9654 (SFD)Building
Owner
Tity/ 014 a"
54-820 HERRERA
. & TERESA P'. SALAS
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Mailing
Address p O BOX 151
City Zip Tel.
LA QUINTA,CA 192253
Contractor
OWNER BUILDER
SAME
City Zip Tela
SAME
State Lic. City
& Classif. Lic. #
Designer
Address Tel.
City Zip State
i 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.
SIGNATURE DATE
I OWNER -BUILDER DECLARATION
1 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, 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 We alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit
cts the applicant to a civil penalty of not more than five hundred dollars (5500). .
I, as owner of the property, or my employees with wages as their sole compensation, will
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
I bulids or Improves thereon and who does such work himself or through his own employees,
provided that such improvements are not intended or offered for safe. If, however, the buAding
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.)
❑ 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 property who builds or Improves thereon, and who contracts for
such projects with a contractor(s) licensed Pursuant to the Contractor's License Law.)
O I am exempt under Sec. B. & P.C. for this reason
Date Owner
i
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. Cornpany
O Copy Is filed with the city. ❑ 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 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, alter 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 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
FINANCE
No. -- 9654
BUILDING: TYPE CONST. S F D OCC. GRP
A.P.Number 774-303-005 & 006
Legal Description LOT 9 AND 10
Project Description SINGLE FAMILY DWELLING
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. No.
Size 3196 Stories
No. Dw.
Units
New ❑ Add ❑ Alter ❑
Repair ❑ Demolition ❑
295' X 6' BLOCK WALL INCLUDED. POOL
AND RETAINING WALLS NOT
INLCUDED.
Estimated Valuation
1 1.990
-PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal. $250.00
Const.
99.00
Mech.
Electrical
Plumbing
S.M.I.
.56
Grading
Driveway Enc.
Infrastructure
1"851.92
Art in public
161.54
TOTAL $1,927.37—
,
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:
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated (619) 347-8631
Date 5/21/91 1 Type of Permit I La Quinta
No. 110612 Permit #
Log #
Owner Name Juan Salas
No. 54820 street Herrera
city La Quinta zip 92253 Study Area 110
APN # I Tract # I j Lot # Square Footage 13196
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 53080
in the amount of Fi.-58--1 X 13.196 1 or $ 5,049.68 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
Vickie/ITF Alfred Durrett
Name on the check
Telephone
By Richard M. Beck
Director, Facilities Planning & Development
� V
Fee collected /exempted by Shelley D. Bennett J ` • '�
Payment Recei.ved,,1,
Signature Check Ni
Collector. Attach a copy of county or city plan check application form to district copyfo'r°a
Yll�w�tatijiv�e
rs.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
P.O. BOX 1504
711,105 CALLE ESTADO
LA OUINTA. CALIFORNIA 92253
Contractor Owner / 6(41J 'S�Q$
Address Job Address-
La
Quinta City License No.: Expires: Bldg. Permit No.:
Roofing
m 4:_70
This form shall be posted on the job with the Building Inspection Card and it
Floors -All Types
shall be the duty of the General Contractor or if owner -Builder Permit, the owner
Glass - Gla q�p`ya^'�
VC-l< 76L)�,
to see that all sub -contractors sign this card, giving his City of La Quinta
L
Sewage Disposal
Business License Number, Contractors License Number and a current certificate
Painting/Decorating
a^�
-of Workman's Compensation Insurance Certificate when he starts the job. Failure
Cabinets -Installations
to comply may cause Building Inspectors to stop work, or complaints to be filed
Ornamental Metal
against such contractors or owners.
9�D
Landscaping
CITY CONT.
OthersJ7L 'C-i,Jf;
SUB -CONTRACTORS NAME LIC. NO. EXPIRES LIC. NO.
EXPIRES
1.
Grade i ExcavateoIr,u D E
2-
2.
2.
Pipelines
es
3.
Cement -Foundations 117,k1LLC11 Z3 _ �z.•s%%fl2-
y�
4.
Cement Walks i Drives
5.
Asphalt Paving
6.
Framing
7.
Steel Structural
8.
Masonry / XYZ? . OS 6�L 4 SO /
Z
11!j 2-
9.
16.
17.
1e.
!9
20,.
.21.
22.
23.
24.
25,
26.
27.
2 6'.
Plumbing
Lathing .
Drywall
Plastering
HVAC
1`713
1492-
Electrical
Roofing
m 4:_70
Sheet Metal�1OCx/.¢L.
Floors -All Types
Glass - Gla q�p`ya^'�
VC-l< 76L)�,
Insulation/Weatherstrip
L
Sewage Disposal
�� 2
Painting/Decorating
a^�
Tile
Cabinets -Installations
Ornamental Metal
Fences/Blockwalls
9�D
Landscaping
OthersJ7L 'C-i,Jf;
__12/3/
DO NOT REMOVE THIS CARD
Before Final Building Inspection Will Be Made
This Form Must Be Completed and Filed With Title 24 Calcs and Plans
/y'92_
i�'•y Z
(o�L
JAMES D. FEIRO
CIVIL ENGINEER - LAND SURVEYOR
P. O. BOX 12980
PALM DESERT, CALIFORNIA 92255
(61.9) 346-8015
FAX (619) 346.2548
May 29, 1991
City of La Quinta
78105 Calle Estado
La Quinta, CA. 92253
RE: Certification for 54-830 Avenida Herrera
Lots 9 & 10, Block 313, MB 19/59-60
The elevation at the centerline crown of the street and the prolongation
of the north property line is elevation 100.00, assumed datum.
The.,elevation at the ceriter.line. crown of the street and the prolongation
of the south property line is 102.78.
The elevation of the finished floor forms is 102.50 and the elevation of
the pad is 101.9.
Sincerely,
aames D. Feiro,
CE -LS
R_$i 12/31/93