001915 (AR)i t Q
P.O. BOX 1504 No. 001915
Building 78-105 CALLE ESTADO
Address l toCtrp_ LA QUINTA, CALIFORNIA 92253 r
1 Owner 111
IrVi l C. Chapmtl
BUILDING: TYPE CONST. OCC: GRP.
Mailing
Address 2%2. AW. A.P. Number t
City Zip Tel. �
YA3a • 92626 (714) 540--I. Legal Description I
Contractor Project Description gAVWt^ Tom-, rtvm
Address
2436 Vhssar Pi.
State Lia
City
& Classif.
Lic. #
Sq. Ft. No.
2
No. Dw.
Size • 60 • Stories-
Units
Arch., Engr.;
Designer
New ❑ Add 9 Alter ❑
Repair O 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
effect
^
+
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SIGNATURE `" ,/' DATE
OWNER -BUILDER DECLARATION
Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following
$ $. 01
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires. a
l ��
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
PERMIT -
i
AMOUNT
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
Any Section 7031.5 'any for
Plan,Chk. Dep.
-
for the alleged exemption. violation of by applicant a permit
subjects the applicant to a civil penally of not more than five hundred dollars ($500).-
•
Plan
361.72
❑ I, as owner of the property, or my employees with wages as their sole compensation, will .
-do
.Chk..Bal.
f the work, and the structure Is not intended or of for sale. (Sec. 7044, Buisness and
Const.
' > A(,�
1 Professions Code: The Contractor's License Law does not apply to an owner of property who
buildsorimproves thereon and who does such work himself or through his own employees,
Mech
'
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
" EI2CtfICc11
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-
Plumbing
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
S. M. 1.
• such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
O.1 am exempt under Sec. B. & .'P.C. for this reason
i.
Driveway Enc.
Date Owner
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
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. .
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed i1 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. 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.
TOTAL
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY Side Street Setback from -Center Line
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 Setback from Property Line
Lender's Name
Lender's Address FINAL DATE INSPECTOR
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. Issued by: Date Permit
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 J r y Validated by:
Signature of applicant'-'? - /-• r I_. Date
Mailing Address Validation:
City, State, Zip — -
A3435 12 2 _
HARD COPY 1 ' 5 7 2 CK
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
v
COLL. AREA
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL. SQ. FT. ®
BONDING
POR. S0. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
DUCT WORK
ROCK STORAGE
DRAINAGE PIPING
CAR P. S0. FT. ®
GAS (ROUGH)
WALL SQ. FT. ®
HEATING (FINAL)
DRINKING FOUNTAIN
SQ. FT. ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
TEMP. POLE
WATER PIPING
NOTE: Not to be used as property tax valuation
GROUT
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
WATER SYSTEM
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GRADING
cu. yd.
$ plus x$
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
FIREPLACE
SQ.FT.GAR ® 3/ac
HOUSE SEWER
SPARK ARRESTOR
GAS PIPING
PERMIT FEE
r/
GAR. FIREWALL I a1 x i
u
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 !� �6
SEWER OR SEPTIC TANK
OUGH WIRING / 8 �6
V
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 BrEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP.
FRAMING {{
u
FINAL INSP.
ROOFING
/ /
Z�p /._ L
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
r/
GAR. FIREWALL I a1 x i
u
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
-FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS_
GARDEN WALL FINAL
Irit Ok,( ,1C* -Ce 'It P111 %�;
q q -,ea
DESERT WATCH
PROPERTY MANAGEMENT
June 18, 1985
W. Irvin Chapman
2962 Airway Ave
Costa Mesa CA 92626
(619) 568-5055
Dear W. Chapnan;
The Architectural Carmitteehas reviewed your request for interior alteration to your home, and
approves the alteration, subject to the following conditions:
1. Your alterations meet all of the City of La Quinta's building codes and you are granted
city approval to complete the addition.
2. You shall pay for all work.
3. All debris shall be removed upon completion.
4. No.material shall be.stock piled as to create a nuisance or be detrimenal to the appearance
of the development.
5. You shall hold the Santa Rosa Cove Hom>eowners.Assoc iation harmless and shall defend the
Association against all lawsuits and/or claims due to damage or liability arising from or
due to the performance of this work.
8. All work shall be corpleted six (6) months frau date above.
9. Your shall keep the Association's property free from any and all mechanics liens, judgments,
etc, as may occur due to this work.
10. Any relocation of irrigation lines will be done by the Association's landscape crew at your
expense.
Sincerely,
�-
C), �Ouzdcc,
Mich al O'Rourke
Santa Rosa Cove Architectural Committee
MD/bv S4-0 9� Ccs
Post Office Dox 6000-371 • Polm Desert, Colifomio 92261
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