14838 (RPL){ Q
44.
P.O. BOX 1504 No. '°%� T V
Building J- - 78-495 CALLE TAMPICO
Address 79"• 05 Iris C6utt ( LA QUINTA, CALIFORNIA 92253 • .
Owner P&:,t8ks
BUILDING.- TYPE CONST.- OCC: GRP
Address
CityZip
-°-La Quinta12: jc�k 92253.
Contractor
tt�.�il��g2 `Pt3�J15
Address
P. 0. Box 1791
City"' Q>da xs a a:. CA ZIp 92253 ..
State Lic. C53• ' 6'3 .361.1
& Classif.
Arch.; Engr.;.',` .'
Designer
Address
CityZip
LICENSED_COt
I here.bDaffirm ttbhaem Iicensed,aunnydl
wn3 .Bsiness,
e0tsio
A.P. Number
Tel.•• ..
.' Legal Description
Project Description Qo6l and Spa
Reduction of ..:r ar setback to, 3'
I Approved per .S. BA '.95^'293
1Tel.:
342. 3.521
City I945
Lic.# Sq. Ft. No.. No. Dw
Size.. Stories i • •Units
New ❑ Add ❑ . Alter ❑ _." Repair -0,
Lic#.
P.ECLARATION
i of Chapter 9 (commencing with Section'
.Code, and my license is in full force and ' ,
OV
w i r roc
SIGNATURE —;� DATE
"OWNER -BUILDER DECLARATION' ` ' Estimated Q
I hereby affirm that I am exempt from the Contractor's License law for the following Valluation
reason: (Sec., 7031.5, Business. and. Professions Code:_ Any city, or County, which requires a
:40
permft to, construct, after, Improve,. demolish,' or,repair any structure, prior to its issuance also.
re put res, the'applicant =!o%such permit •to: rile a signed. statement that he Is licensed pursuant to .
- - PERMIT
AMOUNT'
the provisions of the Contractor's :Ucense Law; Chapter 9, (commencing with, Section 7000) of
.. -
hiJlslon .3 o% the'Business and'Professions, Code, or that. he -is exempt therefrom, • and the• basis
for the alleged exemption. AnjRw Iatlon of Section 7031.5 bp 'any applicant, for a. perms
.Plan Chk..Dep.
-
subjects the applicant to a civilpenalty of not more than rive hundred dollars (S500). - •. .'
Plan Chk. Bal.
-
10'S.6 3"{)
❑ 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, euisness and"COf1St:
' 2Qj'`a? ,�.
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.
RR
00
.proJlded that' such improverrienls. ere. nor'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
Electrical
w°'d . -
'��•
of proving that he did not butte or bnprove for the purpose of sale.) ..
.
' O I, as owner of the'property, am exclusively contracting with licensed contractors to:con-
Plumbing•
27.-00
struct-the project. (Sec. 7044, Business and •Professions .Code: •The Contractor's. Ucense'Law
does not. apply to an ownerof property -who -builds or improves 'thereon, and who contracts for.
:S.M.I.
A- .. -
' such projects witha contractor(s) Ocensed pursuant to the Contractor's License Law.) • .
Grading
❑ I am.exempt under Sec B. ti P.C..-for, this reason
Driveway Enc.
Dateowner
Infrastructure .
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self-insuie, or. a certificate: of
Worker's Compensation Insurance, ora certified copy thereof. (Sec: 3800, Labor Code.)
Policyr,No. Company ..
"`�""`�9°Copy fs.filed;w'`th the city, • •❑ Certified copy is hereby furnished.
' �°�%/'
TOTAL
363.30
CERTIFICATE OF EXEMPTION FROM _
REMARKS.
•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 tha 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:'. 8, alter' 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
ine
" Rear Setback from.RearFnter:L
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL; AND'
Side Street' Setback fro
SHALL SUBJECT ANEMPLOYER.TO, CRIMINAL PENALTIESAND CIVIL FINES UP. TO ONEHUNDRED
THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION;.
Side Setback from Pr i
DAMAGES AS PROVIDED "FOR IN SECTION'3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
This is a lbuildin g per iit When properly filled.out, signed and validated And�is subject to
FINAL DATE
INS' CTQi
expiration if work thereunder is suspended for 180 days.
#m0t
1 certlfy that I have read this application and state' that•the:above information is correct.
Issued,by:
Date P IhY-
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
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
1ST FL. SQ. FT. ® $
UNITS
2ND FL. SQ. FT.
GROUND PLUMBING
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO_ FT, ®
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT._®
HEATING (ROUGH)
DRAINAGE PIPING
WALL SQ. FT.
SEWER OR SEPTIC T K
DRINKING FOUNTAIN.
SQ. FT. ®
DUCT WORK
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GAS (ROUGH)
IlIV
WATER PIPING
NOTE: Not to be used as property tax valuation
HEATING (FINAL) .
FLOOR DRAIN
MECHANICAL FEES
GAS (FINAL) 3
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GROUT
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
SERVICE
LAUNDRY.TRAY-
AIR HANDLING UNIT CFM
BOND BEAM
KITCHEN SINK -
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSED
COMPRESSOR HP
POLE, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER.
FIRE ZONE ROOFING
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. -I'
STRUCTURE PLUMBING I ELECTRICAL If' 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 T K
ROUGH WIRIN
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
IlIV
METER OP
HEATING (FINAL) .
OTHER APP7EQUIP.
REINF. STEEL
GAS (FINAL) 3
pp
1jI 1
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
V / 1
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING ff
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESJINITIALS •
GARDEN WALL FINAL
T4t!t 4 4 Q"
MEMORANDUM
CASE:S$q QS aQ3 r Location (a):
Requests) cl1,9vr 19,4-' r lir set6A�,� �'rory, 5-e�7�
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: AS a e 14 -
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: _S) ?_ e a¢ 7ti C_ 1074-, ,
Thank you for your cooperation.
Sincerely,.
ommunity a elopmen Department
Attachments
c: Building_and__Safety Department
IF
CASE NO: -,5k3,#
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.
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PL -EASE PRINT OR TYPE
APPLI CANT / CONTRACTOR : � 1 r11 j ee Poo) S DATE 3 s
CONTACT PERSON (IF DIFFERENT)
MAILING ADDRES
OWNER'S NAME:
PHONE 2 y 2 -ZS 0 /
MAILING ADDRESS: %c� - 163 ,I- Ci S CUU/,�-- fes( Qy,A rig G/ 233
(Address) (City) (State) (zip)
STREET ADDRESS OF PROPERTY:
LEGAL DESCRIPTION OF PROPERTY: LOT #
ASSESSOR'S PARCEL NUMBER:
ADJUSTMENT REQUESTED:
TRACT
REASON FOR REQUEST: ( zfQr nU�f f' �S�/� zzaI US wd:j
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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
1
��- 03 -Tri-s'. C000-
G-�.c Q u t ✓1 C 4.
APPROVED BY PLANNING & DEVELOPMEN EPARTMENT
BY DATE -
EXHIBIT
CASE NO. 1A/7'
EXHIBIT
RCASE NO. a%
-: GENERAL SPECIFIC
SIZE = y AREA
1145 O DEPT),
SHAPE 5 m
'PERIF
TEMPLATE NO.
CUSTC
TILE SIZE
TILE COLOR
COPING
COPING COLOR
POOL CAPACITY
PUMP CAPACITY
MOTOR H.P.
FILTER
m 1
FILTER RATE
TURNOVER
VACUUM UNE & SKIMMER
RETURN LINE
MAIN LINE
SKIIAMER-MODEL
BACKWASH TO
H - OF 1/2" FILL
UNE
ANTI -SYPHON VALVE
A li�U
HEATER
SIZE E
GASOLINE BY:
VENTED
LIGHT Ll otvc i
CLOCK
AP
.•� � �t yre
01s, s' Spas
La Quinta, CA alarm
819.342-3521