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12674 (SPIN)P.O. BOX 1504 Building 54-227 Eisenhower Dg. 78-105 CALLE ESTADO Address LA QUINTA, CALIFORNIA 92253 `Owner Helodee Cash Mailing Address P.O. Box 522 City Zip Tel. La tit rota, C 92253 1 Contractor Address Zip State Lic. City & Classif. Lic. # Arch., Engr., Designer Address Tel. CityI Zip I State I Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I em licensed under provisions of Chapter 9 (commencing with Section 70 OO) 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 rile 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 or the Business and Professions Code, or thathe 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 rive 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 or 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 or 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 or property who builds or improves thereon, and who contracts for 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 ate A/ "/% ! r� 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. ❑ 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 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 i 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. 12674 LDING: TYPE CONST. OCC: GRP.; P. Number Legal Description Project Description Special Inspection { Sq. Ft. No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure mi.scGll,anec s 100.00 • 100.0 i? TOTAL 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: I AR I i i i il. CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FESS 1ST FL. SQ. FT. ® $ UNITS SLAB GRADE ROUGH PLUMB. BONDING Y ARD SPKLR SYSTEM 2ND FL. S0. FT. p FORMS SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SQ. FT. p GAS (ROUGH) METER LOOP HEATING (FINAL) POWER OUTLET ROOF DRAINS GAR. SO. FT. ® TEMP. POLE I GROUT DRAINAGE PIPING CAR P. I SO. FT. ® FINAL INSP. WALL SO. FT. ® WATER SYSTEM DRINKING FOUNTAIN GRADING cu. yd. $ plus x$ _$ LUMBER GR. URINAL SQ. FT. ® FRAMING FINAL INSP. ESTIMATED CONSTRUCTION VALUATION $ ROOFING WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES VENTILATION WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER (1CTnc�Ll ✓ � arc�l L� GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED GAR. FIREWALL LAUNDRYTRAY AIR HANDLING UNIT CFM SD(%KC� Avtd dT ! di S vno ct r / 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 SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac 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 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 APP.IEQUIP. 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: /WD yy. i 0.3 --r/„[C et;-ji.ic PAI Z VENTILATION FIRE ZONE ROOFING r- to P FIREPLACE (1CTnc�Ll ✓ � arc�l L� SPARK ARRESTOR GAR. FIREWALL LATHING SD(%KC� Avtd dT ! di S vno ct r / MESH S INSULATIONISOUND —161 d Wpg A-2 Gtr' FINISH GRADING I m( S d1n'C h©7 'v FINAL INSPECTION CERT. OCC. ala S "I FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL A -- • vl 4 4a "� r 78495 CALLE TAMPICO - LA GIUINTA, CALIFORNIA 92253 - (619) 777-7000 FAX (619) 777-7101 January 14, 1994 Melodee Cash P.O. Box 522 La Quinta, CA 92253 SUBJECT: Special Inspection at 54-217 Eisenhower, La Quinta California Dear Ms. Cash: A special inspection was conducted at the above address on January 12, 1994. It was determined that an existing patio enclosure was converted into two room additions without proper permits or required inspection. It is not known if insulation is installed in the walls and ceiling. It was noted that footing sizes are 12" X 12" minimum and all 2 X 4 walls arenon- bearing. I was not able to inspect some items such as framing, rough electrical, drywall and lath -nail. This special inspection revealed that requirements for emergency egress and setback were being met and in compliance with current codes. There were no apparent structural deficiencies noted at the time of the special inspection. If you have any further questions, feel free to call me at 777-7027. Sincerely, BUILDING SAFETY DEPARTMENT Lonnie Day Building Inspector I ti MAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253