001508 (SATT)State Lic.
& Classjf. 442B22
Arch.- Engr., -
° Designer New Add ❑ '
Address Tel.
-11271-7977
City Zip State
. 19..'1..,..'.!'L,,.,.1'.x .. •... !R'A'�?C_�S LIC-# .
Tel.
• 4 -4 0
�
P.O. BOX 1504 No. 001508
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
+
BUILDING`TYPE CONST. V N OCC: GRP. R 3
A.P. Number
0-367-5054 Legal Description
- Project Description Hinizon ']Fa
.146 UrdtS- DeVel,
City 1247
Lic. # 237Sq. Ft. GAR 433 No. No. Dw.
Size - . • Stories - Units
I hereby affirm thatjl am licensed under provisions of Chapter 9 (commencing with; Section
70 OO) of Division 3 of (the Business and Professions Code, and my license is` in full force and
effect.... .FIF,i. /' ;,- . I...` ) _ I) `t,
_SIGNATURE -+✓../f ! s 'k,• 1 e.{ i e ry - DATE _
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following Estimated Valuation
reason: (Sec. 703.1. 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 PERMIT
- the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
'Division 3 of the'Business and Professions Code, or lhat.he is exempt therefrom, andthebasis
/or the alleged exemption. Any, violation of Section 7031.5 by 'any applicant for a permit Plan Chk. Dep.
subjects the applicant to a civil penalty of not more than five hundred dollars ($500). '.. ..
❑ I, as owner of the property, or my employees with wages as their sole compensation, wing , Plan Chk. Bal.
do the rk nd th tr tt' t d d ff d f
wo a es uc ure I
is no in en a oro ere or sa e. (Sec: 7044, Bwsness 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 /or sale. If, -however, the building ..
or improvement, is sold within one year of completion, the owner -builder will have the burden
- o/ 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-
- 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
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) -
❑ I am exempt under Sec. - B. t. P.C. for this reason
r;
Mech.'
Electrical"
Building
79-2"
Address
RM
Owner
Infrastructure
Rear Setback from Rear Prop. Line
37.00
Mailing
Side Street Setback from Center Line
Address
�.;r
City
Z
Contractor
Lender's Name
as
rm. nmv L. DitwWr
Address ..
_ .. .
State Lic.
& Classjf. 442B22
Arch.- Engr., -
° Designer New Add ❑ '
Address Tel.
-11271-7977
City Zip State
. 19..'1..,..'.!'L,,.,.1'.x .. •... !R'A'�?C_�S LIC-# .
Tel.
• 4 -4 0
�
P.O. BOX 1504 No. 001508
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
+
BUILDING`TYPE CONST. V N OCC: GRP. R 3
A.P. Number
0-367-5054 Legal Description
- Project Description Hinizon ']Fa
.146 UrdtS- DeVel,
City 1247
Lic. # 237Sq. Ft. GAR 433 No. No. Dw.
Size - . • Stories - Units
I hereby affirm thatjl am licensed under provisions of Chapter 9 (commencing with; Section
70 OO) of Division 3 of (the Business and Professions Code, and my license is` in full force and
effect.... .FIF,i. /' ;,- . I...` ) _ I) `t,
_SIGNATURE -+✓../f ! s 'k,• 1 e.{ i e ry - DATE _
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following Estimated Valuation
reason: (Sec. 703.1. 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 PERMIT
- the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
'Division 3 of the'Business and Professions Code, or lhat.he is exempt therefrom, andthebasis
/or the alleged exemption. Any, violation of Section 7031.5 by 'any applicant for a permit Plan Chk. Dep.
subjects the applicant to a civil penalty of not more than five hundred dollars ($500). '.. ..
❑ I, as owner of the property, or my employees with wages as their sole compensation, wing , Plan Chk. Bal.
do the rk nd th tr tt' t d d ff d f
wo a es uc ure I
is no in en a oro ere or sa e. (Sec: 7044, Bwsness 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 /or sale. If, -however, the building ..
or improvement, is sold within one year of completion, the owner -builder will have the burden
- o/ 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-
- 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
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) -
❑ I am exempt under Sec. - B. t. P.C. for this reason
COnSt. '
Mech.'
Electrical"
Plumbing
S.M.I. .
Grading
Driveway Enc.
Date owner
Infrastructure
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.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed i/ 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.
TOTAL
REMARKS:
Alter ❑ Repair ❑ Demolition ❑
1.00
ZONE:
BY:
AMOUNT
Minimum Setback Distances: '
105.72
202.24
367.00
Rear Setback from Rear Prop. Line
37.00
Side Street Setback from Center Line
hereby affirm that there is a construction lending agency for the performance of the
' 85.i�tf
5.46
Side Setback from Property Line
Lender's Name
as
rm. nmv L. DitwWr
Eitt�f'33E
FINAL DATE
INSPECTOR
' This is a building permit'when properly filled *out, signed and validated, and is subject to .'
expiration it work thereunder is suspended for 180 days.
52.160
756.88
Date Permit
I agree to comply with all city and county ordinances and state laws -'relating to building
ate 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
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.) - -
Side Setback from Property Line
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 it 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
I agree to comply with all city and county ordinances and state laws -'relating to building
const ruction,and hereby authorize representatives of this city to enter, the above-.
-
mentioned property for inspection purposes.
Validated by:
_ �/ f ,!% t
Signature of applicant Y / /%,r' + / !% -, Date •""/
Mailing Address �' — �/
Validation.
City, State, Zip r
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
2ND FL. SQ. FT.
FOR. SO. FT. ®
GAR. SQ. FT. ®
CARP. SQ. FT. @
WALL SO. FT. ®
SO. 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.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP./EQUIP.
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
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. ®c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/. c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
REMARKS:
VENTILATION
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 APP./EQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
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
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
I145FLU I UN'5 WUNAI UMt5/1N1I IALS
GARDEN WALL FINAL
Y
LICENSED CONTRACTORS 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 Lew 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 life 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 o1 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 penally of not more than five hundred dollars ($S X)J:
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, them
building or improvent is sold within one year of completion, the owner -builder will have the burden of proving that
he did not build or improve for Me purpose of sale.).
0 1, as owner o1 the property, am exculsively 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
builQs 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
PERMIT APPLICATION
City of La Ouinta
Department of Building and Safety
This permit becomes void if work not commenced within 180 days from date of issuance. OR, If work has been suspended or abandoned for a period of 180 days.
CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATIONINSURANCE: 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,perforrnance o1 the work for which this permit is
Sion 3 of the Business and Professions Code, and my license is in full force issued,) shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws o1
California.
MI)APPLICANT NAME (L. F. M
JL Construction
ADDRESS
P.O. Box 173
CITY/COMMI TY/STATE2I P
U4
Nestor, CA 92053
JOB SITE ADDRESS/SPACE
CITY/CONITY/STATE/ZIP -
IixU
La. to CA 92253
BOK
PAG
PRC
C
cMT Fee 5.46
TWN
PING
SE
S
TRACT
19903
LO�
t Department
MOD
SB
TRACT NAME HORIZON PALMS
OWNER NAME (L. F. MI) General Management Corp. '
CONTRACTOR -FIRM NAME '
J.L. Construction
ADDRESS
above
CITY/COM LP41TY/STATE/ZIP
PHONE •
LICNC •
-
ARC/ENG FIRM NAME no '
Michael BucciAssoc.
ADDRESS
340 S. Farrell Dr. A212
CITY/COMMUIITY/STATE/ZI P
Palm inas, CA 92262
PHONE •
323-7877
LICN C to
USE OF PERMIT '
Single Famil D1ATellin
BL
ZON,
FSB
SSe
SSS
RSB
OFC
ZONE ORD •
LOT SZ
END
- SIDE
Date Applicant
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.
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
0 I 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 32, Grp 2. Art 2, Sec341, Title 8,
C.A.C.)
O 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. 3097, Civ. C.).
Lender's Name
Lender's Address
1 certify that I have read this application and state that the above information is correct. l 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 above mentioned 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 buldling
construction, and authorize a'representative of the City of La Duinta 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
Print AppncanuAgent Name � o (.fin q,
Date
APPLNRMT T
�Y L. DA 22-85 S.F.D.
Pennit to construct 1247 sq. ft. of
livingarea and 433 . ft. of age
as a roved plans.
Ylech. Fee 37.00
Plan Check Fee 307.96
Const. Fee 367.00
60.18
cMT Fee 5.46
Plurrbing Fee 85.00
Trifrastructure
862.60
105.72 DEP. PAID
756.88
* a eembint
t Department
TOTAL •
'FEE •
2.60
H , I L L! D L / 5& 8 8 CK
FINAN[_E 77, 9
VALUATION 48 .00