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15613 (SFD)AddBuilding r 255 Delldtrit Fi Address Owner E.G. Williams Deve P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Mailing Address 42-600 Cook St. , Ste. 120 Cit Zip Tel. ' Palm Desert, 92212 {619} 341--6880 Contractor Same as above Tela State Lic. City & Classif. B 493919 Lic. # 1231 Arch., Engr., Designer Sto-f1gren Fuller a Assoc. ALWWa.s487 E. Palm Cyn. Ste JTJ.4 320-1801 Cit�athedral Citlfzi; CA 9226�LLii�t# LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 1000) t. of Division 3 of the Business and Professions Code, and my license is in full force and . �LGNATURE 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, 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 o/ 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, Buisness and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or knproves thereon and who does such work himself or through his own employees, provided that such improvements are not intended or offered /or sale. If. However, the building or improvement is sold within one year of completion, the owner -builder will have the burden o/ proving that he dM 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.) ❑ 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 [D 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.) 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: ff, 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. 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 fit(ed out, signed and validated, and is subject to expiration If work thereunder is suspended for 180 days. 1 cer Illy 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 No. 15613 _1 BUILDING: TYPE CONST. VIS OCC. GRP. R3 A.P. Number 769--791-031 IM Legal Description #` Zct 28019 Project Description SFD Plan 1 -BR The Seasons Villas Sq. Ft. No. Size 1286 Stories No. Dw Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Permit does not include block walls or (Estimated Valuation $78,953.00 PERMIT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS AMOUNT 464.15 545.00' 49.00 116.91 132.00.- 7.90 20.00 .00 1.756.39 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. PLUMBIWU FEES IST FL. SO. FT. ® $ UNITS ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK YARD SPKLR SYSTEM 2ND FL. SO. FT. p DUCT WORK ROCK STORAGE FOUND. REINF./ y MOBILEHOME SVC. BAR SINK POR. SO. FT. ® REINF. STEEL �' �� GAS (FINAL) TEMP. POLE GAR. SO. FT. ® POWER OUTLET ROOF DRAINS WATER HEATER SERVICE FINAL INSP. DRAINAGE PIPING CAR P. SO. FT. ® WATER SYSTEM FINAL INSP. .� 6 FINAL INSP. ' WALL SO. FT. LUMBER GR. DRINKING FOUNTAIN SO. FT. ® �, '_'�� /��/�/ `�(p / f URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation VENTILATION FLOOR DRAIN MECHANICAL FEES FIRE ZONE ROOFING WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY 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. SO. FT. ® c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR ® 3/ac HOUSE SEWER FENCE FINAL 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 G 9� GROUND PLUM fSI �� UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS 4XI& ' EWER OR SEPTIC TANK ` ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF./ y GA �� METER LOOP HEATING (FINAL) OTHER APP./EQUIP. ` REINF. STEEL �' �� GAS (FINAL) TEMP. POLE \ ' GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM FINAL INSP. .� 6 FINAL INSP. GRADING cu. yd. $ plus x$ =$ LUMBER GR. FRAMING _ / �l/ ROOFING 7 ` �, '_'�� /��/�/ `�(p / f REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL DESERT SANDS UNIFIED SCHOOL DISTRICT 82-879 Highway 111 NOTICE: Indio, CA 92201 Document Cannot Be Duplicated 619-775-3500 Date 11/14/95 Type of Permit I La Quinta No. 113884 Permit # Log Owner Name Seasons Villas No. 78255 Street Desert Falls Way City La Quinta Zip 92253 Study Area 118 APN # 769-791-031 Tract # Lot # 0 Square Footage 11286 Type of Development I Single Family' Residence 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 1286 or $ 2,211.92 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 ` po341= Tel�ehrie '" Fee collected /exempted by Pauline Pearson V Payment Received Signature Q&AA Iva $2,211.92 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