14895 (SOTB)P.O. BOX 1504
Building 78-495 CALLE TAMPICO
Address 54-535 Inverness LA QUINTA, CALIFORNIA 92253
Owner Robin Jacobs
Mailing
Address .Saab '
City Zip
La Quinta a CA
Contractor
ieri
Address
P.O. Box 1425
-City Zip
La Quinta, CA
State Lie.
& Classif. B 559460
Arch., Engr.,
Designer
No. 14895
BUILDING: TYPE CONST. OCC. GRP. .
A.P. Number
.92253 Legal Description
Project Description BBQ
92253 Tel.: 771-1008
City
Lie. # 3545 Sq. Ft. No. No. Dw.
Size - Stories Units
New ❑ Add ❑ Alter.❑. Repair ❑ Demolition ❑
Address
Tel.
0A
R
City
Zip
State
Lie. #
ZONE: BY:
Minimum Setback Distances:
!%
LICENSED CONTRACTOR'S DECLARATION.
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section -
70pp) t. of Division 3 of the Business and Professions. Code, and my license is in full force and
effec
Rear Setback from Rear Prop. Line
-
Side Street Setback from Center Line
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I herebyaffirm that I am exempt from the Contractor's License Law for the followingEstimated
.. 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 or Section 7031.5 by 'any applicant for a permit
subjects the applicant to a civil penalty of not more than rive 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
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 knprove for the purpose of sale.),.
21 a owner of the property, am exclusively contracting with licensed contractors to con.
s ruct 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) pcensed pursuant to the Contractor's License Law.)
❑ 1 am exempt'under Sec B. & P.C. for this reason
Valuation .
, 5 V J V V
I
PERMIT
AMOUNT
-
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
ElectPicalrj
• IQ
Plumbing
S.M.1.
Grading
Driveway Enc.
�) F .W. !
bate (owner - �r n
Infrastructure
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`rGf Company
- O;Cor"Is filed with the city,.. ❑ Certified
�„ PY • ty, copy is hereby furnished.
TOTAL
.5.00
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed If the permit Is for- one., hundred dollars (S 100) valuation
or less.)
I certify that in the performance of the work for which this permit is issued, I shall .not
employ anyperson in any manner so as to become subject to the Workers' Compensation
Laws of California
-'Date Owner
NOTICE TO APPLICANT: If, aRer'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
{ SHALL 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 property filled out, signed and validated, and is. subject to
expiration if work thereunder is suspended for 1130 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
REMARKS
0A
R
'fist\ty }1t
RA
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: PLUMBIW FEES
1ST FL. SO. FT. @ $
1
UNITS
SLAB GRADE
2ND FL. SO. FT. @
BONDING
YARD SPKLR SYSTEM
POR. SO. FT. @
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. @
POWER OUTLET
ROOF DRAINS
CARP. S0. FT. @.
GAS (ROUGH)
DRAINAGE PIPING
WALL SO. FT. @-
OTHER APPJEOUIP.
DRINKING FOUNTAIN,
SO. FT. @
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
iFINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN. EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
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.
SO. FT. @ c
BATH'* TUB 1
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 1% c
SEWAGE DISPOSAL
GAR. FIREWALL
SO.FT.GAR @ 3/ac
HOUSE SEWER
LATHING
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
NOTAL FEES
MICRO FEE
MECWFEE 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 APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
iFINAL INSP.
BOND BEAM
WATER SYSTEM
:GRADING .
cu. yd.
$ plus x$
.,
=$
LUMBER GR. '
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FI ISH GRADING
NAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
PGA WEST RESIDENTIAL ASSOCIATION, INC.
March 2, 1995
Mr. & Mrs. Jacobs
54-636 Inverness
La Quinta, Ca 92253
Dear Mr. & Mrs. Jacobs:
Thank you for submitting the additional information needed for your architectural variance
application. Don Adolph, the Architectural Committee Chairman, has reviewed your application
and has approved it with the following conditions:
1. You must supply our office with copies of the gas and electric city permits.
2. You must clear the landscape sprinkle modifications with Bill Bobbitt prior to doing the
work.
If you have additional questions, please feel free to call our office at (619) 771-1234 or Don
Adolph at (619) 771-0577.
Sincerely,
Rachelle A. Thompson
Business Manager
P.O. Box 1060, La Quinta, California 92253, Telephone 619-771-1234 Fax 619-771-5125