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08136 (MISC)Building Address 49-274 Vist Owner tbl�cr�» Mailing Address City "°' ' Zip La Quiata Contractor AF HM49 Ccnstmeld Address A191 T-i.hf " P.O. BOX 1504 N o , U51-40 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 BUILDING: TYPE CONST. OCC'GRP;. A.P. Number Santa Rasa Cme Legal Description Project Description Atm fans A tights. Add sky 11cfhts.. Tel. City I I. - - Zip Tela ' Holith Wal ria 92258 340-2533 State Lic., City 854 & Classif. � Lic. # { Arch., Engr., Designer Address Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that l am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and SI WTURE' DATE OWNER -BUILDER DECLARATION I hereby _affirm•thabl.am exempt from the Contractor's License Law for the following reason: (Sec.1703'1 5;Busfhess and Professions. Code: Any city or county which requires a permit to-.constiuct: alter, improve, demolish, or repair any structure, prior to its issuance also requires the applicant forsuch 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 Birsinessand Professions Code, or thathe is exempt therefrom, and the basis fol the alleged. exemption. Any violation of Section 7031.5 by 'any applicant for a permit i subjects the applicant to a civil penalty of not more than five hundred dollars ($500). " El 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 safe. 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, asowner 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 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 Ihereby 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. ­3�A .rr & ! Company e a e� r /� IXCopy is filetl with the city. O 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 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. 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 ZONE: BY: Minimum Setback Distances: Sq. Ft. Size No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date 620/"Permit Validated by: Estimated Valuation Validation: PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading 'Driveway Enc. Infrastructure r TOTAL 2& !If REMARKS z .U."ip: Aiii4l+l td: .f ' n;u A,65 i. a['?��. X5"1'& dNdA 41. vx 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 620/"Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ 2ND FL. SQ. FT. FOR. SQ. FT. ® GAR. SQ. FT. ® CAR P. SQ. FT. WALL SO. FT. ® SQ 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.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYE14 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. SQ. FT. ® c BATH TUB SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1+/a c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER REMARKS: 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 LOLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING, DUCT K 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. FI 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 INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL - ,SANTA ROSA COVE,ASSOCIATION- ``- EXTgERICR ARCHITECTURAL /LANDSCAPE-VARIANCE REQUEST' ` r y Request riurnL_r Ha anr3 Marinnne-Matheson '1-2-91 ;. Owners Name $ Date, a. , _ tom• . •. �lQ-�7Jd. Ave' Vi gi-A Rnni ta' I8i12 WakecreSt Dr. `.` Property address- Mai ling.address t • _ Malibu. Ca 9026'5 Ta Qni-nta, Ca ' CAt ',State;Zip. Mailing.City, State,Zip a, ti 56V4 3830 s 213-454-1692 W: .r., TeTephone number-local-, Telephone number-permanent' , The fol lowing ,m6di'f•ication'. is proposed and,-approval is requested . fo;r an Architectural/Landscape variance in accordance with the ,'� we have -attached the necessary; documents 'as-outl�i ned in the r ' procedures sheet. , We understand that, -if"approval i-s granted, we be.; -responsible for` the'°;costs of ,said modification and any end all damage �which`'may occur-to-'any common.' area`property �`includi.ng but not limited to;.sprinkler -systems, utilities, ".,bui-,Idings, lawns and plants.We understand that the A'rchite'ctural` 7.Committee may impose additional.,restri•ctions-or. obl.i,3*ations °of ti . the homeowner which shall pass to .successive owners-.•5f the r` property and as a conditicn of approval applicant for the �,variance wi'l 1 be-required to execute ?a' written :agreeiient and u , not,i ce of that agreement using' the' 'attached forms`. for recordati;on.,we understand`that;the recordation•will'be at our expense.we further understand,-that ahl' buildingtmodifidationS%' requ i re-the approval of the City of La; Qu i nta and: ,that ` modifications shall'_'be performedFby,a licensed contractor. The ' cc's-t of the approvals and permi ts'< wi 11 be 'bo'rne -b Y a�pPl• can � . we ' • further agree thiat,..if• approved, the modifications Wi1.1 be made - i n strict comp,l�i ante. with. the plans submitted with .th i-s ,` *;application.41 i TYPE OF REQUEST': ` See, attached ` ' _ F Please provide a_complete narrative description .1 rof -the proposed modification,'including specific mate rials,colo`r ., and dimensions CONTRACTOR A.E. Howe - f .TELEPHONE NUMBER 34.0-26.33 CONTRACTOR L«ICENSE NUMBER, 293444- r, , - lam• .Cy/—f • . - ',� Owners Si•g'nature T Matheson 49-274 Ave Vista Bonita" 1. Skylites in interior bathrooms.. (Low dome, self flashing with recessed diffusers.) 2. French doors in entry. 3. Indirect, recessed lighting in,the livingroom, diningroom, entry hall, bar, kitchen, master bedroom and bath. 4. Ceiling fans in livingroom, master bedroom, gc.est room, guest house and patio. Patio.fan-has-a single light. 5. Marble floor tile s in kitchen. 6, Wall cabinets in garage. 7. Remove drop ceilings with plastic diffusers .n kitch and- master bath. 8. Mirror walls in master bedroom and bath. 9. Replace shower-tub in guest room with larger...shower and glass door.