07950 (SFD)P.O. BOX 1504 No. 07950
Building 78-105 CALLE ESTADO
Address 78-5513 VilletA ftiVe LA QUINTA, CALIFORNIA 92253
Owner
La QuinU Vista Pali
Address PO Ran 229
City Le quints JZip 92253 - Tel. ....34518
M" BMW
Contractor
Omer
Addfess
ty — - jZip— _ Tel.`
State Lic. : I City
& Classif. 500316 Lic. #
Arch., Engr.,'
Designer
Address Tel.
City I ZipI State
Lic. #
LICENSED CONTRACTOR'S DEC RATION
I hereby affirm that_lam.li ensed urger provisions o aster 9 (commencing with Section
7000) of Diivision 3 oythe Butiness and Professions _ode and,my license is in full force and
effect. I
SIGNATU { w / 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, alter, 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
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).
❑ 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 contractor(s) licensed pursuant to the Contractor's License Law.)
❑ l 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 Nod Company
0 py 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 ($100) valuation
or less.)
I certify that in the performance of thg work for which this permit is i 901 -1 -shall not
employ any person in any manner sops to become su jt ct to the Wo rs%�ompensation
Laws of Caofo 'ia.
Date -- Owner .% i'
NOTICE T APPLICANT: If, alter makff this—Ce Ncate—of E4 mptlon y should become
subject to the Workers' Copenaat16n provisions of the Labor Code, 'you m st' forthwith
comply with such provisions or this permit shall be deemed revoked. -`--- -+^"
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this city to enter the above-:
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
BUILDING:- TYPE CONST. - OCC: GRP.
A.P. Number
Legal Description la Quin$Io Vistas Tract 23269
Project Description Lot 202 Plan 3
Sq. Ft. 2"7 No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
$12393.
�!
PERMIT.
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
722.
Mech.
60,
Electrical'
Front Setback from Center Line
Plumbing
Rear Setback from Rear Prop. Line
S.M.I.
Side Street Setback from Center Line
Grading
Side Setback from Property Li?ie
Driveway Enc.
INSPECTOR
Infrastructure
Date!;/?ermit
Validated by:
Validation:
` z
TOTAL
tri_AM_24 I _ilk_M
REMARKS
�'.s .+• �..f'�.e ' � T��S,...` 4'a`9 Y'�$���x.::i C3 JL 4i
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 Li?ie
FINAL DATE
INSPECTOR
Issued by:
Date!;/?ermit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
COLL, AREA
2ND FL. SO. FT.
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT.
DUCT WORK
DRAINAGE PIPING
WALL SO. FT.
DRINKING FOUNTAIN.
SO FT ®
HEATING (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYE14
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GRADING
cu. yd.
$ -plus-x$_=$
LAUNDRY TRAY
AIR HANDLING UNIT CFM
IMIf NAL INSP.
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 ® 1 Va c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/<c
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
:�-s
SETBACK
GROUND PLUMBI G
UNDERGROUND
A.C. UNIT
COLL, AREA
SLAB GRADE 6 6 ,
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
% ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH) a7�Q� l
666000 ll
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.
IMIf NAL INSP.
FRAMING I �? i/ec �„�
6�v
FINAL INSP.
ROOFINGIf
O C
�
aO GD
l
REMARKS:
VENTILATIONN
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND d•
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES11NITIALS
GARDEN WALL FINAL
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This Ceitificate'issued-pursuant-to the=� requiretments of Section 306 of the-Uniform'Building.
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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:
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BUILDING ADDRESS • 78-550 Villeta- Drive
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Use Classification, ' x a SFD _ ` Bldg. Permit No. 07950
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R3 t 4Y e'Consfr'uction' VN" Fire Zone Use'Zone PSR
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owner of Building. LaQuiritl Vista Prtn'rshp._ Address P.O. Box 227, rs
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,city La Quinta, `CA- '92*253 •_ r
BY; Richard Kirkland
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` Building -official
P0ST IN 'A'CONSVI000U3 PLACt