002407 (SFD)• Qumra
P.O. BOX 1504
Building 54-475 & LA QUINOTACCALIFORNIA 92253
Address w ,
Owner
Mailing I
Address P.o_ PM 22a$
City lZip ITel.
Contractor
Address
Sam
City' lZip Tel:
No. 002407'
BUILDING: -TYPE CONST -.-OCC. GRP.
A.P. Number 774-233-4123. *MIA 024
Legal Description Lot U and 12
Project Description•"�•
State Lic. 9
& ateClassif. ;+ 7 %
City
Lic. # _111 ^1
mr. 1727
Sq* Ft.
�
No.
_-
Size 492
SNo.tories
Stories �
s
� Units -
Arch., Engr.,
CONSTRUCTION LENDING AGENCY
Side Street Setback.from Center Line
Designer
`New OX 'Add ❑
Alter ❑
Repair ❑ Demolition ❑
Address
Tel.
Lender's Name
Lender's Address
FINAL DATE
INSPECTOR
This is a building permit when properly filled out, signed and validated, and is subject to
City
Zip
State
_.
I certify, that 1 have read this application and state that the above information is correct.
Lic. #
Date Permit
I agree to comply with all city and county ordinances and,state laws relating to building
LICENSED CONTRACTOR'S DECLARATION,
construction, and hereby authorize representatives of this city to enter the above.
mentioned property for inspection purposes. / /
Validated by:
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and�dfProfessions Code, and my license is in full force and
Signature of applicant.-/' •:1r� � Date_
effect. r / !/gr � A /-I'- A/-_ 54 /^
Mailing Address f.
Validation_:
SIGNATURE" DATE
City, State, Zip
OWNER -BUILDER DECLARATION
Estimated Valuation
6 11 227&86 CK
HARD COPY
I hereby affirm that I am exempt from the Contractor's License Law for the following.
e
��n
0
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
-'AMOUNT
—PERMIT�
®� .
9
..�
' the provisions of the Contractor's License Law, Chapter 9 (commencing with Section7000) or
Division 3 of the Business and Professions Code, or- that.he is exempt therefrom, and ,the basis '
for the Any Section. 7031.5 by 'any for
Plan Chk. Dep.
-
alleged exemption. violation of applicant a permit
' 'subjects the applicant to a civil penally of not more than five hundred dollars ($500). '
Plan ChkBal..,
❑ 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
. ,��..,��
'• COnSt..
+�g .y
Professions Code: The Contractor's License Law does not apply to an owrier*of property who
_
J7 / .��
builds or improves thereon and who does such work himself or through his own employees,
Mech.
�. 00
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
Electrical
70.12
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 con-
Plumbing
e�
$9.00
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not to who builds improves thereon, for
S.M.I.
�`��
apply an owner of property or and who contracts
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
20.00
❑ I am exempt under Sec. B: 8 P.C. for this reason
Driveway Enc.
20.00
Date owner
Infrastructure
1,314.08
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.
TOTAL
2,278.$6
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.) - -
1 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
ZONE:.
BY:
subject to the Workers' Compensation provisions of the Labor 'Code: you must forthwith
comply with such provisions or this permit shall be deemed revoked.
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from.Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback.from Center Line
Ihereby affirm that there is a construction lending agency for the performance of'the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Side Setback from Property.Llne
Lender's Name
Lender's Address
FINAL DATE
INSPECTOR
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.
�v
S —1of
I certify, that 1 have read this application and state that the above information is correct.
Issued by:
Date Permit
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. / /
Validated by:
�,f
Signature of applicant.-/' •:1r� � Date_
Mailing Address f.
Validation_:
City, State, Zip
A5781
6 11 227&86 CK
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
ORMS// / � 7 /
WER OR SEPTI
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
GAS (ROUGH)
METER LOOP
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE /
DRAINAGE PIPING
CAR P. I SQ. FT. ®
GROUT
I
WALL SQ. FT.
FINAL INSP.
DRINKING FOUNTAIN
SQ. FT. ®
WATER SYSTEM
URINAL
ESTIMATED CONSTRUCTION VALUATION $
=$
WATER PIPING
NOTE: Not to be used as property tax valuation
��
BNAL INSP.�v At �
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN. EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIRE ZONE ROOFING
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
//'' L L
?4C LATHING 0- 7 O
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
FINISH GRADING
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
I
MICRO FEE
I
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
-f
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING?'IfUNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
ORMS// / � 7 /
WER OR SEPTI
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE /
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
r
cu. yd.
$ plus x$
=$
LUMBER GR.
��
BNAL INSP.�v At �
MING /l
`(NAL INSP. �
e� (`� / c
OFING
O7�
�t.
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
//'' L L
?4C LATHING 0- 7 O
MESH
46IINSULATIONISOUND S^
FINISH GRADING
,aLFINAL INSPECTION lG a!'S
CERT. OCC.
FENCE. FINAL
INSPECTOR'S SIGNATURES/INITIALS,
GARDEN WALL FINAL
��f1Ep
c
h BERMUDA DUNES r
RANCHO MIRAGE
INDIAN WELLS �+
PALM DESERT a
J' LA OUINTA
'gyp INDIO
Desert Sands Unified School District
82-879 HIGHWAY 111 O INDIO. cALIFORNIA 92201-5878 S (819) 347-8831
June ll, 1986
City of La Quinta
Department of Community Development
78-105 Calle Estado
La Qui'nta, CA 92253
Re: Block 262, Lots 11 & 12
Gentlemen:
The developer of the above referenced lots (1 unit)
has mitigated its impacts on our overcrowded schools by payment
of the amount of $628 per unit to be applied to the cost of
district educational facilities made necessary by such new
development.
Sincerely,
Q rL 1. 4
John D. Brooks
Assistant Supe.ri.ntende.nt
Business Services
JDB/crm
REMARKS:
L
-* I v, .-- - - � -1 -
Signature "j-