10432, 10855 (SFD)Td
P.O. BOX 1504 ) No. 10432
Building 78-105 CALLE ESTADO
Address 53-840 Herrera LA QUINTA, CALIFORNIA 92253 ,
Owner � V
SY19L'YCc�' Dev' Corp
BUILDING: TYPE CONST. OCC: GRP.
Mailing
Address 7.4940 r3vy 111 #8429 A.P. Number
City Zip Tel.
I4-nd• Wells 92210 771--33133 Legal Description
Contractor Project Description
Pelletier Cors tr=tion
FD
Address
74691 Sweetwell F -d
City Zip Tel.:
1000 Palms 92276 567-0321
State Lic. City
& Classif. , 260484 Lic. # Sq. Ft. 1546 No. No. Dw.
Arch., Engr., Size Stories Units -
Designer David Dietrick New ❑ Add El Alter El Repair ❑ Demolition ❑
Address Tel.
45320 Driftwood Dr 341-'3.426, �'e�it does not include any block malls
City Zip State or Pool
Paha Desert 1 92260 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 an&Professions Code; and,my.license is in,full foFce and
effect.
>�' t!".�i •!:M �.�:,4f��� ! •�i".,i'�: .La .i.� T.� -,f R§.�r`t,Z'%h B• .��1:17A}F's!.
SIGNATURE DATE
OWNER -BUILDER DECLARATION Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following 06,489.30
reason: (Sec. 7031.5,Business 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 file a signed statement that he Is licensed pursuant to PERMIT AMOUNT
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section '7000) of
Division 301 the Business and Professions Code, or that. he is exempt therefrom, and the basis�y [�
for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit Plan'Chk. Dep.- - .Z,tJ' 0.00 .b�A
` subjects the applicant to a civil penalty of not more than live hundred dollars.(S500). a • 1 C
❑ I, as owner of the property, or my employees with wages as theirsole compensation, will . _ Plan Chk. Bal. q 15 {fir
do the work, and the structure is not Intended or offered for sale.. (Seo. 7044, Buisness and Const.�•
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, ' Mech. E
provided that such Improvements are not intended or offered for sale. If, however, the building IIA -2 'V - 41 F,r
or improvement is sold within one year of completion, the owner -builder will -have the burden . -Electrical - C. ��,
of proving that he did not build or improve for the purpose of sale.) . V
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing ,Q � � eit
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.I. - 8 70
�
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) - -
Grading 20 00
0 I am exempt under Sec. B. & P.C. for this reason -
Driveway Enc. 20.00
Date Owner Infrastructure . 1907476
WORKERS' COMPENSATION DECLARATION `n
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.). _4 ; t l
Policy No. /� Company �� n _'°3C f �✓ a -5q-
0, Copy is filed with the city. .O Certified copy is hereby furnished. q^�
TOTAL ya!,rC•i 'aRiw.�il'l� 4`'6�i.'0 �
CERTIFICATE OF EXEMPTION FROM REMARKS r
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation o'3tl'ar;• ; �3") { P: ,!, 7; �;'f 491-..A11 ;7...4�'� t
or less.) o Ir,
_. j ) - T _
I certify that in the performance of thg work for which this permit is issued,.I shall not +fi�- f �. 1 ,3 L(/ti.
employ any arson in any manner so as to become,subject to the Workers' Compensation
Laws of Califpornia. �t�r
Date Owner,t"itl...
NOTICE TO APPLICANT: If, after making jthis Certificate of Exeinption you should' become ZONE: BY:
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Minimum Setback Distances: -
comply with such provisions or this permit shall be deemed revoked.
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line
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
This is a building permit when properly filled out, signed and validated, and is subject to FINAL DATE INSPECTOR
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. 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. Validated by:
Signature of applicant Date
Mailing Address Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
DIST FL. SO. FT. ® $
UNYrS
COLL. AREA
2ND FL. SO. Ff.
ROUGH PLUMB.
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. Ff.
DUCT WORK
DRAINAGE PIPING
WALL SO. Ff.
GAS (ROUGH)
DRINKING FOUNTAIN.
SO FT ®
HEATING (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GAS (FINAL)
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER HEATER
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, TENPERM
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 ® I Vi c
SEWAGE DISPOSAL
SO.Ff.GAR ® Vac
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PLCK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR GOND. SOLAR
SETBACK ( �3
GROUND PLUMBING! 9r
NDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
2 Ila.
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 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 ! L
FINAL INSP. T
ROOFING 3e (� ��
7�
�a /� Q/�
LIP
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LYTHING
MESH
INSULATIONISOUNDal 1)a
FINISH GRADING �7 9
FINAL INSPECTION 7 (�
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated (619) 347-8631
Date 1/2192 1 Type of Permit I La Quinta
No. 111079 Permit ii
Owner Name ,S Log #
ynercon Development Corp .
No. 74-940 street Highway 111
city Indian Wells zip 92210 Study Area 111
APN N --� Tract if Lot # = Square Footage 14638
Type of Development I Single Family Residence No. of units
Comments SR -095 OhrPornn 1.ri44; c f - RR-RRn HprrPrn 1.54R c f - RR -94(1 1FTarrarn 1 c f
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 533M
in the amount of 1.58 X ® or $ 7,328.04 have been paid to D.S.0 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 _ Synercon Development Corp
Name on the check
By James E. Lively
Assistant Superintendent, Business Services
Fee collected /exempted by Peeey Reyes
Telephone
n n Payment Received
Signature r,; I� l�L� check No. 1026
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
COACHELLA VALLEY WATER DISTRICT
CASH RECEIPT DETAIL
Received From:
t,
❑Copy to:
Address:
---
Check
Account No. "
Cot (s) a
Service Address r ?
64
Meter(s)
1;i'5ervice(s)
❑ Backflow(s)
❑ House Lateral(s)
❑ DetectorCheck(s)
❑ M ter Surcharge
anitation Capacity Charge
p
❑ W.S.B.F.C.
❑ Temporary Construction Meter
❑ Turn on Charge
❑ Uncollected Account - Name
❑ Inspection Fee - Tract -
Fee -
❑ Plan Check Fees Water / Sewer -
Tract -
❑ Bond Payment - A.D. - Bond
Assmt.
❑ Customer Deposit
❑ Other
Remarks:
❑Copy to:
Cash
Check
Money
Order
�i►y SQr16 �
Date: —
G.A. Code /
a 75-0,00
02 YY U. 0
TOTAL $ h t)2 � , Q
Water Service
Cashier % 1
CVWD-438 (11189)
4P. O. sox 1"4
T6/05 CALLS ESTADO
LA OUINTA. CALIFORNIA 9225,7
Contractor owner
Address Job Address
La Quinta City License No.: Expires: Bldg. permit No.:
This form shall be posted on the job with the Building Inspection Card and it
shall be the duty of the General Contractor or if Owner -Builder Permit, the owner
to see that all sub -contractors sign this card, giving his City of La Quinta
Business License Number, Contractors License Number and a current certificate
of Workman's Compensation Insurance Certificate when he starts the job. Failure
to comply may cause Building Inspectors to stop work, or complaints to be filed
against such contractors or owners.
CITY CONT.
SUB -CONTRACTORS NAME LIC. NO. EXPIRES LIC. NO. EXPIRE!
Grade c Excavate a 30
2. Pipelines
1p Cement -Foundations nrt(t-
4. Cement Walks i Drives
5. Asphalt Paving
Framing
7. Steel Structural
8. Masonry
0 Plumbing
L0.- Lathing
L1. Drywall
L2. Plastering
KVAC a 3g 3 3c_
l4 Electrical paac,
L5. Roofing
16. Sheet Metal
17. Floors -All Types
18. Glass - Glazing
19. Insulation/weatherstrip
20. Sewage Disposal
21. Painting/Decorating
22. Tile
23. Cabinets -Installations
24. Ornamental Metal
25. Fences/Blockwalls
26. Landscaping
27., Others
28.
DO NOT REMOVE THIS CARD
Before Final Building Inspection Will Be Made
m 1.. _ C u ...- * n rte 11 - _.. 1 o 4 , A -4 " . t ., A r.7 4 ♦ L. T 4 6. 1 , - a n - 1 - - - - -7 r, 1 - - -
�_ u�jtrCv
P.O. BOX 1504 No. 10855
Building 53-'$40 Herrera 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner
Synercon Dev. Corp
Mailing
BUILDING: TYPE CONST: OCC: GRP.
Address 74940 Hwy Ill #5429 A.P. Number
City Zip Tel.
T.k16 92220 771--3303 Legal Description
Contractor Project Description
Svnercon Di y/Tony PW
Ws Pl>' iC ei SFD .
Address w
.8 ar.18
City Zip Tel.: '
State Lic. City
& Classif. 337400 Lic. # Sq. Ft. No. No. Dw.
Arch., Engr.,
Size Stories -- Units
- '
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel. SUPPLEMENTAI, PERMIT ONLY: CHANGE OF
City Zip State Cf?AiTIRACTOR. rHES PAID ON 010432
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 Businessland Professions Code, and my license is in full force and
effect. rli, i
( Y SIGNATURES ` -" +�'`� '" •" DATE
OWNER -BUILDER DECLARATION Estimated Valuation
I hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,Buslness 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 signed statement that he is licensed pursuant to PERMIT 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
for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit Plan Chk. Dep.
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 Plan Chk. Bal.
do the work, and the structure is not intended or offered for sale. (Sec..7044, Buisness and (,'const.
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, 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 Electrical
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.I.
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
❑ I am exempt under Sec.- B: & P.C. for this reason
Driveway Enc.
Date Owner Infrastructure +
WORKERS' COMPENSATION DECLARATION r'
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 '
5 Copy is.filed with the city. ❑ Certified copy is hereby furnished.
TOTAL
CERTIFICATE OF EXEMPTION FROM REMARKS
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 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.
Date Owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become ZONE: BY:
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked. 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 if 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. Validated by:
Signature of applicant Date
Mailing Address Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
$
UNITS
SLAB GRADE
1ST FL. SQ. FT. ®
BONDING
HEATING (ROUGH)
2ND FL SO. FT.
FORMS
YARD SPKLR SYSTEM
ROUGH WIRING.
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
GAS (ROUGH)
METER LOOP
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. I SQ. 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
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIRE ZONE ROOFING
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
LATHING
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1% c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
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 d 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.IEQUIP.
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
m�
SYNERCON DEVELOPMENT CORPORATION
74-940 Highway 111, Suite 429
Indian Wells, California 92210
(619) 564-6929
ss-7uoo
Vo
.1 ItlAve eAk�/
%zixrt
ij
of
''/,' q
Orr Ir'k
TiN of 14a(Quinta
Ilut-wng anb �Safet�r
This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building,
Code certifying that at the time of issuance this structure was in compliance with the various
ordinances of the City regulating building construction or use. For the following: .
BUILDING ADDRESS 53-840 AVENIDA HERRERA
Use Classification SINGLE FAMILY DWELLING Bldg. Permit No. 10855
Group R3 Type Construction VN Fire Zone Use Zone SR
SYNERCON DEVELOPMENT 74-940 HWY. 111, S429
Owner of Building Address
City INDIAN WELLS, CA 92210
By: Lonnie Day
Date: APRIL 20, 1992
Building Official
41— POST IN A CONSPICUOUS PLACE