08284 (SFD)='y
Building,
Address
Mailing
Address
City
State Lic:
& Classif.
Arch., Engr.,
Designer
Address
City ;
Lic. #
State
Lic. #
P:O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
LICENSED CONTRACTORS 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
OWNEWBUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec:.7031.5;8uslness and Professions Code: Any city or county .which requires a
permit to, construct, atter, improve, demolish, or repair any structure, prior to Its Issuance- also
requires the applicant for such permit to Me a signed statement that he Is licensed pursuant to
the provisionsof the Contractor's License Law, Chapter 8 (commencing with. Section 7000) of
Division 3 of!the-Buslness and Professions Code, or that he is exempt therefrom, and the basis
for the alleged exemption: Any violation o1 Section 7031.5 by 'any applicant for a permit
aVbjects the applicant toa olvil penaky of not more than five hundred dollars•($500)..
❑ 1, as owner of the property, or my employees with wages as their.sole compensation; will
do,the work; and the structure isnot 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
bulbs or ;Improves thereon and who does. such work himself or through his own employees,
. provided that such Improvements: aro not Intended or offered for sale. H, however, the building
.or Improvement is sold within one year of completion, the owner-tiulider will have the burden
of proving tharhe 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.tor.
such projects with a contractor(s) licensed pursuant to the Contractor's License Law:)
❑ 1 am -exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS', COMPENSATION DECLARATION
I hereby -affirm that l have a certitiratw of consent to self -insure, or.a certificate of
Workers Compensation Insurance, or a certified'copy thereof. (Sec. 3800; Labor Code)
Policy No. Company
❑ Copy1s 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.perfornance of the work for which this permit is issued, I shall.not
employ any parson in any manner so as to become subject to the Workers' Compensation
Laws of California.
DateOwner
NOTICE TO APPLICANT: ti, alter making this Certificate of Exemption you should become
.subject to the' Workers' Compensation provisions of the Labor Code, you mush forthwith
comply, with such provisions or this permit shall bedeemedrevoked.
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. 3087, Civil Code.)
Lenders Name
Lender's Address
This is a building permit when properly filled out;•signed and validated, and'•is subject to
expiration it 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 a6tl1&fze representatives of this city to enter the above-.
mentioned property for insppdtfon purposes r'
Signature of applica F' 7Date
Mailing Address. r
City, State, Zip
if � " No. 08284
�S`lcj
BUILDING: TYPE CONST. OCC: GRP. -
.
Number
Legal Description
Project Description
Sq. Ft. No. No. Dw:
Size Stories Units
New ❑ Add ❑ Alter ❑. Repair ❑ -Demolition ❑
itimated Valuation
PERMIT AMOUNT
Plan Chk. Dep. 250.00
Plan Chk. Bal.161.01
Const. �}
Mech.
Electrical 2,02, 5F1
Plumbing 337.50
S.M.L .,
4.06
Grading 20.00
Driveway Enc. 20.00
Infrastructure 1,222.45
.
i
TOTAL
REMARKS 2 Q23,. Csfl
4°aTitla4Y"sYl 4b fifi _ M15.1
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. SO. FT. $
UNITS
COLL. AREA
SLAB GRADE ' q?j
ROUGH PLUMB.
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SQ. Ff. ®
DUCT WORK
ROCKSTORAGE
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
DRAINAGE PIPING
CAR P. SQ. Ff.
GAS (FINAL)
TEMP. POL
WALL SO. FT. @
DRINKING FOUNTAIN.
SQ FT ®
WATER HEATER
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used,as property tax valuation
WATER SYSTEM
FLOOR DRAIN
MECHANICAL FEES
GRADING
cu. yd.
$ plus x$
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
ROOFING ' R�('b
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
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
GAR. FIREWALL
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B,T.U:
SQ. FT. RESID ® 1Vi c
SEWAGE DISPOSAL
SQ.FT.GAR ® 8'ic
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 & AIR COND. SOLAR
SETBACK r :t�
OUND PLUMBING 7
Y UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE ' q?j
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING.
DUCT WORK
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL 'L
GAS (FINAL)
TEMP. POL
L�
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP. �
FRAMINGL qY2 W
FINAL INSP. " 4�f-a/%
ROOFING ' R�('b
P,� n n
_'/ Off(
pq ��
-ll�-
REMARKS:
VENTILATION
FIRE: 3
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
G
MESH
a
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION-
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESItNITIALS
GARDEN WALL FINAL
T H E
February -5, 1992
C I T Y
La Quinta
1982 - 19.92 Ten Carat Decade
Mr. George Mooney
75-205 Stardust Lane
Indian Wells, CA 92210
SUBJECT': 51--125 A D 51-155 E SENHOWER DRIVE
`' Dear Mr. Mooney:
0 F
Your building currently under construction on the above property meets the La
Quinta Municipal. Code. However, at such time you wish to resolve your property
boundary problem you must submit the. necessary paper work to this Department.
Two applications are needed, a Variance submittal requesting a reduction in lot size
and lot frontage and* a Lot Line Adjustment application.
'yrX
We have already received a partially completed Lot Line Adjustment application.
Application forms plus a fee schedule for both a Lot Line Adjustment and a Variance
are attached . If you have any questions concerning the above matter, please contact
my office.
Very truly yours
JERR ERMAN
Planning & Development Director
JH: GL: bja
Attachment
y<
cc.: Building & Safety Department
LTRGL.066
City of La Quinta.
Post Office Box 1504 # 78-105 Calle Estado
La Quinta, California 92253
Phone (619) 564-2246. Fax (619) 564-5617
Des•gn 6 Production; Mak Palmer Despn. 6193160772