12603 (AR)P.O. BOX 1504 N o . 12603
Building 52-204 Diaz 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner Tex. 9 Mrs. Miller
Mailing BUILDING: TYPE CONST: OCC. GRP.
Address Same A.P. Number
City Zip Tel.
La Quinta, CA 92253 564.-5674 Legal Description
COI^aP6 Project Description Retrofit, for handicap
tLiJ64---
ress
City lZip I Tela
State Lic. I City
& Classif. Lic. #
Arch., Engr.,
Designer Paul. Scott Anderson
'P.W! BOX 277 Te564-5038
CityZip State
Li Quinta, CA 92253 Lic. #
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 Code, and my license is in full force and
effect.
_SIGNATURE 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
-'i 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
j 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
sub'ects the applicant to a civil penalty of not more than five hundred dollars ($500).
=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.)
❑ 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
iC,,Date � � T ---Owner �
WORKERS' COMPENSATION DECLARATION
r. Ihereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, ora certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
O Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF'LXEMPTION FROM
WO R K ERS' 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 ofAhg:work for which this permit is issued, I shall not
employ any person in any manner 'so as 4o becdilie.subject to the Workers' Compensation
k
wsofCalifornia. _te ��' ,/f, :� OwnerTCE TOPLICANT.If, after making this Certificate of Exemption you should become
bjact to the Workers' Compensatidn provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
Ihereby 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
Y
Issued by: s Date-- 3'-"'~s. Permit t
Validated by: -� A
Validation:
ZONE:
BY:
Minimum Setback -Distances:
Sq. Ft. 223
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Rea ear p. L'
Side et S from�ente
e ' I `
1�
' Side ack from Property Lin
`
Estimated Valuation
$ 12, 006.00
PERMIT
AMOUNT
Plan Chk: Dep.
Plan Chk. Bal.
- 93.60
Const.
144.00
Mech.
27.00
Electrical
22.74
Plumbing
33.00
.S.M.I.
1.20
Grading
Driveway Enc.
Infrastructure
TOTAL
321.54'_
REMARKS
Y
Issued by: s Date-- 3'-"'~s. Permit t
Validated by: -� A
Validation:
ZONE:
BY:
Minimum Setback -Distances:
Front Setback from Center Line
Rea ear p. L'
Side et S from�ente
e ' I `
1�
' Side ack from Property Lin
`
(� 1 iqq
DEN. 7cJ@03
FINAL DATE
Y
Issued by: s Date-- 3'-"'~s. Permit t
Validated by: -� A
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FV.S
1ST FL. SQ. FT. ® $
UNITS
SLAB GRADE
`
BONDING
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
GAS (ROUGH)
METER LOOP
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. SO. FT. ®
GROUT
WATER HEATER
WALL SQ. FT. ®
FINAL INSP.
DRINKING FOUNTAIN
SQ. FT. ®
WATER SYSTEM
URINAL
ESTIMATED CONSTRUCTION VALUATION $
=$
WATER PIPING
NOTE: Not to be used as property tax valuation
FRAMING�(/`�
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(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, TEMIPERM
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
INSULATION/SOUND ia8L1
SQ.FT.GAR ® 3/ac
HOUSE SEWER
FINISH GRADING
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
RPLUMB.FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE
STRUCTURE / PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBINGI�IDERGROUND
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 APP.IEQUIP.
REINF. STEEL 17
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/ Z 7� [/40
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALLS-lq (�
LATHING
MESH
INSULATION/SOUND ia8L1
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL , !D �
INSPECTOR'S SIGNATURESIINITIALS
GARDEN' FINAL
BUILDING DEPARTMENT
CITY OF LA QUINTA
OFFICE: (619) 777-7012
TO:
INSPECTION REQUESTS: (619) 777-77153
DATE:
ADDRESS:
CORRECTION NOTICE
INSPECTION: PERMIT NO.:
41
Insa tce o
1
78-105 CALLE ESTADO - LA QUINTA, CALIFORNIA 92253 - (619) 564-2246
September 26, 1990
To Whom It May Concern:
The structure located at 52-204 Avenida Diaz is located in a "B" flood
zone per the revised F.I.R.M. (panels 060709 0005 A and 0010 A) for La
Quinta. The property was previously designated as zone AO (depth two
(2) feet).
If you have any questions, feel free to contact me.
Sincerely,
BUILDING AND SAFETY DEPARTMENT
Tom Hartung
Director of Building and Safety
TH/lc
5 - P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253