05957 (SFD)Building
Address 78-730 Via Sonata
Owner
Mailing
Address 68 -►7I3 Parez t
City Zip
T4tyl 4
P.O. BOX 1504 No. 05957
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Tel.
fame '
Add ress -
Tela
State Lica' City
" & Classif:337077 Lic. # 1219
' Arch., Engr.,-
Address I Tel.
Gity (Zip ( State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division r3,of the usiness and Professions Code, and my license is in full force and
effect. i e j: . '�'--- -risk.. !.. f f ? i ky
SIGNATURE DATE
OWNER -BUILDER DECLARATION
vlhereby 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,. atter, 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) or
Division 3 of the Business and Professions Code, or Nat. he is exempt therefrom, and the basis
kir 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 two hundred dollars (E500).
O 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. ff, 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 contractor(s) licensed pursuant to the Contractor's License law.)
❑ 1 am exempt under Sec. B. 9 P.C. for this reason
Date Owner t` '
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' COMPENSATION INSURANCE
(This section need not be completed ff the permit is for one hundred dollars (8100) 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, ff, 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 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 1 have read this application and state that the above information is correct.
1 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
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number
Legal Description
Project Description
thaft 111 Lot
Plm 1804
17
Parc La Quinta3
Distances:
Front Setback from Center Line '
Rear Setback from Rear Prop. Line
,Sq. Ft. 1804
Size
No.
Stories
No. Dw.
Units
New Add ❑ Alter ❑
Repair ❑ Demolition ❑
INSPECTOR
Issued by:
Date 6-16-69 Permit
.Validated by:
Validation:
Estimated Valuation
93,604.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
•
Const.
Mech..
St3
Electrical
Plumbing
S.M.I.
6.55
Grading
Driveway Enc.
Infrastructure
Z IU6
TOTAL�35�;
REMARKS 4k.ir,';%S A ,.n 1w .�,3n4.4. ilt, a r'a �4�w» :� • .CA
;iYYfiYi.• ;. :Cfi`•Y 1'iv.:" A" wr,r rt,l .i . r
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:
Date 6-16-69 Permit
.Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
A.C. UNIT
COLL. AREA
SLAB GRADE �l
YARD SPKLR SYSTEM
2ND FL. SO. FT.
BONDING
HEATING (ROUGH)
MOBILEHOME SVC.
BAR SINK
POR. SQ, FT. ®
ROUGH WIRING
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
A (ROUGE(`
P
v
METER LOOP
DRAINAGE PIPING
CAR P. SO. FT. ®
REINF. STEEL
GAS (FINAL)
TEMP. POLE
DRINKING FOUNTAIN.
WALL SQ. FT:
GROUT
WATER HEATER
URINAL
SO. FT. @
FINAL INSP.
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
LUMBER GR.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
REMARKS:
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.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 1 V4 c
SEWAGE DISPOSAL
SO.FT.GAR ® V4c
HOUSE SEWER
MESH
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
OUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE �l
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. �5�
A (ROUGE(`
P
v
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$
_$
LUMBER GR.
06NAL I 4-
AMING �/L —
FI AL INS
(/ lC✓
/—
ROOFING
�
!
'��
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
THING
MESH
TION/SOUND '�
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL