14335 (SFD)P.O. BOX 1504
Building 47-115 Via Lorca LA QUINTA, CALIFORNIA 92253
Address
Owner Landrex California. Inc.
Mailing
Address 78-710 .Via AVante
City
Qunta, CF,
Zip
92253.
Tel.
(619) 564.458
Contractor
Roberts 05n'8tructior Compahy '
Address
P.O. Box 1544
l Qu nta, CA
1''p 92253
W-13) 346-4289
State Lic.
City
& Classif.B 246.208
Lic. # . 3377
Arch:, Engr., Fcoi�eit.tCIC
.-Designer: i
Alld=eAO Via Sevilla
Tet_619) 360-096
City ^
L- Q3i13lta, , CFi
Zip
92253
State
Lic. #
I hereby affirm that'I am Incensed underprovisi�n of Chapter 9 (commencing with Section
7000) of,,b+rvgision 3$1 th'e Business and P ofessssiin�Code,'and my -license is in fulVorce an
v
OWNER•BUILDER DECLARATION '
I hereby affirm that 1 am exempt from the Contractor's License Law for the following
-reason: (Sec. 7031.5;Buslness and Professions' Code: Any.city or county which requires a
. _ permit • to construct, after, 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 that. he is exempt therefrom, and the basis
for the all 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 ($500).
❑ I, as owner.of the property, or my employees with wages as their sole compensation, will
do the work, and the structure is not intended or offered.for sale. (Sec. 7044, Buisness and
Professions Code: The Contractor 's. License Law does not apply to an owner of property who
builds or improves thereon and who does such work himself.or through his own employees,
provided that such improvements. are not Intended or offered for sale.. If, however, the building
or Improvement Is sold within one 'year of completion, the owner -builder will have the burden
- of proving that he did not burld or.improve for the.purpose of sale.) -
O 1, as owner of the property, am exclusively contracting with licensed contractors to con- .
struct the project. (Sec. 7044, Business and .Professions Code: The Contractor's. License Law
does not apply to an owner of property who builds- or improves thereon, and who' confrac!s for,
such projects with contractors) incensed pursuant to the Contractor's License Law.)
O 1 am exempt under Sec- B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent.to self -Insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No: Company
O Copy is filed with the city, ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section. :need -not be completed if the pemuMrs for one hundredollars,($f00) va'uafion
or less.) )
I certify that irrthe performance of the. ork for which this per_mrtis iso"e1ed, I shall not
employ anyerson in any -manner so aslto_become subjectAo the orkdirs' ompensation
Laws of li omia
�ate� ��
OTICE TO APPUCANT:.�1!sa/ter making Mis ;Certificate -of Exemption you should become
subject to the Worke Compensation 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 3706 OF'THE LABOR CODE, INTEREST, AND '
ATTORNEY'S FEES.
' TMs 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, and hereby authorize representatives -of this city.to. enter. the above-..
mentioned property for inspection purposes. '
Signature of applicant -Date-
Mailing
ateMailing Address
City, State, Zip
No. 14335 -
VN R3
WILDING: TYPE CONST.--- OCC: GRP.
�.P. Number 617--840-036
26152
egal Description Lot 162 Trac.
)roject Description'aDJQe.1 C
:rake La Qu.inta
Sq. Ft. 2500 No.. No. 'Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑.
itimated Valuation
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical -
AMOUNT'
Plumbing
S.W. 14.81D
Grading 20. UU
Driveway Enc. . Ulu!
Infrastructure 3 1, ;2 i
ilr.C5-1 n l A etceu Jt �
TOTAL 'S, 3
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 j
Issued by:
•Date Permit
Validated by:
l
Validation:
J I
nlnV19 9 1ggd IL II j _
RV
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING. FE121,1111,
1ST FL. SO. FT. ® $
UNITS
_4 it
2ND FL. SO. FT.
BONDING
YARD SPKLR SYSTEM 7
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CARP. SQ. FT.
GAS (ROUGH)
DRAINAGE PIPING
WALL SO. FT.
OTHER APPJEQUIP.
DRINKING FOUNTAIN
SO. FT. ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP. S3 4s
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID a 1+A c
SEWAGE DISPOSAL
GAR. FIREWALL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
LATHING
GAS PIPING
PERMIT FEE
MESH
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 PLUMBIN G
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 APPJEQUIP.
REINF. STEEL
G (FI Ah '� ¢�
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP. S3 4s
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION �.AA�
CERT. OCC. �
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
r
®R
Cott of 4 utnt�
utl to ani $dfjvt3t t /!ei t* ij W
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
y . ordinances of the City regulating building construction or use. For the"- following:
BUILDING ADDRESS 47-115 Via T,nrca
'j Single.Family Dwelling 14335
Use Classification Bldg. Permit No.
Group R3 Type Construction VN Fre Zone Use Zone R3,
Landrex California, Inc. 78-710 Via Avante
i
Owner of Building Address
Cit La. Quinta, CA. , • 92253
Y By:____... Daniel P. Crawford Jr.
Dote: May 1, .19 9 5
uildinq Offici - .•
_— POST IN A CONSPICUOUS PLACIE
I