003535 (SPIN)Building
Address —66Cortax La
Owner Ben R. Olsong, Jr.
Address 79-661 Cortes Lane
City Zip
. &a Olai.n,t'a 92253
Contractor
Zip
State Lic.
& Classif..
Arch.-, Engr.,
Designer
4
P.O. BOX 1504 No. 003535
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Tel..
#
BUILDING: TYPE'CONST. • OCC: GRP.
A.P. Number
Legal Description
Project. Description tneci8l lid pec' tion
No. No.'Dw.
Stories Units
Add O Alter ❑ Repair O
Demolition ❑ .
Address
Tel.
City
Zip
State
_
Lic. #
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm: that I.am licensed under provisions of -Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.
SIGNATURE - DATE
- -
•- - -
OWNER -BUILDER DECLARATION
Estimated Valuation
_
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, demollsh, or repair any structure, prior to its Issuance also
requires the applI ant for such Perm#to rile a signed statement that he Is licensed pursuant to
PERMIT
AMOUNT
Me 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 exampt'therefrum, and the basis
for the Any Section 7031:5 by.any for
Plan Chk. Dep..
-
-
allayed exemption. violation of applicant a permit
subjects the app#cent to a civil penalty of not more than five hundred dollars'. ($500):-
Plan Bal.
❑ I, as owner of the property, or my employees with wages: as their sole compensation, will
.Chk.
do the work, and the structure Is not Intended or offered forsale. (Sec: 7044, Buisness and
Const.
Code: The Contractor's License Law does • not. apply to an owner of property who
builds or bnproves thereon and who does such work himself or through his own employees,
Mech.
provided,that-such improvements,are not intended or.offered for sale. ,#; however, the building
or unprovement is sold within one year of completion, the owner -builder win have the -burden
Electrical-
- -
of proving that he did. not build or improve for the purpose of sale.) .,
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing
struct the project: (Sec_ 77044; Business and Professions Code: The Contractor's Ucense-Law
_
does not apply to an owner of property who builds or Improves thereon, and who contracts for
• S.M.I.
- -
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)- -
Grading
O 1 am.exempt.under-Sec. B. B P.C. for this reason
'
Driveway Enc.
Dater �t 9�i downer -'="�y� •-
Infrastructure _
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WORKERS' COMPENSATION'DECLARATION
1 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
_TOTAL
REMARKS
WORKERS' COMPENSATION INSURANCE
(kris section need not be completed 11 the permit la for � one hundred dollars (S 100) valuation
.. or less.) -
_ ,..: ,-.� a •, - ,.. n , ..:. _ ., r _ .
I certify that In the performance of thy work for which this permit is issued, l shall not
employ any parson in any manner so as to become subject,to the Workers' Compensation
Laws of California.
Date Owner
-
NOTICE TO APPLICANT. #, after making this Certilkate of Exemption you should become.
ZONE:
- BY:
subject to the Workers' Compensation provision§ of the Labor Cade, you must forthwith
comply with such provisions or this permit shaff 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's construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, CtvifCode.)
Side Setback from Property Line
Lenders Name
Lender's Address
FINAL DATE
INSPECTOR
This is abuilding 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.
Issued by:
Date Permit
1 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:
Signature of applicant Date '
Mailing Address
Validation:
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING ES
1ST FL. SQ. FT. ® S
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. SQ. FT. ®
FORMS
SEWER OR SEPTIC TANK
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
OTHER APPIEOUIP.
DRAINAGE PIPING
CARP. SO. FT. ®
TEMP. POLE
WALL. SO. FT. ®
GROUT
DRINKING FOUNTAIN
SQ FT ®
FINAL INSP.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
WATER PIPING
NOTE: Not to be used as property tax valuatlon
=S
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
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.
SO. FT. -c
BATH TUB
GAR. FIREWALL
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1% c
SEWAGE DISPOSAL
MESH
SQ.FT.GAR ® 14c
HOUSE SEWER
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
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)
METER LOOP
HEATING (FINAL)
OTHER APPIEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=S
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIONATURESIINITIALS,
GARDEN WALL ,FINAL 771
78-105 CALLE ESTADO - LA QUINTA, CALIFORNIA 92253 - (619) 564-2246
December 24, 1987
SUBJECT: 79-661 CORTEZ LANE
To Whom It May Concern:
There is no record of a permit being issued for a room addition at
the above address. A special inspection was conducted on the above
date and it revealed that the setback, exiting, ventilation, and
natural lighting all comply with current code requirements. There
were no apparent structural problems.
If you have any further question please contact the Planning and
Development Department.
Sincerely,
Tom Hartung
Building Official
TH:b,ja
ltrth.122
n
MAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253