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/