15611 (SFD)J
Building'��
Address
4
P.O. BOX 1504
78-495 CALLE TAMPICO
$�7 1 LA QUINTA, CALIFORNIA 92253
Owner — I
E.G. Williams Development Corp.
Address 424.500 Cook St., Ste. 120
City Zip Tel.
x alm Desert, 92.2 i i.S 19 j 341-6880
Contractor
Same as above
City lZip I Tel.
State Lic. I City
& Classif. `D 493919 Lic. # 1231
Arch., Engr.,
Designer gStoff• ren Fuller Assoc..
Afsr=487 E. Palm CYn. Ste. T44 328--1801
CCityathedta l Cit JZip CA 92262 I Lic stat#
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 and.Professions Cordae,' and my license is in full force and
eeffect
SIGNATURE - -DATE
4/ OWNEWBUILDER 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, after, Improve, demolish, or repair any structure, prior to its issuance also
requires the applicant. for such permit to rile 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 o/ 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).
❑ 1, 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 of sale.)
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to torr
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) ficensed 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 1 have a certificate of consent to self -insure, or a certificate of
Workers Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No Company
e6opy 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 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. H, after maklog 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. -
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP .TO ONE
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
DAMAGES AS PROVIDED FOR IN -SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 160 days.
I certify that I have read this applicatiom 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
Aul
No. 15611
JILDING: TYPE CONST. OCC. GRP.;
P. Number 769-791-029
R3
Legal Descriptionr t-2-8019
Project Description SFD ' Plan !'
The Seasons V11.1as
Sq. Ft.
Size .1371
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑
Demolition ❑
Permit does
not include block
walls or
poo l .
Estimated Valuation
$2`
PERMIT
a
"' AMOUNT
Plan Chk. Dep.
f \
Plan Chk. Bal.
47.7. 77
Const..
Q
Mech.
49.100 i
Electrical
/ `
119.89
Plumbing
,`
132. 00
S.M.I.
,'
8.27
Grading
/
20.00
Driveway Enc.
.00
Infrastructure
1,860.'24
TOTAL
3,230.17
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 INSPECTOR
Issued by: Date Permit
Validated by:
Validation: 1
V�
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
IST FL. SO. FT. ® $
UNITS
.r
HEATING (ROUGH)
-
YARD SPKLR SYSTEM
2ND FL. SO. FT.
DUCT WORK
ROCK STORAGE
FOUND. REINF..
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
REINF. STEEL /X` 9rI
GAS (FINAL) TEMP. POLE
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
WATER HEATER SERVICE
FINAL INSP.
DRAINAGE PIPING
CAR P. SO. FT.
WATER SYSTEM
GRADING
_cu. yd.
$ plus x$
WALL SO. FT. ®
LUMBER GR.
DRINKING FOUNTAIN
a
SQ. FT.
FINAL INSP.
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.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1 Va c
SEWAGE DISPOSAL
FINAL INSPECTION
CERT. OCC. r
SO.FT.GAR ® 3/ac
HOUSE SEWER
FENCE FINAL
GAS PIPING
PERMIT FEE
INSPECTOR'S SIONATURESIINITIALS
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 �d/ ��
GROUND PLUMBING UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADEA/� ZIlyIll
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS / %�j
SEWER OR SEPTIC TANK ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF..
GAS (ROUGH) D �6 METER LOOP
�J
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL /X` 9rI
GAS (FINAL) TEMP. POLE
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
_cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP.
FRAMING / 3
FINAL INSP.
ROOFING /
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING Z
MESH
�1
INSULATIONISOUND q
v
FINISH GRADING
FINAL INSPECTION
CERT. OCC. r
FENCE FINAL
INSPECTOR'S SIONATURESIINITIALS
GARDEN WALL FINAL
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated 619-775-3500
Date 111/14/951 Type of Permit I La Quinta
No. 113882 Permit #
Log
Owner Name Seasons Villas
No. 78235 Street Desert Falls Way
City La Quinta Zip 92253 Study Area 118
APN # 769-791-029 Tract # I J Lot # 0 Square Footage 11371
Type of Development Single Family Residence I No. of units 0
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 1.72 x 1371 or $ 2,358.12 have been paid to D.S.U.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 E.G. Williams Developement Corp.
Name on the check
By
Dolores A. Ballesteros
Superintendent
Fee collected /exempted by Pauline Pearson' `.,
Payment Received
Signature P?,pk,,, �Q,o�ivL $2,358.12 Check No. 7300
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
Telephone' -
a
1 ..dr y.'
`.+
Fee collected /exempted by Pauline Pearson' `.,
Payment Received
Signature P?,pk,,, �Q,o�ivL $2,358.12 Check No. 7300
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
Certificate of Occupancy
City of La Quinta
Building and. Safety Department,
This Certificate issued pursuant to the requirements of Section 109 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=235 DESERT FALL WAY
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 15611
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: R-3
Owner of Building:. E.G. WILLIAMS DEVELOPMENT Address: 42-600 COOK ST, STE 120
Building Official
City: PALM DESERT, CA., 92211
By: DANIEL P. CRAWFORD JR.
Date: OCTOBER 29, 1996
POST IN A CONSPICUOUS PLACE