14662 (AR)1 �
f . - of
P.O. BOX 1504 N O . 146,69.
Building
Address S3-280 Wie. Villa
Owner Carl '& Salley Filson
Mailing Syme
Address
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
City Zip r564 -0910
t.8 Quint- , CA.92253
Contractor
(3mer/Pjuildek .
Address
Zip I Tel.:
JILDING: TYPE CONST:. ' : OCC: GRP.
P. Number
Igal Description
oject Descriptionition '
State Lic.
City
`
& Classif..
Lic. #
Sq. Ft.
Size • 570
No. No. Dw.
Stories Units '
Arch., Engr., .. ... ..
.,Designer
New ❑ - Add ❑
Alter ❑ Repair ❑ . Demolition ❑
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
t. .. ;
effecs
`DATE
s .
-•_
Valuation
' - -
-.443,260".00
SIGNATURE i.�i3•+
OWNER -BUILDER DECLARATION' t Estimated
I hereby affirm that I am exempt from the Contractor's License Law for the followin4�
reason:. (Sec.- 7031.5,Susiness 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 rile a.slgned statement.that he is license`dpursuanr to .•
requires
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.heiis`exempt therefrom, and the basis
for. the alleged exemption: Any. violation of. Secdon,17031.5 by.'any applicant for a permit
- subjects the applicant to'a civil penaltyof not more thanfive 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 isnot 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 whodoes such work himself or through his own - employees, .
provided that such improvements are bot 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.)
• PERMIT
.-AMOUNT-
Platt Chk.. Dep.' '
-
Plan Chk. Bal.
-
Const.
, Mech.
_
EIBCtrICdl'
-
Plumbing -
O 1, 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 cortracts for
' such projects with a contractors) (sensed pursuant to the Contractor's License Law.) ' -
-- ❑ I am exempt under Sec. B. & P.C. for this reason
`
S.M.I.' -
4.32 _
Grading
Driveway Enc.
Date ' Ownec-=-- ✓rte����
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
D Copy is filed with the city, ❑ Certified copy is hereby furnished. .
TOTAL
4.32
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
REMARKS 'PerMit issued under lot - mercrer -
Incentive�-
12/31/95. 9 �f Y ) [i
.cc'9�4k'�3'leted prior to 12/31,/ 95.
(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: d, after making this Certificate • or Exemption 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. ..
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.
Thie is a building permit when property filled out, signed and validated, and.is subject to
expiration it work thereunder is suspended for 180 days.
I car lfy 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
per Building Official.
ZONE: BY:
Minimum Setback Distances:.
Front Setback from Center Line
Rear Setback from Rear PPewNl_ine
Side Street Setbackj n i enter L• ine -
Side Setback from /PP/roperty'L•ne��
FINAL DATE JI SPECTO'A \J
Issued,by:: Date, _Per it �•
Validated by:
Validation.\ v/�
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE ��
2ND FL. SO. FT.
BONDING
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SD. FT.
GAS (ROUGH)
DRAINAGE PIPING
WALL SO. FT.
OTHER APPJEOUIP.
DRINKING FOUNTAIN
SO. 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
FRAMING //%
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
�:Av
/A
LAUNDRY TRAY
AIR HANDLING UNIT CFM
REMARKS:
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 ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
MESH
INSULATIONISOUND
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 PLUMBIN��
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. F�j
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL &P
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//!//��
�:Av
/A
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
.FENCE FINAL
INSPECTOR'S SIONATURESIINITIALS
GARDEN WALL FINAL
{ DESERT . SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111 ,
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated 619-775-3500
w
Date 1/20/95 Type of Permit La Quinta`
No. 113265 Permit #
Owner Name Carl & Sally Wilson' _ Log
No. 53280 Street Avenida Villa
city La Quinta • Zip 92253 Study Area 111
APN # F Tract # I Lot # 0 ,Square Footage 1576
Type of Development Residential Addition No. of units 0
Comments
t
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 1.72 x 576 or $ 990.72 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 y Carl & Sally Wilson Telephone
Name on the check ,
7
564-0910
By Dolores A. Ballesteros �y� eh#�,`, t�,
Superintendent
Fee collected /exempted by Pauline Pearson,
Payment Re< eived n, ti
Signature �� �Q (4t itA.cl�ti
y' Clie:ck No ,104
Collector: Attach a copy of county or city plan check application form to district cop'y fortitll '-ivaiv`ers.
Embossed Original- Building Dept./Applicant Copy - APPhcant/Recei t 'Copy - Accountin
g