11277 (SFD)r-
• P.O. BOX 1504 No. 11277
Building7 ^'7�5Irwin �1rCly 78-105 CALLE ESTADO
AddressLA QUINTA, CALIFORNIA 92253
Owner
Joie Carper
Mailing
Address P. ®, Box977
City
Zip
Tel.
a Quinta
92253
Contractor z
Blaine R. Grimes _ �t��� k S �41 "k
Electrical
Address + '
P. ®. Box 977
City
Zip
Tel.:
7�aOuinta
92253
State Lic.
City
& Classif. 619680
Lic. #
Arch.,ergr' Apollos Construction
Desig
Addys a as above ITel.
City lZipState
I
Lic. #
LICENSED CONTRACT6R'S DECLARATION
1 hereby affirmjthat I,am licensed under.provisions of Chapter 9 (commencing with Section
7000) of Division 3'of;the Business and`P„rofessions Code, and my license is in full force and
effect.
till/ J , ,Li ..*max+-.� .t R_.,,._ .s"7 M•..e I .�P_ ! .�v,_
SIGNATURE- •r - DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Susiness 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 therefnxn, 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 penally of not more than rive 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, &assess 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 wig have the burden
of proving that he did not build or improve for the purpose of 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.)
O 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
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 (E100) 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
Laws of California.
Date Owner
NOTICE TO APPLICANT: If, alter 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 '
1hereby 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
BUILDING: TYPE CONST. l4 OCC: GRP.
A.P. Number
Legal Description fPi P rra nP1 qn l rPrp,..i-
Project Description $FD
Sq. Ft. No. No. Dw.
Size 1.808 Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Permit does not include black walls
or pool
Estimated Valuation 109,921.40
PERMIT AMOUNT
ZONE:
BY:
Plan Chk. Dep.
250.00
Plan Chk. Bal.
318.60
Const.
674.50
Mech.
55.50
Electrical
139.82
Plumbing
150.00
S.M.I.
11.00
Grading
20.0-00
Driveway Enc.
00
Infrastructure _
2396.03
'arts in Publid
25.00
TOTAL
40100. 45 4b
REMARKS
r _ _. _ .., ki,. _.$;R,_ , _ A ,
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:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIWG FEES
1ST FL. SO. FT. ® $
2ND FL. SO. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CARP. SO. FT.
WALL SO. FT. ®
SO FT ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
I ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN.
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEOUIP.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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.
SO. FT. ® c
BATH TUB
FINAL INSP. /
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1 Vi c
SEWAGE DISPOSAL
SO.FT.GAR ® V4c
HOUSE SEWER
VENTILATION
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PLCK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
OUND PLUMBING&/f%
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE d'/
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 FIPIAZAAS
(FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP. /
FRAMING 0 4,
FINAL INSP.
ROOFIN to '
/ 44
REMARKS:
VENTILATION
+
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING4V/ N �� ��'
MESH
INSULATION/SOUND V
FINISH GRADING
FINAL INSPECTION -
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INfT1ALS
GARDEN WALL FINAL
P.O. Box 15oa. APPLICATION ONLY
Building 78-105 CALLE ESTADO
Address '75--761f �i>Z W/N CIRC-46LAQUINTA, CALIFORNIA 92253
Owner
`4&Htil CA)ZAE/Z
Mailing P.O• Q ►J®x 9 77
Address
City ZipTel.
I -A (Vot kI -A 97-
Legal Description t t M–R941-t SEL SO4—
Project Description D
,; /���
City
#
Licto lv/�%lv�SD
,9 (commencing with Section
my license is in full force�aJ�d
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 Pr9fessions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repairany structure, prior to its issuance also
requires the applicant for such perml4to 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).
21 I,as owner of the property, or my employees with wages as their sole compensation, will
do the work, andr 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 or 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 of sale.)
I I 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.)
0 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
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
17 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.)
1 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
Laws of California.
Date 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 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 sof this city to enter the above-
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
BUILDING DIVISION
Sq. Ft. 1805
No.
Size Stories
New ❑ Add ❑ Alter ❑
-PE Q" tfi
NUT
No. Dw.
Units
Repair ❑ Demolition ❑
11J G f,r4� � C
Poo t_
IEstimated Valuation 0" /O 9. Q..21Yo
PERMIT
AMOUNT
Plan Chk. Dep.
Distances:
Plan Chk. Bal.
e-60
Const.
7 1
Mech.
Side Street Setback from Center Line
Electrical
Side Setback from Property Line
Plumbing
fV
S.M.I.
/ / , 40ro
Grading
Driveway Enc.
---
Infrastructure
Validation:
0 • v
TOTAL
�
REMARKS
►���xs�r�t�u �'�fi T X� f' `��n nn 1
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:
CONSTRUCTION ESTIMATE
GROUND PLUMBING
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. @ S
2ND FL. C SO. FT. @
�
POR. - J SO. FT. @
GAR. S0. FT. @
CAR P. S0. FT. @
WALL SO. FT.
SO. FT. @
ESTIMATED CONSTRUCTION VALUATION $
SLAB GRADE
UNITS
0 MOBILEHOME SVC.
POWER OUTLET
BONDING
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
STORAGE TANK
NOTE: Not to be used as property tax valuation
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
FLOOR DRAIN
FOUND. REINF.
MECHANICAL FEES
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
WATER SOFTENER
GAS (FINAL)
VENT SYSTEM AN EVAP.000L HOOD
SIGN
GROUT
WASHER(AUTO)(DISH)
SERVICE
APPLIANCE DRYER
BOND BEAM
WATER SYSTEM
GARBAGE DISPOSAL
GRADING
cu. yd.
$ plus x$
FURNACE UNIT WALL FLOOR SUSPENDED
LUMBER GR.
FINAL INSP.
LAUNDRYTRAY
FINAL INSP.
AIR HANDLING UNIT CFM
ROOFING
'
KITCHEN SINK
REMARKS:
ABSORPTION SYSTEM. B.T.U.
VENTILATION
TEMP USE PERMIT SVC
WATER CLOSET
_
COMPRESSOR HP
POLE, TEM/PERM
—
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
GAR. FIREWALL
BOILER B.T.U.
SO. FT. @ c
BATH TUB
MESH
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
FINISH GRADING
SO. FT. RESID @ I IA c
SEWAGE DISPOSAL
SO.FT.GAR @ 3/c
CERT. OCC.
HOUSE SEWER
FENCE FINAL
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEEJt
DBL
TOTAL FEES
MICRO FEE
jrMtZH.FEE
PL CIF.; F�
CONST. FEE
6
ELECT. FEE
SMI FEE
PLUMB. FEE
01D
STRUCTURE PLUMBING ELECTRICAL HEATING R 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 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
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
IN51FLU I UN"5 WUNA 1 UMNIN1I IAL5
GARDEN WALL FINAL
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated (619) 347-8631
Date 8/11/92 Type of Permit La Quinta
No. 11640 Permit #
Log #
Owner Name John Carper.
No. 78-765 Street Irwin Circle
city La Quinta zip 92253 Study Area 0
APN # I Tract # I Lot # Square Footage 1808
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 1.58 _ X 11.808 or $ 2,856.64 have been paid 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 John L. Carper
Name on the check
By James E. Lively
Assistant Superintendent, Business Services
Telephone
Fee collected /exempted by Vickie J. Durrett
Payment Received
Signature
- �OUAA Check No. 1 14
Collector: Attach a copy of county or city plan check application form to district copy for all wailers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
0 1 Orr T-r's-61
TiN IIf\ ka (ouinta
�uildin� end s�'Sr�iet� �tbi�si�n
This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building
Code certifying that at the time of issuance this structure was in compliance with the various
ordinances of the City regulating building construction or use. For the following:
BUILDING ADDRESS 78-765 IRWIN CIRCLE
Use Classification SINGLE FAMILY DWELLING Bldg. Permit No. 11277
Group R3 Type ,Construction VN Fire Zone Use Zone SR
Owner of Building JOHN CARPER Address •P. 0': BOX 977.
City LA QUINTA, CA 92253 By, MARK HAROLD
Dote: DECEMBER 4, 1992
Building Official
POST IN A' CON9PIC000! PLACE