04927 (SFD)"414
P.O. BOX 1504 No.
Building 78-105 CALLE ESTADO
Address 78--665 Via 4arrSde LA QUINTA, CALIFORNIA 92253
Owner
Mailing
Address 6i3-713er8� 8Q8c
City Zip Tel.
Cathedral. City 92234 _ 773-:9044.,
Contractor
'Same
Address
LDING: JYPE CONST. . OCC: GRP.
Number- tarC La quinta
Legal Description_
Project Description_
04927
Plea 2017 -- Lot 49
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: 11, 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 =this
that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lenders Name
Lender's Address
This is abuilding permit when properly filled out, signed and validated, and is subject.to
expiration if work thereunder is suspended for 180 days.
I cerlify 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
REMARKS
\
l
ZONE:
BY:
Minimum Setback
State Lic. 337077
City 1219
2017
2
& Classif.
Lic. #
Sq. Ft.
No: • No. Dw.
Arch., Engr.,
Size
Stories Units
Designer
New ❑ Add ❑
Alter ❑ Repair ❑ . Demolition ❑
Address
Tel.
Validated by:
Validation:
City
Zip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby that."
affirm am licensed under provisions of Chapter 9 (commencing with Section
70pp) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.r' "r . • ,�
SIGNATURE DATE
e OWNER -BUILDER DECLARATION
Estimated Valuation
I hereby affirin 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
$ 9'026
permit to construct, after, 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
PERMIT
AMOUNT
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of.Me 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 fora permit
Plan Chk. Dep.
-
subjects the applicant to a civilpenalty of not more than five hundred dollars ($500).
I, owner the
Plan Chk. Bal.
369.95
. p as of 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
Const.
440.50
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. 1r, however, the building
,MECh.
�. �v
.
or improvement is sold within one year of completion, the owner -builder will have the burden's
Electrical
7.r Jv
of proving that he did not build or improve for the purpose of sale.)
❑ ", as owner of the property, am exclusively contracting with licensed contractors to car)-
Plumbing .
-94.00
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
S.M.I.
7.18
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
❑ I am exempt under Sec B. & P.C. for this reason
Driveway Enc.
Date Owner
Infrastructure
2,295.59
WORKERS' COMPENSATION DECLARATION
I hereby affirm that 1 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.
TOTAL$39327.62
. ,1 ", :�' f- 1r��+
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: 11, 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 =this
that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lenders Name
Lender's Address
This is abuilding permit when properly filled out, signed and validated, and is subject.to
expiration if work thereunder is suspended for 180 days.
I cerlify 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
REMARKS
\
l
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
12/19/88
Issued by:
Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
SLAB GRADE
� ROUGH PLUMB. BONDING
YARD SPKLR SYSTEM
2ND FL SO. FT. @
FORMS
SEWER OR SEPTIC TANK ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
,r— S (ROUGH) METER LOOP
HEATING (FINAL)
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL) TEMP. POLE
DRAINAGE PIPING
CARP. SO. FT. ®
WATER HEATER SERVICE
WALL SO. FT. ®
DRINKING FOUNTAIN
WATER SYSTEM
URINAL
SO FT ®
LU ER GR..
FINAL INSP.
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
/f
D `! L� G(/9
f
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTOXDISH)
APPLIANCE DRYER
FIRE ZONE ROOFING
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FIREPLACE
LAUNDRY TRAY
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.
SO. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1+/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/.c
HOUSE SEWER
FINAL INSPECTION
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 PLUM ING UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
� ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK ROUGH WIRING
DUCT WORK
ROCKSTORAGE
FOUND. REINF. Q�ij�)/ �P'
,r— S (ROUGH) METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL) TEMP. POLE
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ —Plus—X$—=$
LU ER GR..
FINAL INSP.
/
NG `7i
!l///
FINAL INSP.
ROOFING �j' L /J
(cam,
/f
D `! L� G(/9
f
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING OW Z
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
CU Q
31
VF,y�F p4 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA. 92253 -,(619) 534-2246
May 7, 1990
Mr. Alex Petrovsky
78-655 Via Corrido,
La Quinta, CA .922.53
SUBJECT: POST BEAM INSPECTION ORR-14DO
Dear Mr. Petrovsky:
A special inspection was conducted at the above location on May
4, 1990, '.which concentrated on the post beam connection in the
garage. Although one of the beams showed approx-imately 1/4
inch of rotation within the steel saddle., it is my opinion that
the structure integrity of the post beam assembly is intact and,
is functioning per design.
If you have any questions,'please'contact the undersigned.
Very truly yours,
JERRY HERMAN,
PLANNING & DEVELOPMENT DIRECTOR
Tom Hartung
Building Official :
TH:,ccs
MAILING ADDRESS P.O. BOX 15041- LA QUINTA, CALIFORNIA 92253
CS/LTRTH.005