12527 (SFD)P.O. BOX 1504 `��..No. 12527
Building78-105 CALLE ESTADO
Addres47-415 Via Cordova LA QUINTA, CALIFORNIA 92253
Owner
Baden
'BUILDING: TYPE CONST. OCC: GRP.-
Mailing
Address
cr
r4annes Construction
Address
154 F. Desert Fabs Drive
City Zip TeL
Palm Desert, idA 92266 340--3522
State Lic. City
& Classif. B 1805303, Lic. # 2579 -'
Arch., Engr.,
Designer Jbbn Wall#g
Address Tel.
145190 Club Drive 360--0250
City Zip State
Indiail.Walls, ICA 92210 - Lic. # 67424
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm thati am licerssed underroroVaions of Chapter 9'(commencing with Section
7000) of Divisi�o�ni�..3 of-the=Business and.Profds"sions Code, and my license is in full force and
effect _...w:�.fit�=`/i Pft� .��:r.F�.sFt�id�f �. 'ri'a, we
"OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: '(Sec. 7031.5,Busines`s.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 file 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 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 ciOl penalty of not more than five 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 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 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 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 the 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
I= 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 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,yand hereby authorize representatives of this city to enter the above-.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
A.P. Number
Legal Description
SFD
Project Description
Infrastructure,823.3
'Art3 irk _ C Places X14.8i
TOTAL r ,
REMARKS
ZONE:
BY:
Minimum Setback Distances:
Front Setback from Center Line
Sq. Ft. 293
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑
Demolition ❑
Permit reels
not include block
walls or
pool.
�T�
FINAL DATE
SPECTOR
Issued by:
Estimated Valuation
$169*924.00
yi
PERMIT
Validated by:
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal
"
M • 02
Const.
Validation:
iirs • �ti
Mech.
Electrical
i •
Plumbing
E `J • 9�
.S.M.I.
e
Grading
Li • td
Driveway Enc.
• u
Infrastructure,823.3
'Art3 irk _ C Places X14.8i
TOTAL r ,
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
f Property Line
�T�
FINAL DATE
SPECTOR
Issued by:
Dal
nFr. `�,Phrn%g
Validated by:
"
By
Validation:
is
CONSTRUCTION ESTIMATE
N0: ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
"' j UNITS
A.Q. UNIT
COLL. AREA
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL. SO. FT.
BONDING
HEATING (ROUGH)
MOBILEHOME SVC.
BAR SINK
FOR. SO. FT. ®
SEWER OR SEPTIC TANK
ROUGH WIRING
GAR. SO. FT. @
POWER OUTLET
ROOF DRAINS
FOUND. REINF.
DRAINAGE PIPING
CAR P. SO. FT. ®
HEATING (FINAL)
WALL SO. FT. ®
REINF. STEEL
DRINKING FOUNTAIN
SO. FT. ®
TEMP. POLE
URINAL'
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING'
NOTE: Not to be used as property tax valuation
WATER HEATER
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DI SH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LUMBER GR.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
FRAMING �L (�
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 ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ic
HOUSE SEWER
SPARK ARRESTOR
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
,(P1DERGROUND
A.Q. UNIT
COLL. AREA
SLAB GRADE
A
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS y
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. , d
$ plus x$
=$
LUMBER GR.
FINAL INSP.'?_r-gy
FRAMING �L (�
FINAL INSP.
ROOFING �� 7-�t
C(4 i/l
/'
F f �
I
T
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWAL
LATHING
MESH
INSULATION/SOUND (�
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated 619-775-3500
Date 12/3/93 Type of Permit La Quinta
No. 112555 1 Permit #
Log
Owner Name Baden
No. 47415 Street Via Cordova
City La Quinta Zip 92253 Study Area 123
APN # I Tract # I J Lot # 0 Square- Footage 12935
Type of Development Single Family Residence No. of units 0
Comments
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:
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to Government Code 53080
in the amount of 1.65 x 2 935 or $ 4,842.75 have been paid to D.S.U.S.D. for
the property listed above and that building permits and/or Certificates of Occupancy for
this square footage in this proposed project may now. be issued.
Fees Paid By T. F. Baden Telephone
Name on the check
By Dolores A. Ballesteros
Superintendent
a
Fee collected /exempted by Vickie J. Durrett
Payment Received s..
g
Si nature
Check RNb: 501
Collector: Attach a copy of county or city plan check application form to district copy or.all waivers.
Embossed Original- Building Dept. /Appicant Copy - APP hcant/Recei t Copy..-;;rAcountin
g