09060 (SFD)Building CO _
Address K.- .1f4
Owner
;�8 �a
Mailing
Address _
T4tit 4 4 "
P.O. BOX 1504 No.
78.105 CALLE ESTADO f r._
LA QUINTA. CALIFORNIA 92253 r' 1 2- Z _
Ltry Zip Tel.
t lm Desert 1 92260
Contractor
OwncrBuilder
Address
City Zip
State LIC.
& Classif. 24 8 B 2 3
Arch., Engr.,
Designer
Address
City
Zip
BUILDING: TYPE CONST. _OCC. GRP.
A.P. Number
340--1361 Legal Description -,+- ? 7
Project Description
Tel.
City
Lic.# Sq. Ft. ��� No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Tel.
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professlons Code, and my license is in full force and
effect.
IGNA oATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's Llcense Law For the following
reason: (Sec. 7031.5,8usiness and Pwfassfons Code= Any rimy at county which raquyss
permit to 4nrrafrucf, nitor, improve, demofish, or repair any structure, prior fo its Issuance elsea
{squires the applicant for such permit to f9a a signed arafernenl that he is licensed pursuant to
the provisions oY the Confraclors Lfcsnse Law, Chapter 9 (corm eacing with section 7000) of
❑iwalun 3 of the Business and Professions Code, Or that. he Is exampf rhararrom, and rho basis
far }he alleged exemptWn. Aray violaflon of 5acttan 7031-5 by 'any appfk;anf for a permit
M1]acls foe applcant 10 a civil penally o! nvt mere than live hundred dollars (5500].
i, as owner of the property, ar my empigyees with wages as their sale compensation, will
the work, and the structure ls. oat Intended or offered for sale. (Sec. 70t4, f3ulsness and
Aralessfans Code: The Conlractar's Cleanse LAw does no[ apply fg era awnar of p+opOrly who
builds ar krrpraYes thereon and who does aucn work himself nr through his awn amployaes,
pmvlded Pita[ such Impravaments are not int®mfed or aflered fur sale. II, however, ?ha building
or knprovemenf is sold within one year of completion, lha Awner-bulh?er wilt Piave the burden
of proving that he did oar build or rrrrprove !pr rho purpose of sale-]
Cl I, as owner gF the property, am exclusively contracfirq with licensed contractors to con-
struct the projgci. (Sec- 7044, r3usloess and Prolessions Coda; The Conlraclor's License Law
does nor apply to an owner of property who builds or improves ihareah, and who contracts for
such pfajects with a conlraclor(s) licensed pursuant to }tie Contractor's Lfcanse Caw.)
❑ 1 am exempt under Sec. B. & P.C. for this reason
Date Owner r
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a a6rtificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, ota certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Compdny
r popy is filed with the city. M Certified copy is hereby furnished.
Y CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars (3100) 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
Laws of California.
Date Owner
NOT;CE TO APPLICANT: It, after making this Carffffcate of Exafnplfon you should become
subject to the Workers' Compensaflon provlstoris of the Labor Cade, you must forthwith
comply with such provisions or this permit shall ba 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.)
Lender's Name.
Lender's Address
This Is a building permit when properly filled out, signed and validated, and is subject to
ex pirail on if work thereunder Is suspended for 180 days.
I certify that 1 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 authgrize representatives or this city to enter the above•
mentlpned property for inspection purposes -
c_sufnateo vaivaiion 85046.05
PERMIT
AMOUNT
Plan Chk. Dep.
2 y0 (!`1
Plan Chk. Bal.
4 r;
Const.
Mech.
R
Electrical
.1 7 4 ,
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
REMA
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;
Validated by:
Signature of applicant Date
Mailing Adores Validation:
City, State, Zip
Date Perm
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES NO.
PLUMBING FEES
$
UNITS
1ST FL. SQ. FT. ®
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT.
POWER OUTLET
ROOF DRAINS
GAR. SQ. FT.
DRAINAGE PIPING
CAR P. SQ. FT.
DRINKING FOUNTAIN
WALL SO. FT.
URINAL
SQ. FT.
WATER PIPING
ESTIMATED CONSTRUCTION VALUATION $
FLOOR DRAIN
NOTE: Not to be used as property tax valuation
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
GARBAGE DISPOSAL
APPLIANCE DRYER
LAUNDRY TRAY
FURNACE UNIT WALL FLOOR SUSPENDED
KITCHEN SINK
AIR HANOI INC UNIT rFM
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
POLE, TEMIPERM
LAVATORY
COMPRESSOR HP
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
SQ. FT. ®c
BATH TUB
BOILER B.T.U.
SQ. FT. ® c
WATER HEATER
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
MAX HEATER OUTPUT, B.T.U.
SQ.FT.GAR ® 3/4c
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 PLUMBI'
Q UNDERGROUND AC, UNIT
TOLL. AREA
SLAB GRADE ( ROUGH PLUMB.
BONDING HEATING (ROUGH)
STORAGE TANK
SEWE
ROUGH WIRING DUCT WORK
ROCK STORAGE
FORMS
FOUND. REINF. GAS (ROUGH)
METER LOOP HEATING (FINAL)
OTHER APP.IEQUIP.
�SiEiNF. STEEL h. GAS (FINAL)
TEMP. POLE
GROUT WATER HEATER
SERVICE FINAL INSP.
BOND BEAM WATER SYS I EM
GRADING
LUMBER GR.
FINAL INSP. (p 9/ cu. yd.
FRAMING 3a FINAL INSP.
$ pfus
4 =$
!/
ROOFING
�j♦ REMARKS
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREy►W�ALL rr
LATHI11Gg!1V�
f! !!!
MESH
INSULATION/SOUND /I. A10
J
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
I NSPEC70 R'S 51G NATL R ESf I N ITIALS
GARDEN WALL FINAL
TW(f 4 6CfV (4"
P.O. BOX 1504 APPLICATION ONLY
Building�'� �J1 /I 78-105 CALLE ESTADO
Address J_57[ �i�.�rFf 't LA QUINTA, CALIFORNIA 92253
M+ ► aTT1
Mailfng
Addresst C [C< f L
City Zip Tel. r
Contractor
Address
City lZip ITel.
State Lic. I City
& Classif. Lic. #
Arch., Engr.,
Designer
Address Tel.
City Zip I State
I
J1 Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed unde: prrvi4;ions of Chapter 9 (commencing with Section
t.
7(XIO) of Division 3 of the Business and Profes:;iun; Code, and my license is in full force and
effec
51GNATURr DA-M
OWNER -BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License Law for the following
reason, (Sec. 7p3I.5,BuaHmess and 13ofasslons: Code: Any city or county which requires a
permit to construct, alley, Improve, demolish, or (apalr any structure, prior to Its Issuance also
requi(e8 the applicant for such pormk to No a signed statement that he is licensed pursuant to
the provisions of the Contractors License Law, Chepfer 9 (commencirg wHh Seetlon 7000) of
Division 3 of the Business and Prolesslens Code, or that, he is exempt therefrom, and the basis
for rho Moped exemption. Any violation of Section 7031.5 by any applicant for a pem*
subjects the applicant la a eivli penally of not more. than live hundred doriars ($500),
E. I, as owner of the properly, or my employaea with wages as their sole compensation, wail
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Professlons Code: 'rho Contractor's License Caw does not apply to an owner of property who
buMds or OWroves thereon and who does such worfr himsarf or through his. own 0mpFDy9es,
Provided that such improvements are not intended or offered for sale. if, however, the bulldog
of improvement is sold wNhln one year of compretlan, the owner•buMar will nave the burden
of proving tbet he dirf not build or improve for the purpose of sale_)
❑ 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 License Law
does nor apply to an owner of property who builds or froproves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Confracfor's License Law.)
❑ I am exempt under Sec.—B. & P.C. for this reason
Date Owner _d:2� I-
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I hav'r a certificate of consent to self -insure, or a certificate of
Worker's Compensation InFurance, 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 callifornia.
Date Owner NOTICE TO APPLfCANT. it, alter making lhis Cerlificafe or Exemption you should become_
subject to the Wor"rs' Compensation provisrans of the Labor Coda, 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.)
Lender's Name
Lender's Address
This Is a bullding 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 ally 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 applican —Date—
Mailing Address
City, State, Zip
BUILDING: TYPE CONST- OCC.GRP.
A.P. Number
Legal Description
Project Description
Sq. Ft No. No. Dw.
ize Stories _ Units
New ❑ Add ❑ Alter Repair ❑ Demolition ❑
Estimated Valuation !r
(J
PERMIT
AMOUNT
Plan Chk. Dep.
;
Plan Chk. Bal.
Const.
Mech.
- 90
Electrical
a 9-2
Plumbing
O0
S.M.I.
3
Grading
Driveway Enc.
trastructure
J63,
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:
BUILDING DIVISION
CONSTRUCTION ESTIMATE
NO.
ELECTRICAL FEES
NO.
PLUMBING FEES
1ST FL. SQ. FT. @
2ND FL. SQ. FT.
POR. SQ FT. @
GAR. SQ FT. ®
CAR P. SQ FT ®
WALL SO. FT. ®
SQ. FT. p
ESTIMATED CONSTRUCTION VALUATION
$
UNITS
YARD SPKLR SYSTEM
MOBILEHOME SVC.
BAR SINK
POWER OUTLET
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
$
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAPCOOI 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,TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U,
SO. FT ® c
BATH TUB
SQ FT g c
WATER HEATER
MAX HEATER OUTPUT, B.T.U.
SO. FT RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE
PL.CK.FEE 7
NST. FEE
ELECT. FEE
SMI FEE
PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
CFOUHD PLUA'B!N:G
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 APP.IEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP
BOND BEAM
WATFR RYRTFM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
INSPECTOR's SIG NATURE$lINITIALS
GARDEN WALL FINAL
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated (619) 347-8631
Date 12/18/90 1 Type of Permit I La Quinta
No. 10&% Permit #
Owner Name James Sattley Log ik
No. 54257 street Carranza
city La Quinta _ zip 92253 study Area 110
APN # I Tract# I Lot # = SquareFootage 11460
Type of Development I Single Family Residence No. of units
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 1460 or $ 2,306.80 have been paid to D.S.0 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 Sattley and Sattley Telephone 340-1361
Name on the check
Ln
Richard M. Beck
Director, Facilities Planning & Development
Fee collected /exempted by Shelley D. Bennett
Payment Received
signature l Check No. 1121
Collector: Attach a copy of County or City plan check application form to DiArict copy.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
a it �iJ v a
JAMES O. WALLACE
Agricultural Commissioner
Director of Weights h Measures
DATE f Z , " -? ' % J
DEVELOPER'S NAME:
ADDRESS:
OFFICE OF
AGRICULTURAL COMMISSIONER
AND
WEIGHTS & MEASURES CALVIN C. KAMINSKAS
4080 LEMON STREET, ROOM 19 Asililant ComrnlSSlarlOr
RIVERSIDE, CALIFORNIA 92501 CLEMENT ISTE
(714) 787-2561 sealer
lor
49613 Highway 86, Suite B12
Coachella, Ca. 92236
(619) 342-8291
CASE NO. �C BLS 17 U
.n-,e--ti �rrl =
Lzs `_c k C_rr(�_ 6- F � �1"
TELEPHONE: ( ) :, U J - ! 3 6
( 0 T- 'L r� I I �_ -L ? )
Dear Developer:
After reviewing your landscapi.ng plans, all plant material listed is not in
violation of quarantine laws governing the Coachella Valley. If substitutions
do occur and they differ froin plant material listed, this office must be notified
immediately.
Thank you for protecting and preserving the Coachella Valley's pest -free environnent.
Agricultural CcurLissio er's Office
cc: Indio and Riverside Office