12655 (SFD)Building 52--230 Diaz
•4
��
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
No. 12555
Owner David Ross Miller
BUILDING: TYPE CONST.
A.P. Number
Legal Description
OCC: GRP.
773-252-001
22 Block 9
Mailing
Address P.O. BOX 722
City
La Quinta j CA
ZipLot
92253
T342-
Description
SFD
Y ContractorProject
Pacific Trades
Adds
City
Zip
Tela
State Lic.42531
& Classif.
City��
Lic. #
Sq. Ft.
Size 1.393
No. No. Dw.
Stories Units
Arch., Engr.,
Designer
New ❑ Add ❑
Alter ❑ Repair ❑ 'Demolition ❑
Address
Tel.
Permit includes
patio cover and 101
garden return wall• detaining wall
City
Zip
State
Lic. #
and./or pool
permits to be obtained
LICENSED CONTRACTOR'S DECLARATION
I heey affirm that, Lam licensed under provisions of Chapter 9 (commencing with Section
7000) of rvision 3 of thejBusiness and Professions Code, ana%my license is in full force and
Y
separately a "
SIGNATURE A 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 ($500).
0 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.)
O 1, 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
Estimated Valuation
$85t580.00 C t�x�
$85 t 580 . 00
PERMIT
AMOUNT
Plan Chk. Dep.
a tis' . wMe
,
Plan Chk. Bal.
- 242.54
Const.T6
•,rim
Mech.%
_
50
Electrical
121.86
Plumbing
A 4v[�
144.
.S.M.I.
* - .5!6
8.56 8 t
Grading
20.00
Driveway Enc.
.00
Date Owner
Infeastructure
1, 925.55
Precise Plan
25.00
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
ptCopy is filed with the city. O Certified copy is hereby furnished.
_
TOTAL ,.
3,369.51 3,119.51
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
REMARKS
(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: If, alter 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.
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street. etback from Center Line
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.) r �•
Lender's Name
Side Setback from PLOper� Line
FINAL DATE INSPIFO OR
v t
Li
Issued by: Date Permit—
Validated by: Jq O Q
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-
ateMailing Address
Mailing
Validation:
T_
F3V Lv
.Z5
,City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
'
SLAB GRADE
ROUGH PLUMB.
YARD SPKLR SYSTEM
2ND FL. SO. FT.
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. S0. FT. ®
DUCT WORK
ROCK STORAGE
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
DRAINAGE PIPING
CAR P. SO. FT. @
GAS (FINAL)
TEMP. POLE
WALL SO. FT.
DRINKING FOUNTAIN
GROUT
WATER HEATER
URINAL
SO. FT. ®
FINAL INSP.
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
WATER PIPING
NOTE: Not to be used as property tax valuation
GRADING
cu. yd.
plus x$
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP(
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 ® 1% c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
INSULATION/SOUND
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 I PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING —fa
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OBs6ERLC TADLIfr
F— —
UGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH) �//�/h
METER LOOP
HEATING (FINAL)
OTHER APP./EOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
$
GRADING
cu. yd.
plus x$
_$
LUMBER GR.
FINAL INSP(
FRAMING i J�e 40!::)
FINAL INSP.��
ROOFING % —L7<) --q q 40
l l/
G.Y�
A�J(
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL `
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION —23 `R
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated 619-775-3500
Date 1/6/94
No. 112598
Type of Permit
Owner Name David Ross Miller
No. 52230 Street Avenida Diaz
City La Quinta Zip 92253
La Quinta
Permit #
Log
Study Area 113
APN # I Tract # I J Lot # 0 Square Footage 11393
Type of Development I Single Family Residence INo. 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 1.65 x 1393 or $ 2,298.45 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 David Miller
Name on the check
By
Dolores A. Ballesteros
Telephone
Superintendent
Fee collected /exempted by Vickie J. Durrett
Payment Received '
Signature Check No 3894
Collector: Attach a copy of county or city plan check application form to districi copy for ail`waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
COACHELLA VALLEY WATER DISTRICT
CASH RECEIPT DETAIL
Remarks:
Dcopy to:
ReceivedFrom:. z
Address: 3 /7/-
0 a""k-
In m
Account No.
Check
Lot(s)
ServiceAddress
Money
M110r1ter(s)
Order
0 Backflow(s)
0 House Lateral(s)
0 Detector Check(s)
0 Meter Surcharge
11--ganit.tim, Capacity Charge
0 W.S.B.F.C.
0 Temporary Construction Meter
QT6'rn on Charge 4179612-2
X
4-63-�.-O
El Uncollected Account -Name
0 Inspection Fee -Tract -
Fee -
0 Plan Check Fees Water I Sewer -
Tract -
0 Bond Payment - A.D. - Bond
Assmt.
0 Customer Deposit
0 Other
Remarks:
Dcopy to:
Cash
Check
Money
Order
J, 9,;L�
Tract 19.
G.A. Code
$
12 5
N
TOTAL $ :2 (' 75'W), e2 62
Water Service
Cashier_
(11189)
F�_ILc_z3ARIEW WE\� �\ - = if I! ,r; 1.+\ c+t l,:j�ili�� bI�.f
F1,��
i,
iN Jaf 419a Qu*uta
juttbi dub �$afe 34illizilan
This Certificate issued pursuant to the requirements of Section 306 of the Uniform Bullding:
`
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 52-230 Avenida Diaz
�I
' IBldg.
use Classification Single Family Dwelling 12655
Permit No.
Group ft3 Type ConstructionVN Fire Zone Use Zone SR
David Ross Miller P.O. Box 722
Owner of Building address
City La Quints CA 92253
Lonnie Day
B Y'
!
I SLI Date; March 23, 1994
Building Official 47-
POST IN A CONSPICUOUS PLACE
--'