11165 (SFD)Building 54-330 Herrera
Address
Jacques Lefbrue
Mailing
Address Box 2795
City T� }� ]Zip
PD .D. 92261
Contractor /
Ow buaKL er k ,r
Address
c&ty/ 4
r
P.O. BOX 1504 N o . 11165
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
BUILDING: TYPE CONST. OCC: GRP.
City *- - Zip I Tel.:
State Lic. I City
& Classif. Lic. #
Arch., Engr.,
Designer
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that- Fdfiw licensed underproBioris of Chapter 9 -(commencing with Section
` 7000) of Division 3 of the Business•and Professions Code, and my license is in full force and
y effect 4 _, __ _ , ,,/•wx - Y
rr •SIGNATURE-+�"- DATE
'0'-- OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
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
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 or 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 rive hundred dollars .($500).
0 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 -budder will have the burden
or proving that he did not build or improve for the purpose of sale.).
as owner of the property, am exclusively contracting with licensed contractors to con -
et 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
•. such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
0 1 am exempt under -Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
Thereby affirm that I have a certificate of consentdto self -insure, or a certificate of
Worker's Compensation Insurance, or a certifieg copy thpre Sec. 3800?
Labor Code.)
)Polic 11he
No. Company /, z _ ,
Copy is filed with the city. Certified copy is reby 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 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 youshould 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.
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.)
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 1 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
Number
Description Lot 21
;t Description 151D
ZONE: BY:
Minimum Setback Distances:
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:
Sq. Ft.
Size .•
No. No. Dw.
Stories •Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Permit does
not include black walls
or Pool
Estimated Valuation
95,915'.30
PERMIT
AMOUNT
Plan Chk. Dep.
250.00
Plan Chk. Bal.
'. ; 274.40
Const.
621.50
Mech. -
' . 49.00
Electrical
130-09
Plumbing
'141.00
S-.M.I.
9..60
Grading
20.00
Driveway Enc.
.00
Infrastructure .
2119.84
.iii P.9. 1 } A9..6:0 ,{-}x "".'k,'1„” r� 14
" TOTAL
_,V 36191:41 "' "L 136 ATver
REMARKS
ZONE: BY:
Minimum Setback Distances:
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. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
SLAB GRADE
2ND FL. SQ. FT.
BONDING
YARD SPKLR SYSTEM
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. 0
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT.
DUCT WORK
DRAINAGE PIPING
WALL SQ. FT.
GAS (ROUGH)
DRINKING FOUNTAIN.
SQ 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
WASHER(AUTO)(DISH)
APPLIANCE DRYER
WATER SYSTEM
FINAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GRADING
cu. yd.
$ -Plus-x$-
LAUNDRYTRAY '
AIR HANDLING UNIT CFM
FRAMING �a c�L
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE,TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER. B.T.U.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1% c
SEWAGE DISPOSAL
SQ.FT.GAR ® 31Lc
HOUSE SEWER
GAR. FIREWALL
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 IN4, DERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR'1jeF119~K
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP.
FINAL INSP.
9
[[,34
GRADING
cu. yd.
$ -Plus-x$-
_$
LUMBER GR.
FRAMING �a c�L
ROOFING L42
C
C�
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
HIENG
MESH
INSULATION/SOUND (,1
FINISH GRADING
FINAL INSPECTION
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 7/10/92
No. 11561
Owner Name
Type of Permit
Jacques Lefbrue
No. 54330 street Herrera
city La Quinta zip 92253
La Quinta
Permit #
Log #
Study Area 110
APN # Tract # Lot # Square Footage 11634
Type of Development I Single Family Residence No. of units
Comments
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 5.3080
in the amount of 1.58 X 11.634 1 or $ 2,581.72 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 Tony Cruz Telephone
Name on the check
By James E. Lively
Assistant Superintendent, Business Services
Fee collected /e empted by Shelley D. Bennett
Paymexif.-Received. '
Signature Check Na. -l055
Collector: Attach a copy of county or city plan check application form to distrsct1c9py .far a:i waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
I ....
CALVIN G KAMINSKAS
Assistant Commissioner
(714) 275.3000
DATE /0-5
DEVELOPER'S NAME:
ADDRESS:
• OFFICE. OF
AGRICULTURAL' COMMISSIONER
JAMES O. WALLACE, Commissioner
83-612 Avenue 45 Suite 7
Indio, CA 92201
(619) 342-8291
DAN RILEY
Sealer, Weights & Measures
(714) 275.3030
CASE NO. 'PC C.IJ ') 10 9�
TELEPHONE:
k_)(� e Y '-
Dear Developers
After reviewing your landscaping plans, all plant material listed is not in
violation of quarantine laws governing the Coachella Valley. If substitutions
do occur and they differ from plant material listed, this office must be notified
immediately.
Thank you for protecting and preserving the Coachella Valley's pest -free environment.
Agricultur Cofitnissioner's Office
ccs Indio and Riverside
4080 LEMON STREET, ROOM 19, RIVERSIDE, CALIFORNIA 92501 — FAX (714) 275-3012
0 1
t.,..•�
r•S,xj•�.
et .
'
4080 LEMON STREET, ROOM 19, RIVERSIDE, CALIFORNIA 92501 — FAX (714) 275-3012
0 1
4t"
COACHELLA VALLEY WATER DISTRICT
CASH RECEIPT DETAIL
/
Received Fro I jor- J, f1% Awl
bP
Address: —7 t4A ..-_ _Oln
Account No. 'Lot(s)
Service Address
eter(s)
P0fA
OF
,viob(s) pj
• Backflow(s)
• HouseLateral(s)
• Detector Check(s)
• Meter Surcharge
11;;odn'Itation Capacity Charge L2/ Sic-
• W.S.B.F.C.
• Temporary Construction Meter
�,q Turn on Charge
b Uncollected Account - Name
• Anspection Fee -Tract -
• Plan Check Fees Water I Sewer -
Tract -
• Bond Payment - A.D. --Bond
Assmt
• Customer Deposit
• Other
Aemarks:
TOTAL
JAW
i f
Cert-i-Flicate of Compliance: Residential
(Page I of 2) CF-1R
Cert
�_1n« u� �s L-e`Cet re- �Go-54
Protect TI
Date
Pruject'
La- tom, t v i a..
project Address (� I
1=dward r 1 Y)�e�– 1�D
_
Building PcrmitM
}}`'A(
Documentation Author Telephone
C}iedted By/ Date
Type
Compliance Method (Padage, Point System or Computer) Cllmale Zone
Esrorccmrnt Agency Use Only
condkic
GENERAL INFORMATION
C
C o t
Total Conditioned Floor Area: Ilo 34 ft2
Motel YPe� � g Y HotelMotel
Buildin T Single Family Hotel/
I<9axin
(check one or more) Multi-Family (less than 4 stories) Addition
Multi-Family (4 or more stories) Exisung-Plus-Addiuon
Front Entry Orientation: North fEaSt)/South '[. "' All Orientations (circle
one or more)
HOT
Number of Dwelling Units:
S%,ster
_(
Floor Construction Type: Sla Raised Floor (circle one or both)
E.-- �
Infiltration Control: Standard fight (circle one)
R-12
BUILDING SHELL INSULATION
SPEC
Component Insulation Location/Comments
Type R-Value (attic, to garage, typica), etc.)
Wall .............. t5
Wall ..............
Roof............. 3
CO.%1
Roof .............
Floor
This c
.............
Floor
Title 2
.............
Slab Edge.....
i
retain aif
in
compl
GLAZING Shading Devices
featun
Glazing Area Glass Type Interior Exterior
Overhang Framing Type
Desigi
Orientation (so (single, double) (roller blind, etc.) (shadescreen, etc.)
(yes/no) (metal/wood)
Name:
Front.... (uJ)
Tide/Fi
—
Front.... ( )
Addres
Left...... ((,4 ; �=
t Left...... ( )
Telephc
Rear..... (E) -74
Lic. N:
'Rear ..... ( )
Right .... (S) 4o
Right.... ( )
—�
(signatt
Skylight.......
Skylight.......
Docur
Name:
THERMAL MASS
Tidc/Fi
i Type/Covering Ana' Thickness
Addresi
f (slab/exposed, tile, etc.) (s f) (inches) Location/Description (kitchen, bath, etc.)
Tclephc
Ttle- -a3 3
(signan.
Revist
Certificate of Compliance: Residential
jac¢,veS L..4� e6vre-
PruJect Tule
Ma
(Page 2 of 2) CF -11R
NOT
S-lz -gz
Date
If VAC SYSTEMS
Minimum Duct
Type .(furnace, air Efficiency Locadon Duct Output
conditioner, heal pump) (SE, SEER.HSPF) (attic, etc.) R -Value (Btuh)
Manufacturer/ Model #
(or approved equal)
DESC
Balk
42.5:
^ de n 5.fr Io.00iElER Attic 8000
R man/a. SRCF-15 VOly
42.5:
Cat eq
Arno na SC1--'C76%0Vr)
42-5:
--
— —
CAL
42-5:
Maximum Furnace Heating Output: 61,000 Btuh
tw
42.5:
rw
HOT WATER SYSTEMS Tank Manufacturer/Model #
42-5:
SN -stem Type (storage gas, etc.) Capacity (or approved equal)
Special Feature(s)
42.5•
cE le c,7- r- t c , 51b ra 99- +O T rte r ri j to tyg C- 41
%f kl /2
a. 1
—=
b. 1
R-12 External Blanket On Storage Tank (Yes or No) -Y& -Sp
C. 1
SPECIAL FEATURES/REINIARKS (Add extra sheets if necessary)
42-5'.
sta
42.5
COMPLIANCE STATEMENT
Tris certificate of compliance lists the building featuresand performance specifications needed to comply with
Title 24, Chapter 2-53 and Title 20, Chapter 2, Subchapter4, Article 1 of the Califomia Administrative code. This
certificate has been signed by the individual with overall design responsibility and the building owner, who shall
retain a cop), of it and transmit the certificate to any subsequent purchaser of the building. When this certificate of
compliance is submitted for a single building plan to be built in multiple orientations, all building conservadon
features µ-hich vary are indicated in the Special Features/Remarks section.
Designer
None:
Titic/Firrn:
Address:
Telephone:
Lic. C.
A, Cc4c"0ti./ a
(signature) (date)
Documentation Author /
Name: 6. GC7wa
Titic/Firm:• Dreo m%n ' 84-s,Ned
Address: u tjP.i-<!u "& 9
s S Cg.
Telephone: eg — 3
(signature) (date)
Revised July 1990
Building Owner
Name:
Title/Firm:
Address:
Telephone:
(signature) (date)
Enforcement Agency
Name:
Agency:
Telephone:
(signature or stamp) (date)
w ----u oy esti partiu as binding minimum component perform— spec
whether they are Ithown etsowhuo In the documents or on this checklist onty-
)ESC MON
loilding Envtlopt Measures
12-5352(a): Mlnimum etiling insulation R-19 weighted average.
12-5352(b): Loose fill insulation muwfactumt's labeled R -Value.
12.5352(c): Minimum wall insulation in based walls R-11 weighted average (docs not apply to
utcrior (mass walla).
12.5352(k): Slab odgo Insulation - watts absorption Tato no grcatu than 0.3%, water vapor
trarsrnitsion rata no X=La than 2.0 pejm inch.
12-5311: Insulation specified or installed moots California ErPM Commisalon (CBC) quality
standards. Indicate type and form.
12-5352((): Vapor barriers mandatory In Climate Zones 14 and 16 only.
12-5317: lnFdUadon/Exfdtmtlon Controls
L Doors and windows betwoen corditionod and unconditlonod spaces dulgncd to limit air
Icakegc.
b. Doors and windows certified.
e. Doors and windows weadwitripped; all joints and perxAmdons caulkod and sealed.
12-5352(e): Special infiltration barrkr installed to comply with 42-5351 meets CEC gt*ity
standards.
p2.5352(d): Installation of Firepplacca
1. Ma3onry and factory -built ftrrplacea have:
a. Tight fining, cloacable metal or glass door
b. Outside air intake with damper and control
e. Flue damper and conuol
2. No oontinuous burning gas pilots allowed.
11VAC and Plumbing Sim Measures
42-5352(8) and 2-5303: Space conditioning equipment sizing: attach calculations.
42-5352(h) and 2-5315: Setback thermostat on all applicablo heating systems.
42-5316(a): Ducts constricted, installed and insulated per Chapter 10, 1976 UMC.
42-5316(b): Exhaust synrms have damper controls.
p2.5314(c): Gas-futd gpaee heating equipment has interudawt Ignition devices.
DESIONER I EMIORCEMFNT
N
42-5314: HVAC equipment, watts heavers, showerheads and fauccu eortiflod by the CEC, t/
62-5352(1): Water ht:atu Imulation blanks (R-12 or greater) or combined Intcriorlexterior
Insulation (R-16 or greater); first 5 feet of pipes closest to tank Insulated (R-3 or gnats).
42-5312(Exccpdon 1): Pipe insulation on steam and steam condensate return tit recirculating '
piping. N )/
42-531R(d): Swimming Pool Heating
1. System has:
L OMofr switch on heater.
b. WC&Lhcrpmd instruction plato on heater.
k c. Plumbed to allow for iota.
2. 75 pement thermal efficiency.
3. Pool cover.
•' 4. Time clock
5. Directional water lnld.
Lighting and Appliance Measures
42-53520: Lighting - 25 lumeraly art or gmatrr for general lighting In kitchens and battuooma.
12-5314(c): Ota fired liana ui with lntermitterit ignition devices.
appliances oq PPS
42-5314(a): Ref igeratm, refrigerstor-freezm. htc= and (luomxwit lamp ballasts entified
by the CEG Indiato make and model number.
Parses R.vlu1 Dwoubw 1917
MA