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15560 (SFD)"."c ... 4.4 P.O. BOX 1504 N0.15590 Addrdess 0-285 Hountain Shadows LA OU NTA, CALIFORNIA 92253 Owner Pti nistral.l.i Constriction Mailing Address . 50-445 Mountain Shadows City A Zip Tel. La Quinta 1 92253 1 554-7818 Contractor Address City. Zip Tel.: State Lia City & Classif. 693$99 Lic. # 3625 Arch., Engr.; • Designer EB G Address Tel. 26: Cmrp�rAte Nark. 714-261-1795 City Zip State Irvine_ 92714 Lic. # 'L'ICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of'Chapter 9 (commencing with Section 4 7000) of Division 3 of the Business and Professions Code, and my license is in full force and ffect. SIGNATURE 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, atter, 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) or 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 (8500). ❑ 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 contractors) licensed pursuant to the Contractor's License Law.) O 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 O 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 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. taws of California. No Owner r) NOTICE TO APPLICANT: ff, after making this Certillcate 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 ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN. SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. This is a building permit when properly filled out, signed and validated, and is subject to expiration it work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information'is correct. I agree to comply with all city and county ordinances. and state laws relating to building construction, and. hereby authorize representatives of this city to enter the . above-. mentionedpropertyfor inspection.purposes. Signature of applicant Date BUILDING: TYPE CONST. %T -N OCC: GRP. R3 A.P. Number 769542.--IDp? Legal Description Lan J Tract 25429 Project Description SFD, Sq. Ft.. No. Size 3058 -Stories New ® Add O O 1. .No. Dw. Units Repair ❑ -Demolition p block wall. or stimated valuation S 94.401.00 PERMIiT Plan Chk. D"ep. . 250.00 Plan Chk. Bal." Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure Arts in Public.• Places c1. 4V 113%,441!1 4 a U-1 ARJBP f"eta 6333.'80 r TOTAL ISS9?A$S2 wr i AMOUNT. 4074.8© REMARKS+rv-� i n �tih i 9 r VI AC. -A, Cr. pAi t tg�r �ffg6LIa1R7 '4�yl4 t r.�,1�oR�.+P1 p' ;�.1P1>y i. rlr3 1') az N _ ;And t1ii" AtrPT`11i C�nil 4Mt=r1l.- ^,n _ r ZONE:' BY: ` Minimum Setback Distances: -Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street -Setback from Center Line 7 =/ Side Settbac fr�otm Property Line FINAL UTE sue� Issued by Mailing Address Validation:' City, State, Zip -%4 CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBINU FEES 13T FL. SQ. FT. $ 2ND FL. SQ. FT. POR SQ FT ® GAR. SO. FT. ® CAR P. SQ. FT. WALL SQ. 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 SEW OR*&4A* ROUGH WIRING FLOOR DRAIN MECHANICAL FEES AS (ROUG if _r g /arS� METER LOOP V ! WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER WATER HEATER SERVICE GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED WATER SYSTEM LAUNDRYTRAY AIR HANDLING UNIT CFM I 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 SPARK ARRESTOR SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1Ya c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER INSULATION/SOUNfyO/,6 �S 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 Wn SETBACK (r S GROUND PLUMBI ` UNDERGROUND A.C. UNIT COLL. AREA /J LAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK . WFORMS 45�0' _4!�� SEW OR*&4A* ROUGH WIRING DUCT WORK RO S `CiOUND. REINF. �' G/, Gt �� AS (ROUG if _r g /arS� METER LOOP V ! HEATING (FINAL) OTHER P QUIP REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE INAL INSP./2 SOND BEAM WATER SYSTEM GRADING cu. yd. $ plus -x$_=$ LUMBER GR./ ! /jEWAL INSP % -S�49 S� r %1MING r/��/?-� (� - �jNAL INSP4,Z—jJ*5 UVJ J OFING / v 3 S p/c TU wti_0) V0 C ^ � `✓ /�' �f� . ^_ �/ � /. / REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GA__R. FIREWALL HING 0 MESH INSULATION/SOUNfyO/,6 �S FINISH GRADING AL INSPECTION1.2 I3 %S CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS CARDEN WALL FINAL r •- DESERT SANDS UNIFIED SCHOOL DISTRICT. 82-879 Highway .111 NOTICE: Indio, CA 92201 Document Cannot Be Duplicated '619-775-3500 ,Date 7/26/95 Type of Permit I La Quinta No. 13576 Permit # Log Owner Name Ministrelli Construction No. 5,40285 Street Mountain Shadows ' City- La Quinta Zip 92253 Study Area 125 APN #. Tract # I Lot # 0 Square Footage 1 Type of Development I Single Family Residence No.. of units. 0 comments Grandfathered 3058 sq. ft. 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: ' Under Mitigation Agreement This certifies that school facility fees imposed pursuant to Mitigation Agreement in the amount of 628.00 x 0 or $ 628.00 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 thisproposed project may now be issued. . Fees Paid By' Ministrelli-Painted Cove, Inc. Telep.horte `564118,49, Name on the check'By Dolores A. Ballesteros Superintendent �5 Fee collected /exempted by Pauline Pearson Payment Received Signature pre1) A.0 JJ' ,A Q �cA, A A 4-tA_ " $628.00 Check No. 1740 Collector: Attach -a' copy of county or city plan check application form to district copy for all waivers. Embossed Original- Building Dept. /Applicant Copy - Applicant/Receipt ; Copy - Accounting