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14293, 15270, 15522, 9807-158 (SFD)tr,x ttc�j� t9w rxi..+z R , 4r i it y..to 1+`jii)„rF;r•�:;? h,�`:.f�Ii' i'i�3�.,�'}'�1iQjr+*J'” I rb .r Tip t _ •4_4 7CV (` P.O. BOX 1504 No. i k,2 101 -V Buildingti_. ' •78"970 Dry Creek 78-495 CALLE TAMPICO Address LA QUINTA, CALIFORNIA 92253 Owner z Al U�tz?�ett COStQt:&"%,. .©n Mailing P.O. BOX 3371 ) Address City Zip Tel. Palm Desert, (A 92261 564-1849 Cgn;txaetor Address City State Lic. D 14035 I city 1463 & Classif. Lic. # Arch., Engr., Ie k--2 -Penne Designer Atdt9es^it40—Hwy -111—#2166.»_-- . Te -L320-2436 CityI Zip I State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions ofrChapter 9 (commencing with Section 7000) of Dw,Yision�3 of the Business and Professions.C'ode, and my license is in full force and effect -,f �.r v: "•.% 'il.d' tis- tr'lr '-SIGNATURE'S DATE OWNER•BUILDER,DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7037.5,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 rile 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 rive hundred dollars ($500). u 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 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 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.) I 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 N0. Company TO Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed H the permit is for one hundred dollars ($700) valuation or less.) I certify that in the performance of thq'work, for. which this permit is issued, 1 shall not employ any pperson in any manner so as to become subject to the Workers" Compensation Laws of Cali ornia. .r'.,Fr+rx./`w-i' ;% ".- - ,,f "I✓'.E 9,+'L"/V` Date `l � � Owner - ,Z NOTICE TO APPUCANT: d, after making this Certificate of Exemptiom' you should become subject to the Workers' Compensation provisions or the Labor - Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Y WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND , SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND: ATTORNEYS FEES. ; 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. Signature of applicant Date Mailing Address City, State, Zip VN BUILDING: TYPE CONST. OCC. GRP.. 769-541-005 A.P. Number Lot 4 Tract 26016 Legal Description SFD Project Description R3 TOTAL K f v d, . tr v I -s , .a ;# A. W V 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 DAl Issued by: - Validated t Validation: Sq. Ft. 2110 Size No. Stories No. Dw. Units New O Add O Alter O Repair ❑ Demolition 0 Permit does not include block wall or goal. Estimated Valuation p123,9U3.00 PERMIT AMOUNT Plan Chk. Dep. '" • _ _ _ Plan Chk. Bal. ? Y 1' ` 4 Const. Y y • 'yam Mech. _ �'u • �_ v Electrical • Plumbing 174.00 S.M.I. 1.... J,S. Grading 20.00 Driveway Enc. • CFO, Infrastructure 2, Y 0 T. v x ['A X t;M it P u L d4 :. Ptumvia -- .Y TOTAL K f v d, . tr v I -s , .a ;# A. W V 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 DAl Issued by: - Validated t Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBINU FEES N IST FL. SO. FT. ® $ UNITS LAB GRADE -/C/ 6 G ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL SO. FT. ® FORMS EWER OR SEPTIC T40 POR. SO. FT. ® MOBILEHOME SVC. BAR SINK _ GAR. SO. FT. ® POWER OUTLET ROOF DRAINS HEATING (FINAL) OTHER APPJEOUIP. DRAINAGE PIPING CAR P. SO. FT. ® TEMP. POLE WALL SO. FT. GROUT DRINKING FOUNTAIN. SO FT ® FINAL INSP. URINAL _ ESTIMATED CONSTRUCTION VALUATION $ WATER SYSTEM WATER PIPING NOTE: Not to be used as property tax valuation =$ 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, TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. ® c BATH TUB GAR. FIREWALL SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR ® Yc 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 I STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK 12-- G —76-1' OUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA LAB GRADE -/C/ 6 G ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS EWER OR SEPTIC T40 ROUGH WIRING. DUCT WORK ROCK STORAGE FOUND. REINF. ��� G 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 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 5/16/94 1 Type of Permit I La Quinta No. 112836 Permit # Owner Name Richard Dodson Log No. 78970 Street Drycreek City La Quinta Zip 92253 Study Area 125 APN # I Tract # 126016 J Lot # ® Square Footage 1 Type of Development Single Family Residence No. of units Comments Grandfather Clause Bajada Tract #26016 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: Under Mitigation Agreement EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Mitigation Agreement in the amount of 628.00 x 0 or $ 628.00 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 By Richard Dodson Name on the check Dolores A. Ballesteros Superintendent Fee collected /exempted by Vickie J. Durrett Telephone Payment Received Signature ?lL r Check No. 174 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 r Address 78-A370 Dry Creek Owner Mini8t. elli Construction P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Mailing Address 50-445 Mountain Shadows City Zip Tel. La .Quintal CA 92253 1564-1849 Contractor Sam City Zip Tel.: State Lic. City & Classif.. B b93899 Lic. # '3625 Arch., Engr., Designer Address Tel. CityI Zip I State I 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, after, 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 Ove 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 or Improvement is sold within one year of completion, the owner -builder will have the burden of proving that he did not bund or Bnprove for the purpose or sale.) D 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) Qcensed 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 ❑ Copy Is filed with the city, ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATIONINSURANCE (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. Dale Owner NOTICE TO APPLICANT: ft, alter me" 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. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 160 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 No. 15270 BUILDING: TYPE CONST. OCC. GRP. A.P. Number Legal Description Project Description Supplemental permit to pemmit no. 142.93, to effect change of ownership ,and contractor Sq. Ft. No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated.Valuation PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL -0- REMARKS ZONE: BY: Minimum'Setback Distances: , Front Setback from Center Line Rear Setback from Rear Prop. Line G Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date ' Permit Validated by: Cis 1% X99 Validation, A\ CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBINV 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 MOBILEHOME SVC. BAR SINK POR. SO. FT. ® GAS (ROUGH) METER LOOP GAR. SO. FT. ® POWER OUTLET ROOF DRAINS GAS (FINAL) TEMP. POLE DRAINAGE PIPING CAR P. SO. FT. ® GROUT WATER HEATER WALL SQ. FT. FINAL INSP. DRINKING FOUNTAIN SQ. 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 WASH ER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED VENTILATION LAUNDRYTRAY AIR HANDLING UNIT CFM O I IKITCHEN 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. SO. FT. ® c BATH TUB INSULATION/SOUND SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1'A c SEWAGE DISPOSAL SQ.FT.GAR ® 3/.c 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 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 FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING O FIREPLACE A If.AA IA4ftj, SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL Building Address t8-97£� Dry Ct=S'- P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 v""mmur Louis Rue Mailing Address P.O. Box 2982 City Zip Tel. Palm Desert, M 92211 Contractor DGH Construction Address 40-993 Sonata Ct. City Palm Keiser::,: Zip 92211 Tel.' 341-4510 State Lic. B�i�i1e� & Classif. City 1526 Lic. # Arch., Engr., Mari Peutz Designer Address1,30 T5-20--2436 65Ham Ill 4216 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 Eusiness,a�nd Professions Bode; andmyliic-ehse'fs in full force and effect - Ir rsfd._^t's}PC trri"l'. r t+!xsrE7r�iX SIGNATURE' - - DATE OWNEWBUILDER 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, demofish'of 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 therefrorim, and the basis for the alleged exemption. -Any violation of Section 7031.5 by 'any applicant for .a permit subjects the applicant to a civfl penalty of not more than rive 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 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) Qcensed pursuant to the Contractor's License Law.) ❑ 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, ora certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company ❑ 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 ($100) valuation 'or less.) I certify that in the performance of the work for which this permit is issued, -I shall not employ anyperson in any manner so as to become subject to the Workers' Compensation Laws of California Date Owner NOTICE TO APPLICANT. If, after me" this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($IDO,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN -SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. This is a building permit when property 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 No. 15522 BUILDING: TYPE CONST. OCC: GRP. P. Number Legal Description Project Description Supplemental permit to permits. 14293 & 15290, to reflect chance, of ownership and constrictor. Sq. Ft. No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation I PERMIT AMOUNT L Plan Chk;,Dep. Plan Chk. Bal. ' Const. Mech. ` Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL --0— REMARKS 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 NO. ELECTRICAL FEES NO. PLUMBIW FEES • 1ST FL. SQ. FT. ® $ UNITS � 2ND FL. SQ. FT. YARD SPKLR SYSTEM BONDING MOBILEHOME SVC. BAR SINK POR. SO. FT. ® SEWER OR SEPTIC TANK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS FOUND. REINF. DRAINAGE PIPING CAR P. SO. FT. HEATING (FINAL) OTHER APPIEOUIP. WALL SO. FT. DRINKING FOUNTAIN SO. FT. ® 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 WASH ER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FINAL INSP. LAUNDRY TRAY 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 FIREPLACE SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1% c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER THING % 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 DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPIEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM I GRADING cu. yd. $ plus x$ _$ LUMBER GR. FINAL INSP. w' FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL41- THING % MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL U) H (V W O � M ti W �ra=� o Z l� cc) O O F— u' w P_ H a U) Z co LO N ON U_ a) 'Z �QO LL Xw — 0 _J mUU O rn H 't Z_ Ob Z r` O J LICENSED CONTRACTOR DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License # Lic. Class Ev- Date 4817121 81 C20 C36, 950/991 /ate'Z_//?, !q4' Signature of Contractorrj OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: ( ) 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, Business & Professionals Code). ( ) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code). ( ) I am exempt under Section , B&P.C. for this reason Date Signature of Owner WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: () I have and will maintain a certificate of consent to self -insure for workers' compensation, provided for by Section 3700 of the Labor Code, for the performa�e of the work for which this permit is issued. #,�) .I�have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier & policy no. are: Carrier Policy No. S'1'R:I'tz J ISD (This section need not be completed if the permit valuation is for $100.00 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, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those�'ovisions' �15ate: /_L/// 1 /''­Applicant::,•p°%,, Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his' application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the/above-mentioned mentioned propel inspection purposes. r i Signature BUILDING PERMIT PERM'980715CONTROL# � DATE VALUATION a LOT TRACT 7393 JOB SITE ADDRESS 7.8-970 DRV CREEK OWNER CONTRACTOR/DESIGNER/ENGINEER nARIJXY' VOM1:ItAI L?I:'VI L0.01MENT CORPI' 4 CHORCHHII,1,,1..ANE 40048 SAG laVOOD DR RANCHO MIRA.CTE CA 912270 PALM DESE1tT CA. 92261 (760)341-4510 CBIA 1526 USE OF PERMIT IWSt RILANROUS SUPT LOWE�1v`'1'AL PEi:M T TO PERMIT W293 Be 05290 & 18522. 6P, CCj1�3p1,r it'It3P3 C:+E' lN`t"E�tic:UR FiNiS1-i Ai�I.)1::r1N9�s`tti:A2'1NC� r h.u.7 i.d I.M.Sd'T���tlr.�lP �A�7,A i✓A'•i.l..7t9eD�Y. i.`V�,i,.ai.�lV 19:40!1 CLNST91J TION .h- 101-000-41.4.0011 5976.50 E�t r Cf?; ,JI.40T AL CONNS'l R T11-? UCN ;f N�D PLt\N CHECK �a7Cy,50 LESS Plf"W-PAID FEES $0.1% AUG 13 1998 TOTAL P FAM -IT FIRPS DUE NOW $976-50 I:RECE2PT I DATE I BY I DATE FINALED I INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms 8 Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans 0. K. to Wrap F.A.U. Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans 8 Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final POOLS - SPAS BLOCKWALL APPROVALS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test Appliances Final COMMENTS: Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power t Final Utility Notice (Perm)