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05867 (SFD)Building Address 54-430 El"Amex Owner Jo'ha Vela Jr. P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Address 53701 A" Velasco City Zip Tel. La Quint& 92253 Contractor owmr/Rudder Address City State Lic. I City & Classif. 337559 Lic. # 45$ Arch., Engr., Designer CityI Zip I State I Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that 1 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,Susiness 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 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 sate 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 orImprovement 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 or sale.) O 1, 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 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 O 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 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 of 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 Ihereby 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 No. 05857 BUILDING: TYPE CONST. OCC. GRP. A.P. Number 774-253003 Legal Description Lot 16 Project Description S.F.H. Sq. Ft. No. No. Dw. Size 1314 Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation 71,181.00 PERMIT AMOUNT Plan Chk. Dep. 250.00 Plan Chk. Bal. 199.78 Const. 513.50 Mech. 55.50 Electrical 102.49 Plumbing 172.53 S.M.I. 5.04 Grading 20.00 Driveway Enc. 20.00 Infrastructure 1566.00 rreC E34' au . i3 TOTAL REMARKS t, 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 6-13-89 Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS SLAB GRADE ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL. SQ. FT. @ FORMS SEPTIC TAN ROUGH WIRING. MOBILEHOME SVC. BAR SINK POR. $Q, Ff. ® GAS (ROUGH) METER LOOP GAR. $Q_ FT. ® POWER OUTLET ROOF DRAINS GAS (FINAL) TEMP. POLE DRAINAGE PIPING CAR P. I SO. FT. ® GROUT WATER HEATER WALL SO. FT. FINAL INSP. DRINKING FOUNTAIN. BOND BEAM WATER SYSTEM URINAL FT ® =$ LUMBER GR. ESTIMATED CONSTRUCTION VALUATION $ AMING /, 7 - WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES REMARKS: WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTOXDISH) APPLIANCE DRYER 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. SO. FT. ® c BATH TUB MESH SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1 Ve c SEWAGE DISPOSAL FINISH GRADING 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 ETBACK ROUND PLUMBI UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEPTIC TAN ROUGH WIRING. DUCT WORK ROCK STORAGE LFOUND. REINF _C :7 C GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM FINAL INSP. / Qfy GRADING cu. yd. $ plus x$ =$ LUMBER GR. AMING /, 7 - FINAL INSP. OOFING/ O .6 REMARKS: VENTILATION FIRE ZONE ROOFING ' FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING'J,*W%I P9 MESH INSULATIONISOUNP/0 /I?-?' FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESJINITtALS GARDEN WALL FINAL Desert Sands Unified School District CERTIFICATION OF PAYMENT _ OF NO Q ICE: THIS Do�a,�� gS2w .F fI.ITY FEES � ulf—IV I TO: City of La Quinta DATE: Department of Community Development 78-105 Calle Estado La Quinta, CA 92253 This is to certify_ that developer of 0 A A I which is located at p within this District, has paid school facility fees imposed pursuant to the $utho y g"n ra d byoGpvernment d Section 53080 in t e mount of `6 ( 4,� ^� covering a total of quare feet of (, ) residential or ( ) industrial/commercial development and that buil ing permits for this footage in.this development may now be issued by your jurisdiction. 61/—�i rm-5 - Z% ovj�y 0 - 1�& fo DESERT ANDS UNIFIED SCHOOL DISTRICT White - Building Department • Yellow - Facilities Planning 0 Pink - Accounting • Gold - Developer (10)-37 ��!'r_C "S?.-'11:),�.'.'tii`^I'C•+,"� �,,`'}.t•',�:�'r'�iF �'lie 7"'1M""_-.rrM'u.� �'J!�•.M4.�.. '` r :�rS'ysy '.5.'.iY n,+ COACHELLA VALLEY WATER DISTRICT CASH RECEIPT DETAIL Received From: � (C C��54UA6.A L.eWV_1 Address: ",00 y 0 t' ,,i L�S x �C Ci Q AAZ) Account �1. Lot(s) Service Address !N-430 t 1SCh1 f „-��• r ❑ Meter(s) ❑ Service(s) ❑ Backflow(s) ❑ House Lateral(s) ❑ DetectorCheck(s) ❑// Meter Surcharge Q'Sanitation Capacity Charge ❑ W.S,B.F.C. ❑ Temporary Construction Meter ❑ Turn on Charge ❑ Uncollected Account - Name ❑ Inspection Fee -Tract - Fee - ❑ Plan Check Fees Water / Sewer - Tract - ❑ Bond Payment - A.D. - Bond Assmt. ❑ Customer Deposit ❑ Other Remarks: ❑Copy to: Cash Check Money Order yy3 �� 4y''4t -N G.A. Code Cl TOTAL $ IS—IS-1013 Water Service Cashier CVWD-438 (11/89)