14663 (AR)Building
Address
Owner
It
a
. BOX 1504
78-495 0CALLLE TAMPICO
80-960. Vista Bonita ;?'rail LA QUINTA, CALIFORNIA 92253
Address. .game
CityZip Tel..
.L& .Qu inta .- 9.2253 1
Contractor
14elco .Cons.tructio_n
Add ass _
3 _ 00 U — --Vlore...
No. 14663
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number
Legal Description
t
Project Description ' Liv, 11ig' ' •'ROOM., Bedroorii r and Stain
WaY Addition _ ..
1000 Pad"
1'92276
343-0096
State Lica
& Classif.. 683274
City ,..�
Lic. # ✓ '
AMOUNT
Plan Chk. Dep.
' Arch., Engr.,
Designer .r
Address
Tel.
City
Zip
State
Electrical
38 _ 5
Lica#
LICE NSED.CONTRACTOR'S DECLARATION
1 hereby affirm thaVt!am licensed under provisions of Chapter (commencing with Section '
7000) of Division 3:1f "the BusiKessya d Professions Code, and my license is in full force and
+,-effect. rf ' �j
SIGNATU.E - 4: DATE
'OWNER -BUILDER DECLARATION E
I hereby affirm that I am exempt from the Contractors License Law for the following
- reason: (Sec. ,703.1.5,Buciness and Professions, Code: Any city or county which requires a
permit to construct, after, pmprove, demolish, or repair any structure, pdor.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'sLlcense Law, Chapter 9 (commencing with Section 7000),of
Division 3 of the Business and Professions Code, or that fie lsexempt 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.civff 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 build or improve for the purpose of sale.)
O I, as owner of the property, e
p party, amexclusively 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
1 heieligiraffirm,that Ihave a certificate of consent to self -insure, or a certificate of
Wo
orkePsN66mpensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy�No. Company
�® Copy is filed with the city, 0 Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed i1 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.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS.UNLAWFUL, AND
SHALI: 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. incorrect.
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
Sq. Ft. 674 No. No. Dw.
Size Stories Units
New ❑ .Add p. ' Alter ❑ Repair ❑
Demolition- ❑.
REMARKS
ZONE: BY:
Minimum Setback Distances
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Si/de Setback from PropertYeVI e�
FINAL DATE � ✓`( INSPE . OR �
Issued by: Date ��� Pei
.Validated by: �\ l
stimated Valuation 2 � i 4' '00
.y
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
176.48
,Const.
271.50 .
Mech.
15 . 0 to
Electrical
38 _ 5
Plumbing.
S.M.I.
2-76
Grading
2111 0
Driveway Enc.
Infrastructure
TOTAL
`a 2 � " "3
REMARKS
ZONE: BY:
Minimum Setback Distances
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Si/de Setback from PropertYeVI e�
FINAL DATE � ✓`( INSPE . OR �
Issued by: Date ��� Pei
.Validated by: �\ l
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING➢ FEES
1ST FL. SO. FT. @ $
2ND FL. SQ. FT. @
POR. SQ. FT. @
GAR. SO. FT. @
:CAR P. SO. FT. @
WALL SO. FT. @
SO. FT. @
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
x.
YARD SPKLR SYSTEM
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.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
(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, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. @ c
BATH TUB
BOND BEAM
SQ. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID @ 11/4 C
SEWAGE DISPOSAL
LUMBER GR.
SQ.FT.GAR @ 3/4c
HOUSE SEWER
FRAM INGL I -/.ROOFING
FINAL INSP.
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
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. .
FRAM INGL I -/.ROOFING
FINAL INSP.
�/ ///
4 [� (" 2-T ! �/ / Wl
/^
/ d/(J�
ve
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
c
LATHING
MESH
NSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
DESERT SANDS UNIFIED SCHOOL DISTRICT
' 82-879 Highway 111
NOTI t: Indio, CA 92201 '
Document Cannot ,Be Duplicated 619-775-3500
Date, 2/1/95 Type of Permit La Qu_nta
No, 13284 Permit ' #
Log
Owner Name Mr. & Mrs. Von Ruden
No: 80980 Street .Vista Bonita Trail
city La Quinta Zip 92253 Study Area
APN.# , Tract # Lot # 0 Square Footage 1674
Type, of Development Residential Addition No. of imits 1�
Comments
s
At the present time, the Desert Sands Unified School District does not collEct fees on
garages/carports, covered patios/walkways, residential additions under 50C 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 674 or $ 1,159.28 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. =
e
Fees Paid By Melco Construction Telephone
34--0096
Name, on the check
By Dolores A. Ballesteros C,
Superintendent��
Fee collected /exempted by Pauline Pearson �'�• �� t' a
Payment ReceiveclN,
Signature �('�.c c �p.0 P Ill A A Aly"- - ' Gh'�c6c''^!o 141
, 5.
Collector: Attach a copy of county or city plan check application form to. district copy for a:11,*Mvers.
Embossed Original. Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
LA QUINTA POLO ESTATES ASSOCIATION t
c/o FORTUNE WEST MANAGEMENT
` G. E. WIEDLE COMPANY
73-900 EI Paseo, Suite 3 (Rear)
Palm Desert, California 92260
(619) 346-8052 FAX (619) 779=1370
ARCHITECTURAL APPLICATION
UNIT ADDRESS: �Jy U i id &--) ► 1 I —,X DATE:
MAILING ADDRESS: 1 66 6-1 WY i 0 PHONE:
MODIFICATION REQUESTED: L- / U i I.i C. aOtit,� ,a C LVS ( P r� ►�$�y ?� .
�Nctosjx, c-Atj
so Ps An I (moi ?z%R aU 2(.L -
Architectural
(. -Architectural Review Committee:
You are hereby advised that the following work is proposed and approval is requested. Attached are the drawings of the work to be
done and the types of materials to be used are indicated on the drawings. We understand that building'permits for home improvements may
be require d.by the City of La Quints and that the cost of the permits and the responsibility of obtaining permits and subsequent inspections
Will be borne by the applicant.
We acknowledge that all approved changes in the original design will be at our expense; that any damage to or relocation of
i existing sprinkler systems, underground utilities, building structure and exterior landscaping or other damage resulting from the construction
of these permitted improvements shall be our expense; and, the maintenance of the permitted improvements shall be at our expense.
We also acknowledge that the construction of the requested and approved modifications must begin within thirty (30) days of our
receipt of written approval and that said approved modifications must be completed within sixty (60) days of the receipt of written approval.
Failure to.comply with these or any of the above specifications, or specifications outlined within the Association's governing documents will
result in the nullification of this document and subsequent approval thereof.
OWNER: SIGNATURE: ' � iJ Av t J t,��►S
lease print)
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The above requested modification has been reviewed by the Architectural Review Committee and has been:
x APPROVED REJECTED HELD PENDING INVESTIG' ATION
ti
COMMENTS:. `
fl
Date Reviewed
APPROVED or REIECTED: Must hove two (2) signatures:
TO THE APPLICANT: Mail this Application to:
LA QUINTA POLO ESTATES ASSOCIATION
c/o Fortune West Management
73-900 EI Paseo, Suite 3 (Rear)
Palm Desert, CA 92260
V.