002965 (SFD)Building
AddressPeWDU
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P.O. BOX 1504 "No.. ' 2.65 :
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
W. & Mrs. "cb Schuffer
Mailing BUILDING: TYPE CONST. - OCC: GRP.• r
_
A,P.'NumbeAddress4-4i4 r
City Zip Tel.
C WVf City. . 92234 222M... Legal Description
Contractor Project Description��"''
.Address..
67-265 Peinsta
City Op.. Tela
State Lic.
& Classif. . B 498210
City
Lic. # 332
1'
Sq. Ft. zq
size.. : - 642 0 � -
No.. • No. Dw.
Stories Units --
Arch., Engr., -
Newer Add ❑
Alter ❑. Repair ❑ Demolition ❑, %
Designer - ¢'
Address
_ •. 68-487 130'..Palm 0WIM ?rive._ _
Tel.
...G'
City
`Cathed1"c" .....
Zip .. . .
. 92234, .
State
Lic. # '
.. .. ..
Y
_ iICENSED CONTRACTOR'S DECLARATION.
e '
hereby affirm that I am licensed under provisions of Chapter 9 (commencing with'Section "
of Division 3 of the Business and Professions Code, and
,,. 7000) e, and my license is in full f
effect } ( y p
SIGNATURE DATE
OWNER -BUILDER DECLARATIONEstimated
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, of 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)... • •:`
p 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.) , ' --
Valuation
�' MhY
q .4l23
- - - -• -
•. PERMIT •' •• 'AMOUNT
_
- -
• Plan.Chk. Dep. .. ` ] .,{� ,. •�
Plan Chk. Bal. .�. .�
rr 9
..Cdf1St.'788.00—
•' ry
Mech..• - 59Uw Wr�V
Electrical 66
Plumbing - •
,
127.00
❑ 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 contractors) licensed pursuant to the Contractor's License Law.)
0 am exempt under Sec. B. & P.C. for this reason
S.M.I.
_. . �!
- - 16.91' •.
Grading
�0.f2
Driveway Eno.
Date owner
Infrastructure
2000,00
WORKERS' COMPENSATION DECLARATION
hereby affirm that I have a certificate of consent'to seWinsure;'dr a'certificate of
Worker's Compensationansurance, or a certified copy thereof. (Sec. 3800, Labor Code:)
Policy No. ! + ! / `-Com_pany � C- 1 j
-
-
„ 0 Copy is filed with the city. , ❑ Certified copy is hereby furnished. ,
TOTAL
S 250.00 & 3544.16
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
-REMARKS
-
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.) .. ...
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:. 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. -
ZONE: -BY: • -
Minimum Setback Distances: •. ,
Front Setb ck f C t L'
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 isa 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 iof this -.
city to enter the above
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
HARD COP
a rom en er Ine
Rear Setback from Rear.Prop. Line
Side Street Setback from Center Line'
Side Setback from Property Line.
FINAL DATE INSPECTOR
•issued by: - ' Date 212-7/87 Permit
Validated by:
Validation:
A744%_ 3 5 3544,16 R
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINO FEW
IST FL. SQ. FT. ® $
2ND FL. SQ. FT. ®
POR. SQ. FT. ®
GAR. SQ. FT. ®
CAR P. SQ. FT.
WALL SQ. FT. ®
SO. 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
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
GAS (ROUGH)�O—
zi oo�C�/ dd
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.
SQ. FT. ®c
BATH TUB
BOND BEAM
SQ. FT. p c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/a c
SEWAGE DISPOSAL
LUMBER GR.
SQ.FT.GAR ® 3/ac
HOUSE SEWER
FRAMING
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 GOND. 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)�O—
zi oo�C�/ dd
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.
FINAL INSP. �� ZC� ,
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
1 UM'J blUNA 1 UPILWINI l IAL5.
GARDEN WALL FINAL
FOR � i .s�i�raL�lJ �-0
Amount of Account. $
Amount Paid....... $
Balance Due....... $
Cash O Check M.O.O
Form No. 1793
THANK YOU/
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OFFICE OF
i GF !CULTURAL 1:.OMMI;SS(0NCR
4050 LENIO+V STREET, ROG'-1 19
RIVERSIDE, CALIFORti A 91'•,01
(714) 787.256'1
Dear Developerhandscaper;
E. LEii F:��r,t'c
totir.,ss,o��c�
`7a;•iES O. % ALIACE
Prior to delivery to the Coachella Valley, the following plants/landscaping
material should be free from the insects /diseases listed. Plants, landscaping
ca[erial; appliances, insects and diseases, other than those listed, are also -
applicable to quarantine laws and regulations.
Citrus Nursery Stock/Citrus Plants;.free from Red, Yellow, and Purple Scale,
.Tristeza Complex, Woolly khitefly, and Comstock t'pal}•bug.
FL•onyz:Js species; free from Fred, Yellow, and P•,:rple scale and Comstock Mealybug.
Crape (Vinifera);.insect's _and diseases,
0live trees; Olive knot and Red, Yellow, and Purple Scale.
Pali trees, genus Phoenix; Prohibited, Please ccntact Agricultural Commissioner'sOffice, .
Psidicm {G'w�)'
Woolly hnitefly. _
Soil, plants'ar.d landscaping material with roots contaminated with Ozonium Foot
Fret; P chibited. Please ccntact Agricultural Co=issioner's Office,
1:}•c illa, viable for=s and appliances associated with; Prohibited. Please ccntact
r.`_ic lural Cc—=issicner's Office.
Certain plants/landscaping material from Tulare C:.0 t} ar.d portions of Kern
CeL;�ty; Prohibited. Please contact Agricultural Ce.—nissioner's Office.
Your ccopera[ion is greatly appreciated, If you hzve any questions on laws End
re`ul—t[iens gove:-;ing the Coachella Volley, please do not hesitate to call cur
oce.
S i:,.c ire 15-, .
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