
Plan Chk. Bal.
construction, and hereby authorize representatives -of this city to enter the above-.
COf1St.
�p
tii '-
Mech.
Signature of applicant Date
Electrical -
if' AR
Plumbing
City, State, Zip
S.M.I.'
OAS
Grading
.. :ter `, Y +'
'rte•
Driveway Enc.
_, .. .. .r•� . . •!f-. _.+t
Date owner
Infrastructure
3oQ2A.
WORKERS' COMPENSATION DECLARATION
Ihereby 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.) y
Policy No. Company
O Copy is filed with the city. . ❑ Certified copy is hereby furnished.
1,
,
TOTAL
.37
CERTIFICATE OF EXEMPTION FROM 1
WORKERS' COMPENSATION INSURANCE
REMARKSr�i3 t t 3 i5 . w.1 (yeg - %f DO �, ,
(This section need not be completed if the permit is for one hundied..dollars ($100) valuation
} }�.0-A-7
-7 d yl►.. t
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: If, after making this Certificate of Exemption you should become
ZONE: BY:
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
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.)
Side Setback from Property Line
Lender's Name
Lender's Address
FINAL DATE INSPECTOR
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.
Issued by: Date ermlt
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
Mailing Address
Validation:
City, State, Zip
.. :ter `, Y +'
'rte•
'i f
_, .. .. .r•� . . •!f-. _.+t
,� .. z. .•ti. .L. . _ f r, d'f .
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
COLL. AREA
2ND FL. SQ. FT.
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT.
DUCT WORK
DRAINAGE PIPING
WALL SQ. FT.
DRINKING FOUNTAIN.
SQ FT @
HEATING (FINAL)
URINAL
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
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GRADING
cu. yd.
$ plus x$
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FINAL INSP.
Q
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
FIRE ZONE ROOFING:
SQ. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SPARK ARRESTOR
SQ.FT.GAR ® 3/4c
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES j
ICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE '
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
OUND PLUMBI /"7 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. RE ti
GAS (ROUGH) 311wid L 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.
Q
FRAMING X1GJO L >
c//�
FINAL INSP. l
�
ROOFING ^/a
S I P f _3 �O
> Q
l a
kcc
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
THING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION Cl v/ lG
t
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
ri
Shining Brighter Than
May 1, 2002
P.O. Box 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Dear Homeowner:.
(7 60) 777-7000
FAX (760) 777-7101
Please be advised of a clarification to. the street name for the following structures.
The structures formerly addressed on Via Calienta will now be addressed ending
with an "e" as follows:
78-345 VIA CALIENTE 604-203-012
78-355 VIA CALIENTE
604-203-006
78-360 VIA CALIENTE
604-202-008
78-365 VIA CALIENTE
604-203-007
78-370 VIA CALIENTE
604-202-007
78-375 VIA CALIENTE
604-203-008
78-380 VIA CALIENTE
604-202-006
78-385 VIA CALIENTE
604-203-009
78-390 VIA CALIENTE
604-202-005
78-395 VIA CALIENTE
604-203-010
The Assessor's Office, Post Office, utilities, and Riverside County 911 have also been
notified. Please contact me at (760) 777-7019 if I may be.of further assistance.
Thank you.
Sincerely,
Diane Aaker
Building & Safety Department
N