001511 (SATT)44
P.O. BOX 1504 No. 001511
Build Fg 79-26'7 C1=11G LA QUINOTACCALIFORNIAALLE 92253
DO
Address -
Owner
Mailing
Address 1001 Bid= St. %rte 2700
City lZip I ITel.
ZiS7sBi?.6.1 .Lu JiJV.i�J i f13JfuY��V9"`7j7
Contractor T
Address
BUILDING: TYPE CONST. V N OCC: GRP. --R3
A.P. Number
Legal Description
Project Description
146 Urdto.�l
P. -O.. B= 173
City Zip Tel...
�S 920 340- _SSU
State Lic. City M• 1247
& Classif. Lic. # Sq. Ft. No. No. Dw.
�2$ Size• ' -• Stories Units
Arch., Efigr.; .
Designer _ � New S • Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
Minimum Setback Distances: .
Front Setback from Center Line
_._.340. S. P*Xre,12 St.
323--7M— ,.♦
Side Street Setback from Center Line
City,,
Zip
State `
Issued by:'
Date Permit
Validated by:
' nari ii1Qii
12262
Lic. #
{— LICENSED CONTRACTOR'S DECLARATION
hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing.(with Section
7000) of Division 3 of,the Business and Professions Code, and my license is iirrrfull force and
effect. 7X). 1{` ?� .! {• 1 P "1
_SIGNATURE - ✓1,i {t t-- r f i t ,6 { ,.r* ! 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-
=�s0�
'
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
- PERMIT
... -
AMOUNT '
.the provisions of the Contractor's License Law, Chapter. 9 -(commencing with Section 7000) of-
Divislon3 of the Business and' Professions Code,,- or thathe is exempt therefrom; and'the basis
for the alleged exemption. Any' violation of Section- 7031.5 - by 'any applicant for a permit
Plan. Chk. Dep. ..
-
105.7)
' subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
❑ I, the
Plan Chk. Bal.
r�}
as owner of 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
Const.
Gil2w24 ,
00
• 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,'.Mech.
that improvements intended
-
-
r
27aa�� yy�� '
_ provided such are not 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
.00
. 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.. 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
S.M.I..��
- such projects with a contractor(s) licensed pursuant -to the Contractor's License Law.)
Grading
- ❑ I am exempt under Sec.- B. 8 P.C. for this reason
. .
Driveway Enc.
Date owner
Infrastructure
Defer
at 19 agreemeft
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I'have a certificate of consent to self -insure, ora 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. O 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'
Laws of California.
Date Owner —'
NOTICE TO APPLICANT., If, after making. this Certificate 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.
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
expiration if work thereunder is suspended for 180 days. ' I
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 sof this city to enter the above-.
mentioned property for inspection purposes. /
. r ) /I
Signature of applicant/ /% l` r� Date
Mailing Address
City, State, Zip
TOTAL 562.60 756.88
REMARKS
ZONE:
J
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:
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
2ND FL. SQ, FT.
POR. SQ. FT. p
GAR. SQ. 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
BONDING.
FLOOR DRAIN .
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEOUIP.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
TEMP. POLE
KITCHEN SINK
ABSORPTION SYSTEM. B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY'.
HEATING SYSTEM FORCED GRAVITY J'
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. ®c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
REMARKS:
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 APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER NEATER
SERVICE
FINAL INSP.
BOND BEAM :
WATER SYSTEM
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.
FENCE .FINAL -
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
LICENSED CONTRACTORS L DECLARATI
(commencing with Section 7000) of Divi
and effect.
License Class Lic. Number
Date Contractor
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, 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) o1 Division 3 of the Business and Professions Code) or that he is exempt
therefrom and the basis for the alleged exemption. Any violation o1 Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty o1 not more than five hundred dollars (5500.):
0 I, as owner o1 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, Business 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 Improvemnt 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.).
0 I, as owner of the property, am exculsivety contracting with licensed contractors to construct the project (Sec.
7044. Business and Professions Code: The Contractor's License Law does not apply to an owner of property who
builgs or improves thereon. and who contracts for such projects with a contractor(s) licensed pursuant to the
Contractor's License Law.).
0 1 am exempt under Sec. B. & P.C. (Attached Certificate).
Date Owner
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell -insure, or a
certificate of Workers' Compensation Insurance , or a certified copy thereof (Sec. 3800. Lab. C.).
Policy No. Company
0 Certified copy is hereby furnished.
0 Certified copy is filed with the City Building Inspection Department or City Department.
Date Applicant
it
PERMIT APPLICATION
City of La Duinta
Department of Building and Safety
This permit becomes void if work not commenced within 180 days from date o1 issuance. OR, if work has been suspended or abandoned for a period of 180 days.
CERTIFICATE OF EXEMPTION FROM WORKERSTOMPENSATION INSURANCE: This section need not be completed if
ON: I hereby affirm that I am licensed under provisions of Chapter 9 the permit is for one hundred ($100) o, less. I certify that in the performance of the work for which this permit is
Sion 3 of the Business and Professions Code, and my license is in full force •Issued. I shall not employ any person inany manner so as to become subject to the Workers'Compensation Laws of
California.
APPLICANT NAME (L. F. MI)JLCflnstruction '
ADDRESS P.O. Box 173
CITY/COMMUNITY/STAT FJZIP
Nestor;. CA 92053
JOG SITE ADORESS/SPACE
CITY/COMMUNITY/STATE/ZIP .
La. to 92253
BOK
PAG
PRC
C
Plurrbing Fee 85.00
TWN -
PING
SE
S
19903
L%3
ZI
TOTAL '.
FEE
MOD
SO
TRACT NAME MS
HORIZON PAL
OWNER NAME (L. F. MI) C>8neral Management Corp -
CONTRACTOR -FIRM NAME -
J.L. Construction
ADDRESS
above
CITY/COMMUNITY/STATE/ZIP
PHONE •
NC
LIC .
.
ARVENG FIRM NAME
Michael Buccino Assoc.
ADDRESS
340 S. Farrell Dr. A212
CITY/COMMUN ITY/STATE/ZI P
Palm cin s CA 92262
PHONE • LICNC •
323-7877
USE OF PERMIT
Single FamilyDwelling
BL
ZON,
FSB
SSG
SSB
RS8
OFC
ZONE ORD 0
LOT SZ
END
SIDE
Date Applicant
NOTICE TO APPLICANT: It. after making this Certificate 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.
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
0 1 hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be
made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or
demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap 3.2, Grp 2, Art 2, Sec 341. Title 8.
C.A.C.)
0 As owner -builder, I will not employ anyone to do work which would require a permit from the Division of
Industrial Safety, as noted above, unless such person has a permit to do such work from that division.
0 Division of Industrial Safety Permit No.
Date Applicant
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. 3D97, Civ. C.).
Lender's Name
Lender's Address
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 county to enter upon the above4nentioned property for inspection purposes.
Signature of Applicant or Agent Date
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have read this application and state that
the information given is correct. I agree to comply with all state laws and county ordinances relating to butdling .
construction, and authorize a' representative o1 the City of La Ouinta Department of Building and Safety to enter
upon the property for which I have applied for this permit for the purpose of making inspections.
Signature of Applicant or Agent Date
Print Applicant/Agent Name 15
APPL/PRMT _ '- TE S.F.D.
i
H
Permit to construct 1247 sq. ft. of
livingarea and 433 . ft. of garage
as a raved laps.
mech. Fee 37.00
Plan Check Fee 307.96
Const. Fee 367.00
Elect, Fee 60.18
CM pp_p_/ 5.46
Plurrbing Fee 85.00
Tnfrastructure
862.60
105.72 DEP. PAID
756.88
* a ee�nt
t De t
TOTAL '.
FEE
2.60
/A 1 L� U 7 L2.
J
,DSIV I�
FINANCE
/76166 R
VALUATION 77,948.00