10710 (SFD)r
44
P.O. BOX 1504 f '� No. 10710
Building ^r �. j st a Ros 7&105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner
Robert Ham
!BUILDING: TYPE CONST. OCC: GRP.
Address
C(s%enbroo.k "59413 ITel.
Contractor
Rancho Capistrano Dev
Address.
P. 0. Box 990
City Tel.:
LaQui.rt1'iP92253
a 564-07015
State Lic. City
& Classif. 597975. Lic. # 1969
Arch., Engr.,
Designer Walling. £t McCallum/Ltd
Ad
dy0 Club ITe1360-0250
Cily.W. IZIp32210 (State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
700b) of Diyision,3 of the Business and Professions Code, and my license is in full force and
effect
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, after, 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 five hundred dollars ($500). '
O 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 riot 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 Ucense•Law
does not apply to an owner of property who builds or improves thereon, and who contracts for
such projects with a contractors) 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
OgCopy 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 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: If, 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. 79
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 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
A.P. Number
Legal Description Lot 4 5
Project Description 'Enclave Mtn Estates
SFD
Sq. Ft. 3, 781 No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ -Demolition ❑
Permit does not include block €aaii or
pool
stimated Valuation
288, 957.30
PERMIT
AMOUNT
Plan CW Dep.
2400 • U0
Plan Chk. Bal.
- 829.09
Const.
1301.00
Mech.
136.50
Electrical
241.55
Plumbing
217.50
S.M.I.
28.90
Grading
20.00
Driveway Enc.
20.00
Infrastructure
6000.00
krts - in Ptiblic
472.39
TOTAL
9516.93 9266.93
,REMARKS
An1.'rf,"_u9A'P.7oin0Ar 14-S'?o,i.e. til
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 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING F
1ST FL. SO. Fr. ® $
2ND FL. S0. FT.
POR SO Fr. ®
GAR. SO. FT. ®
CAR P. SO. FT.
WALL SO. -FT. ®
SO. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTE
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN.
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
ROUGH PLUMB.
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR. SUSPENDED
GAS (ROUGH)
LAUNDRY TRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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
BOND BEAM
SO. Fr. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1% c
SEWAGE DISPOSAL
LUMBER GR.
SO.FT.GAR ® 3/ac
HOUSE SEWER
FRAMING /a2
FINAL INSP. � Zg 2W
,�f
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 PLUMBING
PejgNDERGROUND
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 APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE r" 7
YA WC
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
$
GRADING
cu. yd.
plus x$
_$
LUMBER GR.
FINAL INSP. J2_2, Z
FRAMING /a2
FINAL INSP. � Zg 2W
,�f
ROOFING � -
/
�l (¢ `� � spy*'/2�L %:Z �• �
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LA ING '3
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION- b ��
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
Building'..,
Addres_
Mailing )
Address
City ,
ty t-\ ..
I L- I - :
'APPLICATION ONLY
a P.O: BOX 1504
' 7&105 CALLE ESTADO
1�15>y LA QUINTA: CALIFORNIA 92253 '
BUILDING: TYPE CONST. OCC. GRP.
1-.J ` I 1,A f y UA.P. Number
Zip e -ti Tel.
Legal Description hili �6
�.�f?roject Descriptio�C� .. •
State Lic.
& Classif.
Arch., Engr., `
Designer;Add
� 1 A c) ° 4
c�c� .t>�,tiS :Z`f2 ►Oso
LICENSED CONTRACTORS DECL)
I hereby affirm.th'at 1 am licensed under provisions of Cha
7"
of Divi 3 of h ss and P e slo C
eft ct
eV`.,;�� ,�••) „ fit°
ON-'
(commen
f
cing with Section
k,lcen ` t utlforoe and
�;.'-
UAlt
OWNER•BUILDER DECLARATION
?.
"`I hereby'affirm that [,am exempt from the Contractors License,Law•for the following•
reason (Sec.. 7031.5.Business and Professions Coder Any. city„or' county which: requires a
permit., toconstruct, ager, 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.,
Mof,the Contractor's License Law, er 9- (commencing: with Section, 7009) of
Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for, the alleged axemption."Any-rolatlon of Sectio. 7031:5 by 'any applicant -Tor -a. permit .-
subjects, the applicant to a civil penalty of not more than Ove hundred dollars ($500).' . ; - • ” -
17.1, 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. d,_ however, the bulkling
or improvement is sold, within one year of completion,. the owner -budder wig have the burden.
of proving that he did not build or improve for the purpose of sate.)' -
l'1 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 contraSor(s) licensed pursuant to the Contractor's License Law.)
I I am exempt under Sec B 8 PC for this reason
i
i
Sq: Ft -7 l No. I y No. Dw.
Size ( I 1 Stories Units
New a Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT. ' AMOUNT
Plan Chk.. Dep. -�
Plan Chk. Bal..
Const.
Mech.
Electrical
Plumbing,
S.M.I. "
Driveway Enc-.
I
Date Owner
Infrastructure
I'
I:
.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:)`��
ia7
Po'c C Company
T C
LTJ Ci9.. i'7 f i L 1 �
py WQed with the city. 0 Certified copy is hereby furnished
.2-50.0
TOTAL'
• —^— .
CERTIFICATE OF EXEMPTIONFROM.
REMARKS
f
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the perm@ Is (or one hundred doilars ($100) valuation
r'
or less:)
t I certlry thahe
I. in tfie performance of twork for which this.permlt is issued, f shall not:,
`employ
any person In any manner so as to become subject to the Workers' Compensation
i
Laws of California.,
Date -Owner
NOTICE TO' APPLICANT: O; 'after making this Cengict(fi- of Exemption -.you- should'become-
,,,y
p y •. ,
sub)ecf' to the. fttkers' Compensation provisions of the, La",{:,Code you, must forthwdA
comply wkh'such provisions or this permit shall be deemed revoked.
': ftAinlmlll'11 Setback Distances • s I'•.
A
Front Setback fro Center Line
" ®- 4'tx �, "1 ' ' , } ` T,-�R
• "
Rear Setback frog ar Prop Line
q �? Oa wT' CONSTRUCTIONLENDINOAf3EIlCYx ti r .r, �,a " e.
n
Side Street Setback:frtirnCenter'Line ,
1 hereby afllrm'that:there f"s a'constructlonlending4agency tor, the performance of the
r tiu i"
work for which this permit is issued: (Sec. 3097, Civil Code.) V y
X.�
Side Setback from Property Line-
.. Lender's f Name
'
Lenders Address
FINAL DATE
INSPECTOR -
This is a building permit when properly filled out, signed and 41dated, and is subject to
expiration it.work thereunder is suspended for 180 days.
t r
I certify that'I nave read this application and state that the above Information is correct"
Issued. by:
Dater Permit
.I agree to comply. wit a county ordinances and state laws relating to building
-•
construction, and h eby auth t e representative -of, :hi' city to-enterthe above
I.
mentioned,property for inspect n purpo _
Validated by:
_
k Signature•'of applicant ''• =Date
,•Valldatl0n.
Mailing Address
i
City, State, Zlp
APPLICANT
_ .
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201 .
Document Cannot Be Duplicated. (619) 347-8631
Date 4/15/92 Type of Permit I La Quinta
No. 111324 Permit #
Log #
Owner Name Robert Ham
No. 77440 street Vista Rosa
City La Quinta zip 92253 Study Area 121
APN # Tract # Lot # ® Square Footage 13781
Type of Development Single Family Residence 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 11.58 1 X 13.781 or $ 5,973.98 have been paid to D.S.0 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 Ham Family Trust Telephone'
Name on the check y, r
By James E. Lively
Assistant Superintendent, Business Services'
Fee collected /exempted by Vickie J. Durrett
n Payment Received r
Signature " Check No. 2153
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
A _ - .-• ` � , -- -� �' -' 'ter �� i•..
Tit
a tilt itt1I1 I �i
This Certificate issued pursuant to the requirements of Section' 306 of the Uniform Building 1 ,
'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: 14 .
BUILDING ADDRESS 77-440 Vista Rosa'. I''y
Use Classification Bldg. Permit No. ' 10710 I I�
Single .Family Dwelling
Group R3 Type Construction VN Fre Zone Use Zone SR
_ tI is
Owner of Building Robert Ham' Address 77-440 Vista Rasa ;
City La'Quij2ta, CA 92253
Lonnie Day �.
i 1
By.
A
I = October 28, ,1992
Dote:
111 ,
Building Official 47 - - - -
- POST IN A CONSPICUOU! PLACE -