001565 (SFD).4
P.O. BOX 1504 No. 001565
Buildingr 78-105 CALLE ESTADO
Address 54-845 Amd4a Di= LA QUINTA, CALIFORNIA 92253
Owner .. _.
Mailing
Address P.0. Ww 2288
City Zip
Indio I 92mi
Contractor
Address.,
BUILDING. TYPE CONST. OCC. GRP.
A.P. Number '774-266--0145 Tat a
Tel.'
Legal Description
Project Description__.
Tel.
I State Lic. .11
& Classif. ,519
1
Icity92
Lic. #
Sq. Ft. qr
Size GM 434•.
No. No. Dw.
Stories Units
Arch., Engr., {.
Designer
New i Add ❑
Alter O. Repair ❑ Demolition ❑
Address
Tel.
City
Zip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am lic@nsedrunder provisions of. Chapter 9 (commencing with Section
7000) qf'Division 3 of the Business and Professions Code, and my license is in full force and
leffect\ik'`L�`t�`T4i�t"t':t.^S-1tS—{r{��,
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
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'besis .
forthe alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit
subjects the applicant to a civil penalty ofnot more than five hundred dollars ($500).
O I, as owner of the property, or my employees with wages as their sole compensation,. will
Estimated Valuation
y1 �1 i•7 P_A
81,447.60
t •
PERMIT'
AMOUNT -
Plan Chk: Dep.
Plan Chk. Bal..
31.8.52
Const.
'73'1 w(�
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
Mech.i.n
R7
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.). .--.
Electrical'
Plumbing -
"An
i ❑ 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
_
S.M.-I._
5.71,
Grading
Driveway Enc.
20.00
Date owner
Infrastructure
1.221.71
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. ❑ Certified copy is hereby furnished.
TOTAL
2.135.06
REMARKS
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 the 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.
ZONE: - BY:
Minimum Setback Distances:
Front Setback from Center Line
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 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 of this city to enter the above-
mentioned property for inspection purposes.
i�Signature of applicant \ '"xi c N k ti.f +T' Date k- , A' -
Mailing Address y �'
City, State, Zip
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line -
Side Setback from Property Line
FINAL DATE INSPECTOR 4
` i
Issued by: Date Permit
Validated by: %1
1
Validation:
A 1 6 2 9 6 18 2135,06 CK
I'1AKU UUPY
T �
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
COLL. AREA
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
DUCT WORK
ROCK STORAGE
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
METER LOOP
HEATING (FINAL)
DRAINAGE PIPING
CAR P. SQ. FT. ®
GAS (FINAL)
WALL SO. FT. ®
DRINKING FOUNTAIN
SQ. FT. ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
GRADING
cu. yd.
$ plus x$
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
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, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 C
SEWAGE DISPOSAL
SQ.FT.GAR a 3/ac
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
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTI
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEQUIP.
REINF. STEEL
GAS (FINAL)
i km P. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP.
ARAMING
FINAL INSP.
ROOFING S/
r
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
p`MESH
�— INSULATION/SOUND
I/
FINISH GRADING
FINAL INSPECTIONS / 7H
O
CERT. OCC.
FENCE FINAL
INSPECTORS SIGNATURESIINITIALS.
GARDEN WALL FINAL
r�fIE0
CO) o
_
—0
H BERMUDA DUNES r
RANCHO MIRAGE
INDIAN WELLS rn
PALM DESERT a
& LA OUINTA
410 INDIO y
Desert Sands Unified School District
82.879 HIGHWAY 111 O INDIO. CALIFORNIA 92201-5678 O 16191 347.8631
April 23, 1985
City of La Quinta
Department of Community Development
78-105 Calle Estado
La Quinta, CA 92253
Re: 54-845 Avenida Diaz
Gentlemen:
The developer of the above referenced lot
has mi'ti'gated its impacts on our overcrowded schools by payment
of the amount of $628 pe.r.unit to be applied to the cost of
district educational facilities made necessary by such new
development.
Sincerely,
"�'LI. V^A -j"
John D. Brooks
Assistant Superintendent
Business Services
JDB/crm
Desert Sands Unified School District
CERTIFICATION OF PAYMENT
OF
SCHOOL FACILITY FEES ;
[t1)
(CD)
TO: City of La Quinta DATE:
Department of Community Development
78-105 Calle Estado
La Quinta, CA 92253 NO'T'ICE: 'r1g1S
This is t certify hat
E1VT CANNOT
BE OttlT
Q,ao�i
developer of kijgW7
located at
this District, has paid school facili y fee
authority generated by Government Code Sect
covering a total of /_� �fo squire
( ) industrial/commercial development and
v
�cbich is
ithin
s imposed pursuant to the
ion 53080 in the'amount of
--Zp14A01'1LJ 0-0I/00 e - )
Meet of ("T -residential or
that building permits for
this footage in this development may now be issued by your jurisdiction.
-� S_
09 I2 6�or/DESERT SANDS•UNI IED SCHOOL DISTRICT
White - Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer
(10)-37