15878 (BLCK)' Building
Address
GS
Own;*r
Addre:;s S,aMle aS aboVB
4
I
P.O. BOX 1504
78-495 CALLE TAMPICO
Plora LA QUINTA, CALIFORNIA 92253
City Zip Tel.
L Qui ta 92253
Contractor
owner builder
City IMP I Tel.:
State Lic.. I City
& Classif. Lic. #
Arch., Engr.,
Designer
Address Tel.
City (Zip (State
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. 7031.5,8usiness 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 five 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 bnprove 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 prqperty'Who builds or Improves thereon, and who contracts for
such projects with a contractor(sJlicensed pursuant to the Contractor's License Law.) .
O 1 am exempt u_ndel B. & P.C.1or thiSreason_
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. 0 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 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.
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 property filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days. . .
I certify that I haveread 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
ateMailing Address
City, State, Zip
BUILDING: TYPE CONST
Number
No.15878
OCC. GRP.:
Legal Description
Project Description 6411 of 5' garden will
Sq. Ft. No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation 1386.00
PERMIT AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const. 45 A0
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
h ,r+
s�'• �;,i� 1 /
7-1
ZONE: BY:
Minimum Setback Distances: j ► �=�
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. PLUMBINTFEES
A.C. UNIT
COLL. AREA
1ST FL. SO. FT. ® $
UNITS
BONDING
2ND FL. SO. FT.
YARD SPKLR SYSTEM
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
ROCK STORAGE
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
0
REINF. STEEL
GAS (FINAL)
DRAINAGE PIPING -
CAR P. I SO. FT.
i
WALL SO. FT. ®
WATER HEATER
DRINKING FOUNTAIN .ii►
SO. F7.
URINAL f�
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
WATER PIPING
NOTE: Not to be used as property tax valuation
x$ _$
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
VENTILATION
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 ® 1'A c
SEWAGE DISPOSAL
SO.FT.GAR ® VAc
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 APP.IEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
i
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
wxw
v
FIREPLACE
i
v`e9 S
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
ter"
M
SUNDUNE INVESTMENTS, INC.
1},
-4 CALIFORN1.4 CORPORATION
C/O CRISTE, PIPPIN & GOLDS
77-564 COUNTRY CLUB DRIVE. STE. 220
PALM DESERT. CA 92211
TELEPHONE: (619') 772-7100
FACSIMILE: (619) 7 72-7111
October 30, 1995
VIA FACSIMILE ONLY
City of La Quinta
Attention: Mark Harold
[Facimile no. 777-7011 ]
Re: Sundune Investments; Inc.; 49-085 Calle Flora, La Quinta
Dear Mr. Harold:
Sundune Investments; Inc. hereby authorizes Dan Feathering.ill to execute for Sundune any block
wall permit relative to the above-described property.
ilg/sundune.111
Sincerely:.
Sundune Investments. Inc.
a California corporation
By: Irwin L. Golds, Secretary