9807-175 (SFD). , -e �-_ P.O. BOX 1504 TEL 760-72
44REQUESTS
� 78-495 CALLE TAMPICO INSPECTION REQUESTS
LA QUINTA, CALIFORNIA 92253 760-777-7153 _
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Notice:
Document Cannot Be Duplicated
Date 6/28/99
No. 18952
Desert Sands Unified School District
47-950 Dune Palms Road
La Quinta, CA 92253
760-771-8515
CERTIFICATE OF COMPLIANCE
Owner NameCanaday & Company
No. 47-850
City La Quinta
Tract # 26152
Street Via Opera
Lot # 92
Type of Development Single Family Residence
Comments
APN # 643-140-036
Jurisdiction 643-140-004
Permit #
Log #
Zip 92253 Study Area
Square Footage 2,507
No. of Units 1
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
1.93 X 2,507 or $ 4,838.51 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 cc/CA State Bank/Lake La Quinta Communities Telephone 771-9636
Name on the check
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Juanita Green Payment Received $4,838.51
Check No. 51152
Signature �2
NOTICE: Pursuant of Az�sernbly Bill 3081 (CHAP 549. STATS 1996) this wlll serve to notify you that the 90-day approval period in which you may protest the fees or other payment identified
obowe wlli begin to run from the date on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or to another public entity authorized to
rolled them on the District('s)(s') behalf. whichever is earlier.
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
Building
Address
Owner
Mailing
Address
City
Contractor
T-Mf 0 4 u�i�,f�,
P.O. BOX f 504
78-495 CALLE TAMPICO
n
t C7l ,, LA QUINTA, CALIFORNIA 92253
�--� C
r �c� f ) AVkJ �;O R_
City Zip Tel.
State Lic. City
& Classif. l 1 Lic. # L
Arch., Engr.,D,siC-0 .
Address �) Tel.
ti ) �1 1) 30,
City ! Zi State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am llgensed under proviaigns of Chapter 9 [comlfm"eing with Section
7tXX)) of Division 3 of the•8uafness and-Prnlesa�n�Code, and m�Jicense is in full force and
effect.
SIGNATURE _ DATE
OWNER -BUILDER DECLARATION w
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec 7031.5,Susiness and Professions Code: Any city or county which roquiras 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 five hundred dollars ($500).
[: I, as oner 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 or 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 or completion, the owner -builder will have the burden
of proving that he did not build or improve for the purpose of sale )
I 1 1, 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 L',ar: Law
does not apply to an owner of property who builds or improves thereon, and who Cnnlrac:s for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
17 I 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
f7 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 peraon in any manner so as to become subject to the Workers' Compensation
Lawsof Calilornia-
Date Owner
NOTICE TO APPLICANT: It, after making this Certificate or 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 J
Lender's Name
Lender's Address
This is a building pnrml when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
Cerfily that 1 havo read this application and state that the above. information Is correct.
I agree to comply wllh all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this city to enter the above -
mentioned properly for inspection purposes.
Signature of applicant Date _
Mailing Address
City, State, 2rp
APPLICATION ONLY
.DING: TYPE'CONST. OCC. GRP.
Number
I Description �L
Sq. Ft. No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
A
PERMIT AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
COnst.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
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:
WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION