003460 (SPIN)• r
P.O. BOX 1504 ��. .003460
Building, 78-105 CALLE ESTADO
Address 52-770 Aveni&i Villa LA QUINTA, CALIFORNIA 92253
�.T.^...
Owner
vMattheW A. saweikis
BUILDING: TYPE CONST.
OCC*.GRP..-'
Mailing
Address %7-77n n Bvyp Y A V* 11 .
A.P. Number
773-334-0-01
City
Zip
Tel.
'La -QiUn a .
9225
_ 564-3205
Legal. Description
Project Description
necial insrection
Contractor
Address.. '..... .. ...
City " ............ .....
Zip _ _ ....
Tel..
State Lic.
City
& Classif.
Lic. #
Sq. Ft..
No. No. Dw.
Size • -
Stories Units -
Designer
New: O Add O
Alter ❑ Repair 0 Demolition 0
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 Contractors License Law for the following
,. reason: (Sec. 7031.5,Business. and Professions Code: Any city or county .whicA 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, 'andthe basis
for .the alleged exemption. Any violation of Section 7031:51 by 'any applicant for. a. permit
-subjects'the applicant to'a civil penalty of not more than rive hundred dollars ($500). '
. 0'I, as owner of the property, or my employees with wages as their sole compensation, will V
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.
Estimated Valuation
PERMIT
- -
.. '
AMOUNT -
.Plan -Chk. Dep..
`
— Plan Chk. 681.
..
Const.
A3. Am— Ott-
t-
Mech.- .
..
builds
builds - or improves thereon and who does such work - himselP or through his own employees,.
,provided thal' 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 -
0 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 improvesthereon, and who contracts for
• such projects with a contractor(s) licensed pursuantto the Contractor's License Law.) -
0 1 am exempt under Sec. B. & P.C. for this'reason
$•M;I•'.
- ••
Grading
Driveway Enc.
_Date f�r 90wner �' 37..,�na'i -� -
Infrastructure
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
E;1 nn {^-f1
REMARKS
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed it the permit is for one hundred dollars ($100) valuation
or iess�)
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.
M45t a"L ea iK t l rri0—A30_;2.it ,� J
a •,. ,,pne a
' Date Owner
NOTICE TO APPLICANT: If, alter making this Certificate of Exemption you should become
subject`to'lhe 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
Rear Setback from Rear Prop. 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:)'Side
Side -Street Setback from Center Line
Setback from Property Line ..
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.
FINAL DATE
Issued by:
Validated by:
INSPECTOR
t
Date lA/20I owmlt-
Signature of applicant Dale -
" Mailing Address
Validation:
City,,State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
2ND FL. S0. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. Q. FT.
WALL SO. FT.
SO. FT. @
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP./EOUIP.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1�A c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
REMARKS:
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 APP./EOUIP.
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
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL .
INSPECTOR'S SIGNATURESIINITIALS.
GARDEN WALL FINAL
NF -
78 -105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 (619) 56472246
October 22, 1987'
-Mr. Matthew A. Saweikis
52-770 Avenida Villa
La Quinta, CA. 92253
.Dear Mr. Saweikis:
A -special inspection was conducted at the..above address on.10/22/87.'
Although no permit was obtained to convert the garage `area into
living space no building code violations were apparent at'the time of
the inspection. All alteratiorfs were non-structural:
If you are in need Of�f.urther information or additional
certification,'please'do not hesitate to contact the undersigned.
Very truly yours,
TOM HARTUNG
BUILDING OFFICIAL
PLANNING & DEVELOPMENT DEPARTMENT
THsbja; .. - •
ltrth..104
MAILING ADDRESS; P.O. BOX 1504 LA QUINTA, CALIFORNIA 92263