13597 (AR)C&hf 4
��•
P.O. BOX 1504 No. 13597
Building 57-464 lnterlachen 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner Richard A. Albers
Mailing ''
Address .
City Zip Tel.
. 1(
Contractor
Pette Hendren Construction
Address
P.O. BOX 1804.
ci ta Quinta,, Zip .92253 Tel.:
State Lic. City
& Classif. 190400- Lic. # 2238
Arch., Engr., -CYP Inter -mi lona-1
Designer
I arV92 Mitchell South T610660-0970
c ttv re, CA zip 92714 StaLicte
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
700_0) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.
,kSIGNATURE 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 of not more than five hundred dollars (5500).
p. 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 ;.roving that he did not build or improve for the purpose of sale.)
i
of;
as owner of the property, am exclusively contracting with licensed contractors to con-_
5lruct 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.)
❑ 1 am exempt under Sec. B. & P.C. for this reason
Dale. kf 1 Owne�.""" � t._ . r. �:..f-.%✓c"�4./.
[ f 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. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WO R K ERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars (8100) 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, 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
LDING: TYPE CONST. OCC: GRP.
Number 761-480-033
al Description `�arcol 3 Tract 27332
ject Description Guest House
F_
- -
Sq. Ft. 740
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
_
Alter ❑ Repair ❑ -Demolition ❑
Estimated Valuation
$54,.760.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
1 .46
Const.
437.00 .
Mech.
Electrical
Plumbing
.S.M.I.J
Grading
Driveway Enc.
Infrastructure
r
TOTAL
d9l . U4
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 INSP,ECTORI�)
Issued by: Date
Validated by:
Validati
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
SLAB GRADE
2ND FL. S0. FT.
BONDING
YARD SPKLR SYSTEM
FOR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ, FT. ®
POWER OUTLET
ROOF DRAINS
CARP. SQ. FT.
AS (ROUGH) l�. ?' G}G�
✓ [
DRAINAGE PIPING
WALL SQ. FT.
OTHER APPJEOUIP.
DRINKING FOUNTAIN.
SQ. FT. ®
kTEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN.
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FRAMING C/
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
/
l
'00�
l / —
LAUNDRYTRAY
AIR HANDLING UNIT CFM
VENTILATION
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
SQ.FT.GAR ® 3/ac
HOUSE SEWER
MESH
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
ROUND PLUMBING'2?!ffUNDERGROUND
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.
AS (ROUGH) l�. ?' G}G�
✓ [
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
kTEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP O,?/ L(
r
FRAMING C/
FINAL INSP.
ROOFING Zy. II%eV
/
l
'00�
l / —
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING s- -7- 5o�- [ GI
MESH
r�
/ INSULATION/SOUND'
FINISH GRADING
n
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
CYP. International
Architecture/Planning
17992 MUCIWU South
Irvitu, CA 92714
714/1660-0970
J6b AF&: � 1
Issue Data:
Profact Architect:
DMUNL.DV.
Checked BSI:
COACHELLA VALLEY UNIFIED SCHOOL DISTRICT
'j CERTIFICATE OF COMPLIANCE
(Government Code 53080)
Project Name:
Project Address: 57-464 Interlachen, La Quinta, CA 92253
Project Owner's Name: Richard Albers Phone No.:
Project Description: Guest House
Building Type (Checker :Residential XX (Include No. of Dwellings)
Commercial / ustrial
Tract No.: .27332 Parcel 3 Lot No.:
(If tract attach Schedule "A" of all lots by tract, square footage for each lot and total.)
Assessor's Parcel No.: 761-480-033
(If Schedule "A" is used show Assessor's Parcel No. for each lot if one exists or Assessor's Parcel
No. for parcels before subdivided.)
Total square feet of Building Area: 740 Sq. Ft.
Certification of Applicant/Owners. The person signing certifies that the above information is
correct and makes this statement under penalty of perjury and further represents that he/she is
authorized to sign on behalf of the owner/developer.
Dated: 06/08/94
City/County Certification:
(Signature) Optional
(Title)
SCHOOL DISTRICT REQUIREMENTS FOR THE ABOVE PROJECT HAVE BEEN
OR WILL BE SATISFIED IN ACCORDANCE WTI73 ONE OF THE FOLLOWING
(CIRCLE ONE):
Gov. Code
53080/65995
(AB 181, SB 128
Gov. Code Agreement Existing
65970 prior to 1/1/87
(SB 201)
Note:
Not subject to
fee requirements
Total Nuber of SgJFt. 740
Amount per Sq/Ft. $ 1.72 PAID UNDER PROTEST
Amount Collected $ 14272.80
School District Ofiic'Title: Asst Superintendent, Admin. Serv.
och "T ' Pepsis Date:
Phone: (619 ) 399-513737 Ext 235
Note: AB 2926 and SB 201 fees are capped at $1.72 per square foot for all residential
Construction, and at $0.28 per square foot for commercialrndustrial projects.