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P.O. BOX 1504 No. 142 9
Building 47--175 Via Lorca 78-495 CALLE TAMPICO
Address LA OUINTA, CALIFORNIA 92253
Owner Landrex California, Inc. VN R3
Mailing BUILDING: TYPE CONST. OCC. GRP.
Address 78-»710 Via Avante 617-840 -038
A.P. Number
quinta, CA zip 92253 Tr1619) 564-5458 Legal Description Lot 164 Tract 26152
SFd Plan B
Cont actor a e Project Description
ria rtConstruction Company2.
caress
Box 1504
Im Desert, 4;hp 9'2261 �TiU19) 346-4289
State Lic. 33 246 Z0t3( City
& Classif. Lic. #
Arch., Engr., Robert Ritchey
Designer
`7caes.40. Via Sevilla Ter19) 360-0966
'`Quinta, CA Zip 92256 State
}
Lic. #
fid- LICENSED CONTRACTOR'S DECLARATION
I hereby affirm -that I am licensed undertprovjs)ons of Chapter 9 (commencing with Section
000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect,/-
SIGNATURE
ffectf'SIGNATURE DATE
+� OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors 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, of 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 penally of nol more than rive 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 confractor(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 ($100) valuation
or less.)
I certify that in the performance of thF work for which this permit 'is issuetl,;I shall not
employ any person in any manner so as{to become subject to the WorkersiCom`pensation
aws of California. > /
f f 7 �.
Date r r S 7_Owner 4� f ' •" 1 /' I
NOTICE TO APPLICANT: If, cher making tthis Certificate o!' Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
HUNDRED THOUSAND DOLLARS ($IDO,DDO), IN ADDITION TO THE COST OF COMPENSATION,
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
This is a building permit when properly filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 160 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
Lca a ma Quints.
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Ref o Line
Side Street SetbacCente ineSide Setback fromyerty1
FINAL DATE
Issued.by:
Validated by:
Validation: N��k y__r4r/_
f
Sq. Ft. 2300
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
$133,116.00
PERMITZ
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
044 • 1Z
Const.
1 •
Mech.
e •
Electrical
153 • ,
Plumbing
is • UL)
S.M.I.
1
Grading
�U • ��►
Driveway Enc.
•'
Infrastructure �
46,940. _65
..
Ax i,,- .i.3 . Y'
, l W C. a Z7 rs • r :Y
."
TOTAL
► • �'�
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Ref o Line
Side Street SetbacCente ineSide Setback fromyerty1
FINAL DATE
Issued.by:
Validated by:
Validation: N��k y__r4r/_
f
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBI%FEES {
1ST FL. SO. FT. ® $
2ND FL. S0. FT. ®
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. S0. FT.
WALL SO. Fr. ®
SO. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM I '
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH) �7
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEOUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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 ® IIA c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ic
HOUSE SEWER
REMARKS:
VENTILATION
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 BIN11ff-916KUNDERGROUND
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
q ,
FOUND. REINF. •• L% �j/
(/
GAS (ROUGH) �7
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL) 3 9�
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
c$
LUMBER GR.
FINAL INSP.
� S
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
or
l (t u a Quinta
.suitbin anb df]ON. Wtttun
!; 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 47-175 Via Lorca
Single Family Dwellin 14296.
Use Classification g Y g Bldg. Permit No.
4
Group R3 Type Construction VN ~ Fire Zone' Use Zone R3
Owner of Building- Landrex Califorriia. Inc: Address 78-710 Via Avante
La Quinta CA. 92253 f
City'. Daniel P. Crawford Jr.
= _
�v r�
September, 13, 1995
Dote:
-r-
Building Official
POST IN A 00Ne11000W FLACt,
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