07752 (SFD)Address
Address 53-754 NartirveZ
Dan NR
Mailing
Address
City I Zip
Contractor
Address
State Lic. ' I City
& Classif. Lic. #
Arcn., tngr.,
Designer
Address•< Tel.
City I ZipI State
Lic. #
• "
P.O. BOX 1504 N o .
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that 1, Am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of ttie•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 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 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 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 1 am exempt under Sec. B. & P.C. for this reason �r
Date Owner ��:-G`if�/tsT r =�•/ �It�fi/
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
O Copy is filed with the city. O Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
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 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 or 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.
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
0775
BUILDING: TYPE CONST. • OCC:•GRP.-
A.P. Number 774-172-001
Legal Description tat 24 Black 248
Project Description Stride Family Melling
77—�, I - .. ♦ .
Sq. Ft.
Size ;
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
$W 301
�o
PERMIT
AMOUNT
Plan Chk. Dep.
250.0
Plan Chk. Bal.
9cl. 94
Const.
990-0
Mech.
S3 50
Electrical
113_j7
Plumbing
50
S.M.I.
623
Grading
2000
Driveway Enc.
20-00
Infrastructure
I QAR -491
TOTAL
REMARKS
14
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 5/3/,90 Permit
Validated by:
Validation:
77—�, I - .. ♦ .
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
SLAB GRAPE ,
2ND FL SQ. FT.
BONDING
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. I SQ. FT.
GAS (ROUGH)
DRAINAGE PIPING
WALL SO. FT.
OTHER APPJEOUIP.
DRINKING FOUNTAIN.
SQ FT ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property.tax a uation
FINAL INSF.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
v
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
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 ® 11/4 c
SEWAGE DISPOSAL
GAR. FIREWALL
SQ.FT.GAR ® 3/4c
HOUSE SEWER
n Q
LATHING IFOWN
GAS PIPING
PERMIT FEE
IPERMIT 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
ERGROUND
A.C. UNIT
COLL. AREA
SLAB GRAPE ,
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WOPX
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSF.
BOND BEAM
WATER SYSTEM
GRADING
yd.
$ pus x$
s$
LUMBER GR.
FINAL INSP.
v
FRAMING 3 A/'v Aw
FINAL INSP.
ROOFING &, k�j 'fQ
REMAFKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
n Q
LATHING IFOWN
MESH
INSULATION/SOUND L
FINISH GRADING
FINAL INSPECTION
CERT. OCC,
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
Desert Sands. Unified School District
CERTIFICATION OF PAYMENT
OF
SCHOOL FACILITY FEES
TO: City of La Quinta DATE: t/ CD�
Department of Community Development
78-105 Calle Estado
La Quinta, CA 92253 NOTICE. THIS C,�- UOENT CANNOT
BE DUPLICATE®t
This is to certify that
developer ofwhich is
located at 3within
this District, has paid school facility fegs imposed pursua to the -
authority enerat by Government Code ection 53080 in t e mount of110
$,Mzn " _ ( al ) lOb
covering a total of ware feet of ()() residential or
( ) industrial/commercial development and that building permits for
this footage in this development may now be issued by your jurisdiction.
Ab -70 -
LIC, ID? 7
for DESERT SANDS•UNIFIED SCHOOL DISTRICT
White- Building Department • Yellow -Facilities Planning • Pink - Accounting • Gold - Developer
(10)-37
4
78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 - 16191 564-2246
FAX (619) 564-5617
March 12, 1993
To Whom It May Concern:
Please be advised of an address, change for Parcel -#7,7-,4-172-001,
previously addressed as 53-754 Martinez. The new address will.be
77-877 Arroba.
As this home and entry is situated facing Arroba, the Martinez
address could potentially cause confusion in finding the home.
This could be a problem especially if emergency services were to be
required.
Thank you.
Sincerely,
BUILDING AND SAFETY DEPARTMENT
�,
� �
Kelly Tropple
Counter Technician
MAILING ADDRESS - P.O. BOX 11504 - LA QUINTA, CALIFORNIA 92253
4'
•'� ',��� OFFICE OF
AGRICULTURAL COMMISSIONER
AND
4';%;;:► WEIGHTS & MEASURES
CALVIN C. KAMINSICAs
JAMES O. WALLACE 4000 LEMON SIREET, ROOM 19 AWslont CoMmI311On91'
Aprtcdlmol Commisslonei RIVERSIDE. CALIFORNIA 92601 CLEMENT BENVENISIE
!t : .
tMt�ota of Welphis Meas�ne� Sevl9sr
(714) 7e1•2561 .
49613 Highway 86, Suite B12
" Coachella, Ca. 92236
(619) 342-8291
DATE p �', �' q C� CASE W.
DEVELOPER'S NAME s ,_ _ �: ��/✓ ��G��?/��
ADDRESS s P. t, k
14
TELEPHONES 3 -Gy `q q --� %
t Cpm,"— �-t<t`o -1
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 fran plant nuterial listed, this office must be notified
icmlediately.
Thank you for protecting and preserving the Coachella Valley's pest -free enviroment.
`I
j ':,Agric ural Co mii.ssioner's Office
ccs Indio and Riverside Office
i j'� '
•Si
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l.Y.
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