11262 (SFD)TiN, 4 a& Q
P.O. BOX 1504 N Q . 11262
Building 52-920 Montezuma 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 9225 ,1 C/
Owner j U
Majestic Homes North Prtnrshp. I
Mailing BUILDING: TYPE CONST. OCC. GRP.:
Address p. 0. BOX 76
City Zip Tel.
La Quints 1 92253 568-6014
Contractor
Address 11684 Venture #624
City Zip Tela
Studio City 91604 213/656-3153
State Lic. City
& Classif. Bl 590684 1 Lic. #
Arch., Engr.,
Designer Terry Roach
Address Tel.
i4-558 B Arapaho 360-1114
City Zip State
INdian Wells 1 92210 Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that 1 am licensed u ider,'�pprovisions of Chapter 9 (commencing with Section
700p) of Division of the Busi ass and professions C , and my license is in full force and
o
effect. °
GNATU C - DATE
OWN ER•BUILDERECLARATION
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 rive hundred dollars ($500).
O 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, Bulsness 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.) ,
O I, as owner of the property, am exclusively contracting with licensed contractors to torr
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.)
❑ 1 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 No. Company
❑ Copy 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 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: It, alter 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= 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
P. Number
Legal Description Lot 19 Block 269
Project Description SFD
1764
Sq. Ft. No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Permit does not include block walla
or pool
Estimated Valuation
103.331.60
PERMIT
AMOUNT
Plan Chk. Dep. 250.00
Plan Chk. Bal.
300.40
Const.
653.50
Mech.
55.50
Electrical
136.04
Plumbing
141.00
S.M.I.
10.40
Grading
20.00
Driveway Enc.
.00
Infrastructure
2286.71
Arts in Pubii.
25.00
-----------------
TOTAL 0`lu.
3b�tf.55
REMARKS
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:
7-/
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. SO. FT.
POR. SO. FT. ®
GAR. SO. FT. @
CAR P. SO. FT.
WALL SO. 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
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
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.
SO. FT. ® c
BATH TUB
BOND BEAM
SO. FT. ® c
WATER 'HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1 Vi c
SEWAGE DISPOSAL'•
LUMBER GR.
SO.FT.GAR ® 3/ic
HOUSE SEWER
FINAL INSP. [
!!! �l
ROOFING D
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 (� j^
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADETV
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING.
DUCT WORK
ROCKSTORAGE
FOUND. REINF. 0
GAS (ROUGH)
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
FRAMING
FINAL INSP. [
!!! �l
ROOFING D
/
WdJ
`� µ
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
ULAI
LATHING
MESH
INSULATION/SOUND 0�
!
FINISH GRADING
FINAL INSPECTIONf2 l
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated (619) 347-8631
Date 8/10/92 Type of Permit I La Quinta
No. 11630 Permit #
Owner Name Majestic Homes North Partnership Log #
No. 52920 street Montezuma
city La Quinta zip 92253 Study Area 111
APN # I Tract # 1 Lot # Square Footage 11764
Type of Development Single Family Residence No. of units 0
Comments
At the present time, the Desert Sands Unified School District does not collect fees on
garages/carports, covered patios/walkways, residential additions under 500 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 1.58 X 1764 lor$2,787.12 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.
Fees Paid By General Escrow Co.
Name on the check
Telephone 568,3M
By James E. Lively
Assistant Superintendent, Business Services ,'
Fee collected /exempted by Shelley D. Bennett
Payment Re'6eved �7
Signature
�-
r Check , t o' ,'1 1',0914
Collector: Attach a copy of county or city plan check application form to district copy for ,ail wa" ivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
IF
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car. NO.PlNt100�3 Individual Grant Dead
TO 4993 CA 0 • $31 iw,a 0040 rulmos taa ry 14cam vome 0140juaM
4'he uttdersignedyrantitrfi) dcelare(s):
!)ocumentary ttanst'ee tax i3 ! 95.20
( X ) computed on (a vtiuc of proprrty can veye , of
( ) computed on full valuc'tell Value of {ices t►ttd cncumbtsnccs Ifemaining AE time. of salt.
( ) 'Jnincorparatcd afaa: ( X) City of , !& Quante , and
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
KATHRYN S. BULL, AN UNMARRIED WOMAN WHO ACQUIRED TITLE AS A MARRIED WOMim
hereby GRANTS) to
MAJESTIC BONES NORTH, A GENERAL PARTNERSHIP
the following describ.od teal property in the City of Le Qusnte
County of Rtveraide , State of California:
LOT 19 OF BLOCK 159 OF SANTA CARNELITA AT VALE LA QUINTA UNIT NO. 17, AS
PER NAP RECORDED IN BOOK 19, PAGES 19 and 20 OF MAPS IN 111E OFFICE
OF THE COUNTY RECORDER OF SAID COUNTY
I)3144Julio 5. I901 /A,-
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STATE OF CALIFORNI
'
UOUNTY OF I �rti �.fL. )Ss.
0" N I AA .o Z as before
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me, the M*kfflSrted, a N_a�t�w�yWblic in�„t!offui41Saw.
persoaalty aopeamd f� t tAll
—
.kQA:bxW�
Psrc4tnUly haown to we ue pmwd to ms on lbs basso sat
lLtAFtOry CY'.dCike! to be 411. person rhoar itanAo�„„
w.•e•N.w.w•••.•••N.eeeee.eeae�
FICAL S9A$6
subscd d to ft wishin mstrumens and aclut9wkdgut
CIIIPY NRUR
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h1AIL TAX STP it uaENT5 A5 DIRECTED ABOVE
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I
Received From:
Address: t
COACHELLA VALLEY WATER.DISTRICT
CASH RECEIPT DETAIL
Account No. ' �' o` /
— ' �' t /
Service Address
'Loott(s)
C ��/ ��+�✓
Meter(s) ��
Service(s)
❑ Backflow(s)
❑ House Lateral(s)
❑ DetectorCheck(s)
❑ Meter Surcharge
Sanitation Capacity Charge :;�d_!5_477-
❑ W.S.B.F.C.
❑ Temporary Construction Meter
❑ Turn on Charge
❑ Uncollected Account -Name
❑ Inspection Fee -Tract -
Fee -
❑ Plan Check Fees Water / Sewer -
Tract -
❑ Bond Payment - A.D. - Bond
Assmt.
❑ Customer Deposit
❑ Other
Remarks
❑Copy to:
Cash
Check
Money /
Order
i
��--� G.A. Code
TOTAL $
Water Service
W
Cashier
r
CVWD-438 (11/89)