14295 (SFD)Building
Address
CV
P.O. BOX 1504 N o .
47.035 Via L6 ca 78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
v" Ul Landrex California, Inc. VN R3
Mailing 57-055 V.11 LorcaBUILDING: TYPE CONST. OCC. GRP. Address
+^ A.P. Number 517"617-840-035
c,itt Quinta, CA Zip 92253 Te1%6 991564-545E Legal Description Loft 161 Tract 26152
Contractor SFd PlanA
Roberts Construction Company Project Description
Lake Iia Quinta
Address
Bob: 1504
Alm Desert, 947AP 92261 1619) 346-4289
State Lic. City 3377
& Classif. H 246249 Lic. #
Arch., Engr., Robert Ritchey
Designer
Addrre5340 Via Sevilla TF 1i 19 ) 360-0966
Cya Quinta, CA I Zip 92256 (State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions,of Chapter 9 (commencing with Section
000) of Division 3 of the,Business and Professions Code, and my license is in full force and
ettect�.,.��!!„�,r,- n.r»w(_j• �/� ��'t`r i'� jl .� r"/.
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 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 rive hundred dollars ($500).
❑ 1,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.)
D 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.)
0 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' COM P ENSATION INSURANCE
(This section need not be completed H the p� ffP 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 pperson in any manner so as'to become subjecl,to the Worker"syCompensation
Laws of California` . Pyr
Date f . .y s
Owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become
subject to the Workers'4C6;npensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND .
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
This a is building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
1 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
Sq- Ft- 2000 No. No. Dw.
Size Stories Units
New ❑ Add O Alter O Repair ❑ Demolition D
Estimated Valuation+
PERMIT AMOUNT
Plan Chk. Dep. _
Plan Chk. Bal. _A� �
Const. 2.30 .'i_
Mech. a F3.50
Electrical 144.30
Plumbing 1 • tJ
S.M.I. ii . 8
Grading 20.00
Driveway Enc.*
Infrastructure 2,579.49
ArtArtis JL i1 Pabtkc P .1. .:a d
TOTAL w, 4 4 a• t O
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line -
Rear Setback from Rear Pro/ ne
Side Street Setback fromfCe I Lin
Side Setback from Pro//pj Ine
FINAL DATE ' INSPECTOR NO \
Q
Issued by: Date ey Permit V
Validated by:
Validation: \�� /
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
tST FL. SO. FT. @ $
2ND FL. SO. FT. @
POR. SO. FT. @
GAR. SO. FT. @
CAR P. SO. FT. @
WALL SO. FT. @
SO. FT. @
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as properly tax valuation
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPIEOUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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. REBID @ 1 Vi c
SEWAGE DISPOSAL
SO.FT.GAR @ 314c
HOUSE SEWER
REMARKS:
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 �G
[[[[
GROUND PLUMBI O�G
UNDERGROUND
A.C. UNIT
COLL. AREA
LAB GRADE
Y -22G
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 APPIEOUIP.
REINF. STEEL
GAS (FINAL) �, �f`
/ ✓
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP.
A01
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 SIGNATURES/INITIALS
GARDEN WALL FINAL
C;qt AXM
OF
fi.
Cott un Wuinta,
'
, ltt� to �IIt�1 ,`afpt 4 ttyatulT
This Certificate issued pursuant to the. requirements 'of Section 306 of the Uniform Building
Code. certifying that at the time of issuance. this structure -was in compliance with the various
ordinances of the City regulating building construction or use. For the following:'
''BUILDING ADDRESS _ 47-085 Via Lorca
Single Family,Dwelling, _ 14295
Use Classification Bldg. Permit No.
Group R3 Type Construction VN Fire Zone- Use Zone R3'
Owner of Building ' Landrex . California, inc. Address 57-055 Via -,Lorca
City "La Quinta, CA., 92253 `
By... ; Daniel P. .Crawford Jr. -
"`
................. Date: November 20, 1995 `
Building Official POST INA CONe?ICUOU! PLACE