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10597 (SFD)Building Address 53-040 Diaz Owner Ti4 W&AJ No. 10a9T JILDING: TYPE CONST. OCC: GRP. P. Number 774•-04.2-002 (gal Description Lot 23 Block 177 oject Description SFT) P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Mailing Address P. 0. Box 59 City Zip Tel. La Oui.nta 92253 564-1486 Contractor General Contract Management Address . same City Zip I Tel.: State Lic.I City & Classif. 524325 Lic. # 1235 Arch., Engr., Designer Address Tel. City( Zip ( State I Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provlsi�f Chapter 9..(commenci_ng with Section 7000) of Division 3 of,the•Business•�-Professions Code;.and'm license is in full -force and effect. +"`��" -� SIGNATURE \ DATE OWNER -BUILDER DECLARATION J ' 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 fila 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). ❑ 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 orimprovement 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 contractors) licensed 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 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 O,'Copy 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 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 -Sq. Ft. 1536. No. No. Dw. Size - Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Permit does not include block galla or pool stimated Valuation RYR IRA.. 971 nn PERMIT AMOUNT Plan Chk. Dep. 250.00 Plan Chk. Bal. S AA Const. Mech. '•, >y Electrical AA Plumbing bra OO S.M.I. Li an Grading 7A n Driveway Enc. _71, O Infrastructure 1956.R9 �r TOTAL 3412.55 .3162.59 REMARKS .lip .•1tiJ!`' A 1004L» t ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop:'Line 1 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. PLUMBING FEES IST FL. SQ. FT. ® $ UNITS SLAB GRADE 2ND FL. SQ. FT. BONDING YARD SPKLR SYSTEM POR. SQ. FT. ® MOBILEHOME SVC. BAR SINK GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS CAR P. Q.. Fr. ® GAS (ROUGH) DRAINAGE PIPING WALL SQ. FT. OTHER APPJEQUIP. DRINKING FOUNTAIN. SQ FT ® TEMP. 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 INSP. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM. _ KITCHEN SINK ABSORPTION SYSTEM B.TM. 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 SPARK ARRESTOR SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR ® VVac HOUSE SEWER 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 2 t'j x L GROUND PLUMBIN (�,OUNDERGROUND 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 APPJEQUIP. 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 l �j� FINAL INSP. ja ROOFING ^[[ � /A� � ^ _ REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND 3 l FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL Building r ;Q Address `_� G' Q � L Owner Contractor Address Zip State Lic. & Classif. I,. ec/ �Z Arch., Engr., Designer Ste? Address City Zip T4',v,, 4 4 Qum& P.O. BOX 1504 APPLICATION ONLY - 78 -105 CALLE ESTADO \ LA QUINTA, CALIFORNIA 92253 f BUILDING: TYPE CONST. . OCC. GRP. A.P. Number -% 7 LI . r,L��i Tel. ' Legal Description i T z 3 314.. Project Description 5 F D- Lic. # Tel. State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that 1 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 �thajtl WNEWBUI ER DECLARATION I hereby affjexempt from the Contractors License Law for the following reason: (Sec. 70 -and -Professions Code: Any city or county which requires a permit to construct. atter, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to We 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 ciW penalty of not more than rive hundred dollars ($500). ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his,own employees, provided that such hprovements are not intended or offered for sale. If, however, the building orimprovement is sold within one year of completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale.) ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractors) licensed pursuant to the Contractor's License Law.) ❑ lam exempt under _$ea R. & 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 Workers 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 WORKERS' COMPENSATION INSURANCE (This section need not be conpleted If the permit is for one hundred dollars (5100) valuation or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ anyppeerson in any manner so as to become subject to the Workers' Compensation Laws of Califomia. Date Owner NOTICE TO APPLICANT: tt, after making this Cerlifk:ate 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. � 4 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.) Lenders Name Lenders Address This is a building permit when properly filled out, signed and validated, and is subject to expiration it 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 sof this city to enter the above- mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip BUILDING DIVISION REMARKS OQ,182 _10_7419_01-31-92 in AV LM1 IUIHL 1 (D. VU 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: Sq. Ft. �`�'S� Size No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation c> 6 7 3 D O PERMIT AMOUNT Plan Chk. Dep. OLZ EnC' Plan Chk. Bal. Const. O. on Mech. s• �n Electrical r S - Plumbing / 3f__ Op S.M.I. 91,470 Grading _�2,0 — Driveway Enc. 29 -- Inf. astructure r 34M.54 TOTAL __? 7_5_ REMARKS OQ,182 _10_7419_01-31-92 in AV LM1 IUIHL 1 (D. VU 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 GROUND PLUMBING NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. 6 SO. FT. ® $-7 l UNITS — �— HEATING (ROUGH) STORAGE TANK 2ND FL. SO. FT. SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK YARD SPKLR SYSTEM -- GAS (ROUGH) METER LOOP SVC. OTHER APPJEOUIP. BAR SINK GAS (FINAL) POR. SO. FT. ®MOBILEHOME GROUT WATER HEATER SERVICE GAR. '9SO. FT. `-� POWER OUTLET WATER SYSTEM ROOF DRAINS GRADING cu. yd. $ plus x$ =$ LUMBER GR. FINAL INSP. FRAMING DRAINAGE PIPING CAR P. SO. FT. ® REMARKS: � VENTILATION WALL SO. FT. 7o o FIREPLACE DRINKING FOUNTAIN SO FT ® GAR. FIREWALL URINAL ESTIMATED CONSTRUCTION VALUATION $ MESH INSULATION/SOUND WATER PIPING FINISH GRADING NOTE: Not to be used as property tax valuation FINAL INSPECTION FLOOR DRAIN MECHANICAL FEES INSPECTOR'S SIGNATURESIINITIALS WATER SOFTENER VENT SYSTEM 2— FAN EVAP.COOL HOOD SIGN WASH ER(AUTO)(OIS H) 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 6 ^V 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 3 176 SEWAGE DISPOSAL SO.FT.GAR ® 3/ac 0 HOUSE SEWER z z GAS PIPING PERMIT FEE -- PERMIT FEE PERMIT FEEDBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FE� CONST.T. FEE ELEC SMI FEE PLUMB. FEE � Sv oo �l �.oo flE `3f, o v . 9% STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND 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 APPJEOUIP. 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 FINAL INSP. ROOFING 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) 347-8631 Date 2/7/92 1 Type of Permit La uinta No. 111175 Permit # r. I Log # Owner Name General Contract Management No. 53040 Street Diaz city La Quinta zip 92253 Study Area 112 I APN # Tract # Lot # Square Footage 11536 Type of Development Single Family Residence ? No. of units 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 1.58 X 1536 or $ 2,426.88 have been paid to D.S.0 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 Michael Bangerter 'Telephone Name on the check - �y. By James E. Lively Assistant Superintendent, Business Services Fee collected /exempted by Vickie J. Durrett Payment Received Signatures a m. Check No. 104 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 ❑Copy to: Cash Check 4 t. Money Order Water Service 0 Cashier CMD -43801/ COACHELLA VALLEY WATER DISTRICT ,. 8 CASH RECEIPT DETAIL �^ Received From: �a C/y�/i C•OA/7rrc'.� C% is9�. /,d �^<< r��.�t..�17 �+ Date: '� /—y /— `2- Address: Account No. �'� �) ° Lot(s) Tract 1 Service Address »L " /lc� �f+ l.'/f/2 J). o G.A. Code fid v�leter(s) —2. ,Z, c:3 o. $ cJOG p O� O Backflow(s) ❑ House Lateral(s) O DetectorCheck(s) ❑ Meter Surcharge . (;?'Sanitation Capacity Charge r -- a' ❑ W.S.B.F.C. ❑ Temporary Construction Meter O Turn on Charge ❑ Uncollected Account -Name O Inspection Fee - Tract -. Fee - ❑ Plan Check Fees Water I Sewer - Tract - ❑ Bond Payment - A.D. - Bond Assmt. ❑ Customer Deposit ❑ Other _ ✓ TOTAL $ ✓ `' Remarks - r:CJt'n 1 ^s . 342 .G O L37 -7 A E3 UL —7_7 ❑Copy to: Cash Check 4 t. Money Order Water Service 0 Cashier CMD -43801/