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002944 (AR)Building Address 53--875 AverAa Owner Damiell E. & Beth El Mailing' Address sMW as abom City Zip Lim' nU 922-53 Contractor Address . . - Zip State Lic. & Classif. Arch.- Engr., Designer P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 VN Tel. Lic. # Address Tel. City Zip State _ 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, atter, improve, demolish, or repair any structure, prior. to its issuance - also requires the.applicant for such permit to lila 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'Piolessions Code, or thathe 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 We civil penalty of not more than live hundred dollars ($500). ❑ 1, as owner of the properly, 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 Seca B. & P.C. for this reason r Date . y- `� r' 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 .❑ 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.) •- 1 certify that in the performance of thg work for which this permit is issued,.) 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 shouldbecome subject to the Workers' Compensation provisions of the Labor Code, you must Iforthwith 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 HARD COPY No. 002944 R-3 BUILDING: TYPE CONST.w OCC: GRP. A.P. Number Legal Description Project Description Sq. Ft. No. No. Dw. Size " Sq• • Stories Units New ❑ Add [I= Alter ❑ Repair ❑ Demolition ❑ REMARKS ZONE: BY: Minimum Setback Distahces: Front Setback from Center.Line Rear Setback from Rear Prop. Line Estimated Valuation 10C �{� . �S>•RaJ7V Side Street Setback from Center Line PERMIT AMOUNT Plan Chk. Dep. FINAL DATE Plan Chk. Bal.. 40162 Const. " 62.50 Mech. Electrical 12.00 Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL $ 115.�a REMARKS ZONE: BY: Minimum Setback Distahces: 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 2/24®87 Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS SLAB GRADE ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL. SO. FT. FORMS SEWER OR SEPTIC TANK ROUGH WIRING G —a 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. SD. FT. GROUT WATER HEATER WALL SQ. FT. FINAL INSP. DRINKING FOUNTAIN SO. FT. ® WATER SYSTEM URINAL ESTIMATED CONSTRUCTION VALUATION $ _$ WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER VENTILATION 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. SQ. FT. ® c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER FINISH GRADING 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 GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING G —a DUCT WORK ROCK STORAGE FOUND. REINF.3�3+&� GAS (ROUGH) METER LOOP HEATING (FINAL) OTHERAPP./EQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ _$ LUMBER GFt. FINAL INSP. ?U&RAMING :�/�3`�S FINAL INSP. ROOFING a 26i �� G �� REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL ,t,/IATHING t �� 'J MESH INSULATION/SOUND FINISH GRADING qqqq ////FINAL INSPECTIONL — v'Cc !f / CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS, GARDEN WALL FINAL Desert Sands Unified School District t CERTIFICATION OF PAYMENT OF (( SCHOOL FACILITY FEES 1A C> TO: City of La Quinta DATE: Department of Community Development 78-105 Calle Estado La Quinta, CA 92253 This is to certify that developer of et which is located at 4'4- 9-7,q' within this District, has paid school facility feet/ imposed pursuant to the authority generated by Government C de Section�5 080 in the amount of covering a total of s q u a e feet of ( residential or ( ) industrial/commercial development and that building permits for this footage in this development may now be issued by your jurisdiction. i r C for DESERT SANDS-UNIFIE15 SCHOOL DISTRICT White-��Building /Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer (10)-37