001501 (SATT)4
P.O. BOX 1504
Building 78.105 CALLE ESTADO
Address 7.9'309 HOri24M Pal= CiXr.L-_ LA QUINTA, CALIFORNIA 92253 _
Owner
td'l wftnaamnm own.
No. 001501
Date Owner
BUILDING: TYPE CONST.
V OCC: GRP. r, I
Mailing
Address 1001 DisbopSt. SUite 2700.
A.P. _Number
subject to the Workers' Compensation provisions of the Labor Code, you' must forthwith
comply with such provisions or this permit shall be deemed revoked.
City
Zip
Tel.
H=JUJU
96$I3,
1—S00"3f}7_WS4
Legal Description
Project Description>I"_;Ytl't
CONSTRUCTION LENDING AGENCY
Contractor
J.L. OMVtiWtiM
I hereby affirm that there is a construction lending agency for the performance of the
Address.
work for which this permit is issued. (Sec. 3097, Civil Code.)
.
P 0. ` -1
_City.... ... .. 'Zip
sett
9 3
Tela
340.551.. .
Lender's Address
'This
.
State Lic.
& Classif.. �$��
City
Lic. # X37_ y . J _
]XV 1247
Sq. Ft.
Size,- MR. 433
No. No. Dw.
Stories Units
Arch., Engr.,
Designer
New Add p
Alter ❑ . '. Repair ❑ Demolition ❑
Address
TeL
construction, and hereby (authorize representatives -of this city to enter the above-
mentioned property for inspection purposes.
Validated by:
Signature of applicant i 1 i 1 c" 1 f- Date 1
City
Zip
State
Validation:
92262
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 Professions Code, and my license is in full force and '
- effect. j
_SIGNATDRE DATE
OWNER•BUILDER DECLARATION
I hereby affirm that I am exempt' from the Contractors 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:a
-requires the, applicant for such permit to rile 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 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
subjects the applicant to a civil penalty of not more than five hundred dollars (8500).
O Ias 'owner of the property, or my employees with wages as their sole compensation, will
i
do he•work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Professions Code: The Contractor's License Law does not apply to -an owner of property' who
• builds' or improves theieon 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 improvement 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.)
Estimated Valuation
77pQwm
PERMIT
AMOUNT'
Plan Chk: Dep.
- -�
Plan Chk. Bal.
�.
Const:
' l
' Mech.
- 17_o
Electrical
Plumbing
�lA�
0 li 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 contractors) licensed pursuant to the Contractor's License Law.)
❑ I am exempt under Sec. B. & P.C. for this reason
S.M.I.
_
•'
Grading
Driveway Enc.
_ Date Owner
Infrastructure
f_inw�±
......
•Gtvi-fit c 3! �'l3.
WORKERS' COMPENSATION DECLARATION
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
p.Copy is filed with the city. O Certified copy is hereby furnished. ...
TOTAL
is 6 - !?
_
REMARKS
CERTIFICATE OF EXEMPTION FROM
_WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars (8100) 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
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
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.)
-
Side Setback from Property Line '
Lender's Name
Lender's Address
'This
FINAL DATE
INSPECTOR
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 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
construction, and hereby (authorize representatives -of this city to enter the above-
mentioned property for inspection purposes.
Validated by:
Signature of applicant i 1 i 1 c" 1 f- Date 1
Mailing Address f' r
Validation:
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FErb
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT. @
POR. SO. FT. ®
GAR. SO. 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 APPJEQUIP.
LAUNDRY TRAY
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 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
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
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
un a alumA f uncwmI i IAw
GARDEN WALL FINAL
1
PERMIT APPLICATION
City of La Ouinta
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 WORKERS'COMPENSATIONINSURANCE: This section need not be completed if
LICENSED CONTRACTORS DECLARATION: I hereby affirm that 1 am licensed under provisions of Chapter 9
the.permit is for one hundred (5100) o. less. I certify that In the performance o1 the work for which this permit is
'(commencing with Section 7000) of Division 3of the Business and Professions Code. and my license is in full force
issued. I shall not employ any person Many manner so as to become subject to the Workers'Compensation Laws of
and effect.
California.
License Class tic. Number
Date Applicant
Date Contractor
NOTICE TO APPLICANT: If, alter making this Certificate of Exemption, you should become subject to the Workers'
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractor's License Law for the
Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall
be deemed revoked.
following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to
S
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License law
01 hereby certify that no excavation five (5) or more feet in depth into whicha person is required to descend. will be
(Chapter 9(commencing with section 7000) of Division Sof the Business and Professions Code) or that he is exempt
made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or
therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap 3.2. Grp 2, Art 2, Sec 341, Title 8,
subjects the applicant to a civil penalty o1 not more than five hundred dollars (5500.):
C.A.C.)
O I, as owner of the property, or my employees with wages as Meir sole compensation, will do the work, and the
O As owner -builder, I will not employ anyone to do work which would require a permit from the Division of
structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License
Industrial Safety, as noted above, unless such person has a permit to do such work from that division.
Law does not apply to an owner o1 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. It, however, the
o Division of Industrial Safety Permit No.
building orimprovemntissold within one year ofcompletion, the owner -builder will havethe burden of provingthat
Date Applicant
he did not build or improve for the purpose of sale.).
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance
❑ I, as owner o1 the property, am exculsively contracting with licensed contractors to construct the project (Sec.
of the work for which this permit is issued (Sec. 3097, Civ. C.).
7044. Business and Professions Code: The Contractor's License Law does riot apply to an owner of property who
Lender's Name
builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the
SSB
Contractor's License Law.).
Lender's Address
O 1 am exempt under Sec. B. & P.C. (Attached Certificate).
1 ceAity that I have read this application and state that the above information is correct. I agree to comply with all
Date Owner
'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.
WORKERS' COMPENSATION DECLARATION: 1 hereby affirm that I have a certificate of consent to self -insure, or a
certilicate of Workers' Compensation Insurance , or a certified copy thereof (Sec. 3800. Lab. C.).
Signature of Applicant or Agent Date
Policy No. 'Company
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify Ihave read this application and slate that
O Certified copy is hereby furnished.
the information given is correct. I agree to comply with all state laws and county ordinances relating to buidling
l7 Certified copy is filed with the City Building Inspection Department or City Department.
construction, and authorize a'representative of the City of La Ouinta Department of Building and Safety to enter
upon the property for which 1 have applied for this permit for the purpose of making inspections.
Date Applicant
Signature of Applicant or Agent Date
APPLICANT NAME (L, F. MI) JLConstruction
WL1
ADDRESS
P.O. Box 173
CITY/COMMUNITY/STATE/ZIP
Nestor; CA 92053
JOB SITE ADDRESS/SPACE
CITY/COMMUNITY/STATE/ZIP
La. to CA 92253
BOK
PAG
PRC
I C
SMI Fee 5.46
TWN
FIND
SE
S
CT
19903
19903
LO
//1
t De t
MoD
S13TRACT
NAME
HORIZON PALMS
OWNER NAME (L. F. MI) GBneral Management Corp. '
CONTRACTOR -FIRM NAME
J.L. Construction
ADDRESS
above
CITY/COMMUNITY/STATE/ZIP
PHONE It
LICNC •
ARC/ENG FIRM NAME
Michael.Buccino Assoc.
ADDRESS
340 S. Farrell Dr. A212
CITY/COMMUI ITY/STATE/ZI P
Palm Springs, CA 92262,
PHONE LICNC
323-7877
USE OF PERMIT ,.
Single Family Dwelling
BL
ZON,
FSB
SSB
SSB I
Rse
OFC
ZONE ORD .
LOT SZ
END
SIDE
Print Applicant/Agent Name 00150
1
APPL/PRMT= I W r I M 11 DATE '
i 5-2�=85 S.F.D.
Permit to construct 1247 sq. ft. of
living area and 433 sq. ft. of garage
as Per a roved lans.
h. Fee 37.00
Plan Check Fee 307.96
Const. Fee 367.00
Elect, Fee 60.18
SMI Fee 5.46
.PluffbiW Fee 85.00
Tnfrastnxture
862.60
105.72 DEP. PAID
756.88
*DeftmrrM pa=mt as = a eemint
t De t
TOTAL
FEE
862.60
H 1 L 1 7. 7 L
FINANCE
/7688 CK
VALUATION 77,948.00