11171 (BLCK)Buildin
Address 52-035 Eisenhower
Owner
W. W. Scott
Mailing
Address
City Zip
La Qairita 92253
Contr ctor
hr er/B ilde' r
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Tel.
Zip t Tel.:
('
State Lic. I City :
& Classif. Lic. #
Arch., Engr.,
Designer
Address Tel.
CityI Zi p I State
Lic. #
LICENSED CONTRACTOWSAECLARATION
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
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 17110 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
i"i
the alleged exemption. Any violation o/ Section 7031.5 by
'any applicant lora permit
ects the applicant to a civil penally of not more than five hundred dollars.(E500).
asowneropoperty, ormyemployeeswithwages astheir solecompensation,willhe work, and the. Structure is not intended or offered far sale. (Sec. 7044, Bulsness 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 contractors) licensed pursuant to the Contractor's License Law.)
O 1 am exempt under Sec.! B. & P:C. for this reason
t
Date Owner�'�
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 -
❑ Copy Is filed with the city. O 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 tnp work for which this permit is issued, I shall not
employ any person in any panner so as to become subject to the Workers' Compensation
Laws of California rr�yC`
Date Owner
NOTICE TO APPUCAN . g, after making this Certificate 'of Exemption you should become
subject td 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, CM 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
No. 11171
ILDING: TYPE CONST. OCC: GRP
P. Number
Legal Description
Project Description
401f of 41 block vial.l
X
t
Sq. Ft. No. No. Dw.
Size - Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated. Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
S
Const.
251. UU
Mech.
Electrical
Plumbing
_
S.M.I.
Grading
Driveway Enc.
Infrastructure
t Hitr4k I UU
TOTAL
25. 10
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. SO. Fr. ® $
UNITS
SLAB GRAD
2ND FL SO. F7.
BONDING
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. F7.
GAS (ROUGH)
DRAINAGE PIPING
WALL SO. FT.
OTHER APPJEOUIP.
DRINKING FOUNTAIN.
SO FT ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
G OUT
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
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,TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER, B.T.U.
SO. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1% c
SEWAGE DISPOSAL
GAR. FIREWALL
SO.FT.GAR ® 3Ac
HOUSE SEWER
LATHING
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 / LMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GR ND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRAD
UG PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMSSEWER
OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOU D. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
R INF. STEEL
GAS (FINAL)
TEMP. POLE
G OUT
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
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION(�——
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
4
78-105 CALLE ESTADO — LA QUINTA, CALIFORNIA 92253 - (619) 564-2246
FAX (619) 564-5617
May 26, 1993
W. W. Scott
52-035 Eisenhower Drive
La Quinta, CA 92253.
Dear Mr. Scott:
It has come to the attention of the City of La Quinta Department of
Building and Safety that your building permit number 11171 at 52-
035 Eisenhower Drive has expired.
According to the Uniform Building Code, Section 303(d), no further
work.shall be performed ..on.:the..above .permitted job -site until a new
permit has been issued or an -extension granted. An extension of
this permit :can•.be..requested in writing within 14 days of the date
of this letter. 14 -
If a final inspection has not been requested due to an ogetsight by
either yourself or your contractor, please schedule that final
inspection within 14 days to resolve this matter. Failure to do so
will result in -further -action -by -the City.
Please contact me at your -earliest convenience. We appreciate your
immediate attention to this matter.
Sincerely,
BUILDING AND SAFETY DEPARTMENT
Lonnie Day
Building Inspector
kt
Attachment
MAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253