003212 (SOTB)P.O. BOX 1504 No. 003212
BuildingLA QUINTA, CALIFORNIA 92253
Address 46-40046-400D :�SAp36.' Palm Road ... .. _ .
Owner
BUILDING: TYPE CONST. OCC. GRP.-
Mailing
Address sama'ag m A.P. Number Dune Palms Mobile 85tates
City Zip - Tel.
La (ugtnta 92253 Legal Description
Contractor. �i�.:t minor Closed I
Project. Description
Address
City - Zip Tela
State Lit.
& Classif.
Arch-,-Engr.,
Designer
Address
Lic. #
el.
Sq. Ft. No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑
City Zip State
Lic. #
LICENSED CONTRACTOR'S. DECLARATION
1 hereby affirm that I am licensed under provisions of Chapter'9 (commencing with Section
7000) of Divislon 3 of the Business and Professions Code, and my license is in full force and
effect: -. - -
SIGNATURF DATE
OWNER -BUILDER: DECLARATION Estimated Valuation
I hereby affirrn that I am exempt from the Contractors License Law for the following
reason: ($ec. 7031.5,Business and Professions Code: Any ,city or county which requires a 4
permit to, construct, alter, Improve, dorft h, or repair any structure, prior to its Issuance also ••
requires the applicant for such permit to 51ea signed statement that he is licensed pursuant. to PERMIT
the provialons of the Contractors 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
to the at, exerrnption. Any violation of Section' 7031.5 'by 'any applicant for a permit Plan Chk.. Dep.
b)ects the applicant to a civil penalty of not more than five hundred dollars ($500).
❑ 1, as owner of the property, or my employees with wages as•their sole compensation,- will Plan Chk. Bal.
do the work, and the structure isnot Intended or offered for sale. (Sec. 7044, Bulaness and
Professions Code: The Contractors License Law does not app/y:to an owner of property who
.Const.
builds or pnproves thereon and who does such work lihmsell or through -his own emproyees,
Mech.'
prowled that such Improvements are not Intended or offered for sale. g; however, the building
Minimum Setback
or Improvement Is sold within one year of completion, the owner-bullder will have the burden
Electrical
of proving tha(he did not bulM,or Improve for the, purpose of sate.)
- ❑ 1, as owner of the property, tun excluslvely.contracting with licensed contractors to con-
Plumbing
struct the project. (Sec. 7044, Business and Professions Coder 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:) -
Gradin
11 1 am:exempt under.Sec. B. & P.C. for this reason to
Driveway Enc.
gate I owner. Infrastructure
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have 'a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, ora certified copy thereof. (Sec. 3800, Labor Code.)
Policy No Company
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 anypparson in any manner so as to -become subject to .the Workers' Compensation
Laws of'Cahf0 nla
Date Owner —'
NOTICE TO APPLICANT: It, after making this Certificate of Exemption you should become
subject: to the Workers' Compensalkm provisions • of the 'Labor Code; you must forthwith
oomp/y with such provisions or•thls permit shall be deemed revoked. -
CONSTRUCTION LENDING AGENCY
I herepy affinn'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.
1 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
REMARKS
.Demolition ❑
HARD COPY
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 ?r9/$7 Permit
Validated by:
Validation:
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES T'
IST FL. SO. FT. ® $
UNITS
•
2ND FL. SO. FT.
YARD SPKLR SYSTEM
POR. SO. FT.
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
ROUGH WIRING
DUCT WORK
DRAINAGE PIPING
CAR P. SO. FT. ®
I
WALL SO. FT. @
HEATING (FINAL)
DRINKING FOUNTAIN
SO FT a
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GRADING
cu. yd:
$ -Plus-X$-=$
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FINAL INSP.
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.
SO. FT. ® c
BATH TUB
FIRE ZONE ROOFING
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1% c
SEWAGE DISPOSAL
SPARK ARRESTOR
SO.FT.GAR ® V4c
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
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 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
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE,
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
Q(6INAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS,
GARDEN WALL FINAL
CITY &
[�mSTATE
PARK NAME PARK ADDRESS l
CUSTOMER'S
NAME — SPACE NO: _ — S(ZE
g�
PLOT .PLAN
I
g --- /o
I
I
I
I
I
I
I
I
0
SPA NO
5 /-44
WE. THE UNDERSIGNED HEREBY APPROVE THE INSTALLATION OF THE ABOVF STRUC:TURFISI AND AGREE THAT THE INFORMATION IS CORRECT
AND IN ACCORDANCE WITH APPLICABLE PROVISION OF THE HEALTH AND SAFETY 'CODE. AND RELATED RULES OF THE STATE OF CALIFORNIA.
TENANT PARK MANAGER
SIGNATURE i4p —
7.SIGNATURE--
o i
AA -2-72
s
I
i 1 � M
V
I
I
I
r
I
/�.�.e.coc�or•1
I
STREET
SPA NO
5 /-44
WE. THE UNDERSIGNED HEREBY APPROVE THE INSTALLATION OF THE ABOVF STRUC:TURFISI AND AGREE THAT THE INFORMATION IS CORRECT
AND IN ACCORDANCE WITH APPLICABLE PROVISION OF THE HEALTH AND SAFETY 'CODE. AND RELATED RULES OF THE STATE OF CALIFORNIA.
TENANT PARK MANAGER
SIGNATURE i4p —
7.SIGNATURE--
o i
AA -2-72
_ MOBILEHOME
0
V
LOT LINES
1 z •
_y_.
Minimum distance from porch ' The.tota.l occupied area
to lot lines shai? be 3'-0" of a mo�)ilehome lot shall
except lot lines bordering not exceed 75% of the lot
driveways. area.
HCD 538 (Rev. 10-85)
i y> 'O.'P'tOO—T PLAN LOT# S�
Department of Housing
and Corruunity 'Development Hwy:
Division of Codes and Standards
Park Name,
Address
City Zd Cy-G�- ZiP
Applicant il r/!A /t<2�
Address.S�
3. .8 I Expanding Room Co
Mira Loma Space Center
Building 95.1
Miro Lamm. California 91757
I THE UNDERSIGNED, AS AN.AUTHORIZED
REPRESENTATIVE OF THE OWNER OF THIS
PARR, HEREBY CERTIFY THAT ANY AND ALL
LOT LINES AS SHOWN ON THIS PLOT PLAN
ARE TRUE AND ACCURATE AND ARE CLEARLY
NARKED ON THE SITE AS REQUIRED BY
CALIFORNIA ADMINISTRATIVE CODE,
TITLE 2.5, CHAPTER 2, SECTION 1616.
PARK WN / IRA DATE`
46-400 DUNE PALMS ROAD - LA QUINTA, CALIFORNIA, 92253 - (619) 347-7513
9
?7.
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated (619) 347,8631
Date 11/20/90 Type of Permit La uinta
No. 16273—T Permit N
Log #
Owner Name Lucila Rosales
No. 46400 street Dune Palms Road #80
City La Quinta Zip 92253 study Area 231
AM # I090-623-2297 Tract # Lot # = Square.Footage 1788
Type of Development I Mobilehome No. of units
Comments T .nt nrpvi nrn al v nem mi pcl
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 frompaying school fees at this time due to the
following reason -
le linob0lehome
This certifies that school ' 'ty flees imposed pursuant to Government Code 53080
in the;amount of Q00 X ® ar$ Q00 have been paid to DaU.S.D. for
the property bsted above and that ' permits and/or Certificates of Occupancy for
this square footage inthis proposed project may now be issued.
Fees Paid By Telephone
Name on the check
By Richard M. Beck , -
' P
Director, Facilities Planning & Development
Fee collected /exempted by Shelley D. Bennett
77
Signature Check' No. N/A
Collector. Attach a copy of County or City plancheck application form to 1 kr-tA&f copy.
Embossed Original- Building Dept -/Applicant Copy - ApplicantMeceipt Copy - Accounting
GREEN
TREE
9948 HOEM ST. • SUITE 210 • P.O. WX 262015 • SMI DIEGO. CA 921264M 1(800) 8433891
PARK CERTIFICATION
This certifies that the park rental payments on the mobile home described
below are. current:
Present owner 4�91e'IZ-7 � 5A; 9 .
• Lot Number
aake of Home-
Year
ome Year
Size
we further certify that LU GAG ';;i�05A4Z:f&
buyer of the home described above.. has met the requirements to be accepted
as a resident in this park and .has been notifed of their acceptance...,.
It is further understood all monies have been received. There are no .other
agreements. with this customer for improvements or upgrading.
Name of Park
Signature of Park Owner or Park Manager
Date
Park llanaE-:r': 'telephone. Number
Im
-GREEN
TREE
1
9948'HWff ST. • SUITE -210 • P.O. BM 262015 • SAN D EW. CA 92125-0968 1(800 84.1J891
PARK CERTIFICATION
This certifies that the park rental payments on the mobile home described
below are current:
Present owner
Lot Number
!lake of Home /7��ih/y�i��/%�
Year9y
Size
We further certify that eoOti77 %%1',41e Z.
buyer of the home described above.. has met the requirements to be accepted.
as a 'resident in this park and has been notifed of their acceptance..
It is further understood all monies have been received. There are no, other
agreements with this customer for improvements or -upgrading, - -
Name of Park
gnatu= of T Owner or Paft Manager
Date
Park Hanat^_r'telephone Number
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 9220.1
Document Cannot Be Duplicated (619)347 -Ml
Date 11/20/90
No. 110272
Owner Name
Type of Permit
Gonzolo Jimenez
No. 46400 street Dune Palms Road #59
city La Quinta zip 92253
Laum: to
Permit i
Log #
Study Area 231
AM090-429-0977 Tract # I Lot # square Footage 1960
Type of Development I Mobilehome No. of unite
Comments T.nt 12revi nu a ynemipied
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:
ReFlac�ement mob�leholme
This certifies that school facility fees imposed pursuant to.Govwnment Code 53080
in the amount of 0.00 X ® or$ 0.00 have been -paid to DS.U.S.D. for
the property listed above and that building permits and/or Certificates of Occupancy for
this square footage in this proposed Pi'oJect ma now be.issued.
Fees PaidBy Telephone
Name on the check
By Richard M. Beck
Director,.Facilities Planning. & Development
Fee collected /exempted by Shelley D. Bennett - - -
Signature -. Check No. -N/A
Collector:. Attach.w copy of County or City plan check application form to District copy:
Embossed Original --Building DeptJApplicant Copy - ApplicantBeceipt Copy - Accounting