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15730 (SFD)Building Address Owner 414 Q fRF P.O. BOX 1504 No. 15730 78-495 CALLE TAMPICO 47-270 Via Ravenna LA QUINTA, CALIFORNIA 92253 Landau Development Co. Inc. Mailing Address P.O. Box 1725 City Zip Tel. Palm Springs 1 92263 324-1476 Contractor 7.pexial Sun Construction Address P.O. Box 2082 I City Zip Tela Palm Springs 92263 328-2277 State Lic. City & Classif. 479669 Lic. # 3787 Arch., Engr.,Kendell Veith Designer �' Address P.O. Box 2050 Tel. 320-'1211 Cit Zip State Paim Springs 1 92263 Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 71000) of Division 3 of the Business and Professions Code, apd my license is in full force and Xect. q—II—q., %SIGNATURE+• ° "°""' -`"' f r 4 DATE OWNER -BUILDER DECLARATION'' I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Businass and Professions Code: Any city or county which requires a permit to construct, atter, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to ft 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 or 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 Gnprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of conpletron, the owner -builder will have the burden of proving that he did not burnt 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) icensed 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.Compan t ❑.Copy is filed with the city. ertified copy is hereby furnished. V' 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: It, 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. 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. This is a building permit when properly filled out, signed and validated, and is subject to expiration if 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 Address City, State, Zip 11LDING: TYPE CONST. Vin OCC. GRP. R3 P. Number 643-100-009-7 gal Description Lot 188 Tract 26152 roject Description S F D Plan 1R 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 Issued by Validated Validatior Sq. Ft -2794 Size No. Stories No. Dw. Units New ► Add ❑ Alter ❑ Repair ❑ Demolition ❑ Permit does not include block wall or Pool. Estimated Valuation $167,436.00 PERMIT AMOUNT Plan Chk. Dep. $258.00 Plan Chk. Bal. $491.05 Const. $877.00 Mech. $109.00 Electrical Plumbing S.M.I. Grading Driveway Enc. $176.03 $ .00 Infrastructure $3,738.59 Arra In -Fu -1511a PlacesIn-Fu-1511 fits.5y TOTAL r► >r-�6 REMARKS ,IK 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 Issued by Validated Validatior CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING. FEES 1ST FL. SQ. FT. ® $ UNITS SLAB GRADE 0 2ND FL. SQ. FT. BONDING YARD SPKLR SYSTEM POR. SQ. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. SQ. FT. re*A-S (ROUGH) /7 1/ y/ / DRAINAGE PIPING WALL SQ. FT. OTHER APPJEQUIP. DRINKING FOUNTAIN SQ. 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 WASHER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM 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 S SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1 Vac SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER 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 S GROUND PLUMBIt��fJ� UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE 0 ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS /Q /�1�SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. �D 9✓� re*A-S (ROUGH) /7 1/ y/ / METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL A / J� GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ _$ LUMBER GR. FINAL INSP. FRAMING / FINAL INSP. ROOFING/ ,O /2 �j( D!�/ , v 0 A, low /�w/' / ,�/6 �� �.1�f�•4 /_ REMARKS: VENTILATION FIRE ZONE ROOFING ' FIREPLACE SPARK ARRESTOR . GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION S CERT. OCC. FENCE FINAL , INSPECTOR'S SIGNATURESlINITIALS GARDEN WALL FINAL T4ht 4 4 " F.O. BOX 1504 APPLICATION ONLY Building � �� � � 0 AA I F�, /A 7&10i , CALIFORNIAE ESTAD9 Address ,}!1( /V LA QUINTA, CAORNIA 92253 Mailing Po Address CityZip 3�8 Tel. gl'a-c"m '�t4� q�� h3 Contractor F Address /-�) City Zip Tel. �'� /,� 5��7f'rC s raa v3 �a y State Lic. / ` City ?^ & Classif. 7 7 40 1 0 C, _ Lic. # J / S 7 Arch., Engr.,,, ! 'L Designer VV EL_ t) 10, L L V0 t` 4 k Address Tel. 4�5,)J 0 V 0aevrC 39P o -ia I I City / Zip State Lic. a csa LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Sect on 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. SIGNATURE rATE 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 iso requires the applicant for such permit to file a signed statement that he is licensed pursuanr to the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000P of Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis for the alleged exemption. Any violation or Section 7031.5 by any applicant for a pernit subjects the applicant to a civil penalty or not more than five hundred dollars ($500). I ' 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 Ind Prolessions 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 employ®s, provided that such improvements are not intended or offered for sale. If, however, the buildng or improvement is sold within one year of completion, the owner -builder will have the bur -den of proving that he did not build or improve for the purpose of sale.) I' 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 _aw 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.) ! I am exempt under Sec. B. 8 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 certificaE of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company I 1 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) valLRtion or less.) I certify that in the performance of thg work for which this permit is issued, I shat 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 be.ome 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 1 hereby 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 if work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is cosect. Iagree to comply with all city and county ordinances and state laws relating to bui ding 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 BUILDING DIVISION 1ILDING: TYPE CONST. OCC. GRP. P. Number Igal Description oject Description Sq. Ft. Size New No.G.a.. Stories ( Stories G Add ❑ Itimated Valuation PERMIT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure No. Dw. Units Alter ❑ Repair ❑ Demolition ❑ AMOUNT 3 U. Issued by Validated Validatior TOTAL 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 Issued by Validated Validatior CONSTRUCTION ESTIMATE NO, ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. @ $ 2ND FL, SO, FT. POR. SO. FT. Lal GAR. SQ. FT. @ CARP. SO. FT. @ WALL SO. FT. BEd 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 property 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 APPJEQUIP. 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 SQ. FT, @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/. c SEWAGE DISPOSAL SO.FT.GAR raT 3hc HOUSE SEWER REMARKS: VENTILATION GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE _—JCO NST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING 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 GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ —Plus—x$—=$ LUMBER GR. FINAL INSP. 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 VR JJIVMNIYACJ/1191tIHlJ GARDEN WALL FINAL DESERT SANDS UNIFIED SCHOOL DISTRICT 82-879 Highway 111 NOTICE: Indio, CA 92201 Document Cannot Be Duplicated 619-775-3500 Date 9/11/95 1 Type of Permit I La Quinta No. 113671 Permit # Owner Name Landau Development Co., Inc. Log No. 47270 Street Via Ravenna city La Quinta Zip 92253 Study Area 123 APN # 643-100-009 Tract # 126152 Lot # 188 Square Footage 12794 Type of Development Single Family Residence I No. of units 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 1.72 x 2 794 or $ 4,805.68 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 Imperial Sun Construction, Inc. Telephone 328-2277 Name on the check A By Dolores A. Ballesteros ' Superintendent - Fee collected /exempted by Pauline Pearson Payment Received Signature ; ,(`� i_� c n n o A -C 0 ,O t n ,A ,CLin ' _ . + � e t $4,805'.68' Clheck No. 14079 Collector: Attach a copy of county or city plan check application form to district copy for all waivers. Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting