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001499 (SATT)T 44 4h IOU P.O. BOX 1504 No. 001499 Building 78-105 CALLE ESTADO Address 79" 317 Ham. Fta= M=Je LA QUINTA, CALIFORNIA 92253 Owner _ [3ra11ei BUILDING: TYPE CONST. .SCC Q N OCC. -GRP." Mailing- Address ailing Address 1001 Bisbap St. Sidte 2700 A.P. Number CityZip Tel. 9683 Legal Description Contractor Project Description ... Address .. .. ...:.. A_()s PAW 1,311 -14 City Zip_ Tel.... ! . State Lic. City & Classif:�� � Lic. #� Sq. Ft.S 1247 No. No. Dw. Size. � "'433 • Stories Units Arch., Engr. - • . Designer ft=iW New a Add ❑ Alter ❑ Repair ❑o • Demolition ❑ Address . Tel. " 340 S, FarrQU St.... 323-7877 CityZip State , ... , ... h`rXr�i�xa�t >pk:,7s; Lic. # _ w LICENSED OONTRACTOR'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 .%' ! t✓' i i :_ .. r i} .. SIGNATUREDATE gWNER•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 fo construct, "alter, improve, demolish, or repair any structure, prior to Its issuance also the .arequires the applicant fon 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) of Division 3'of 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 penalty of not more than five hundred dollars ($500).. „ ❑ I, as owner of 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, Buisness 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 Estimated Valuation f� t�fqal S 7�71 949.W - PERMIT. - AMOUNT _a - Plan, Chk. Dep. 105.72 Chk' B. h �rf� s ' Plan al 202.24 Const. �� �{A lr . • Mech. «f1 �! " - 3 / ..00 Electrical - . orimprovement 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.) .MIA Plumbing �� ❑ 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 or property who builds or improves, thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) 0 I am exempt under .Sec. B. & P.C. for this reason S.M.I. Grading _ Driveway Enc. Date owner Infrastructure Defaximill vavmm v as aC.iY1t WORKERS' COMPENSATION DECLARATION With Com_ . ni:z+ " 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. TOTAL A62.60 756.RA REMARKS 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.) — - - 1 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. ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line 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. 3 09 7, Civil Code.) Side Street Setback from Center Line. Side Setback from Property Line Lender's Name Lenders 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: . FINAL DATE INSPECTOR I certify that I have read this application and state that -the above information is correct. 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. Signature of applicant h/ .t / ; / fr :. Date Mailing Address '� a r 1 Issued by: Date Permjt Validated by: Validation: City, State, Zip j HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ 2ND FL. SQ. FT. POR. SQ. FT. ® GAR. SQ. FT. ® CARP. 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.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APPJEQUIP. LAUNDRYTRAY AIR HANDLING UNIT CFM TEMP. POLE 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. SQ. FT. ® c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR ® 3/.c 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 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 INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL PERMIT APPUCATION 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 1180 days. LICENSED CONTRACTORS DECLARATION: 1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) o1 Division 3 of the Business and Professions Code, and my license Is In full force 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, after, 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 700) of Division 3 of 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 penalty of not more than five hundred dollars (5500.): O 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not Intended or offered for safe (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. It, 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.). O I, as owner of 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 o1 property who builds or improves mereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.). O 1 am exempt under Sec. B. d P.C. (Attached Certificate). Date Owner WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a Certificate of consent to self -insure, or a certificate of Workers' Compensation Insurance , or a certified copy thereof (Sec. 3100. Lab. Q. Policy No. Company O Certified copy is hereby furnished, O Certified copy is filed with the City Building Inspection Department or City Department. Date Applicant APPLICANT NAME (L. F. MI) JL Qxistx LL:t.1On ADDRESS P.O. Box 173 CITY/COMMUNITY/STATE/ZIP Nestor; CA 92053 JOB SITE ADDRESS/SPACE CITY1COMMUNITY/STATE/ZIP _ - La. to CA 92253 Bole PAG PRC C TMM RNo SE S 199 03 L%/ Plect. Fee 60.18 MoD sa .21imbing Fee 85.00 TRACT NAME HOMON PTT*RC . ilVi�N^M<L Va11Y tMan^� OWNER NAME (L. F. MI) �t1GJ. Management agement Corp. ' CONTRACTOR -FIRM NAME J.L. Construction ADDRESS ahicivie CRY/COMMUNITY/STATE/ZIP PHONE . 756.88 LICNC e * ggreeirifint ARC/ENO FIRM NAME Michael Buccino Assoc. ADDRESS 34.0 S. Farrell Dr. A212 CrTY/COMMUNITY/STATE/ZI P Palm Springs, CA 92262 PHONE • LICNC 0 - 323-7877 I I USE OF PERMIT ' S' le Family Dwelling BL ZON, FSB Sse Sse RSB OFC ZONE ORD / LOT SZ END SIDE k CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATIONINSURANCE: This section need not be completed it the Permit is for one hundred ($100) o, 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 California. 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: O 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 12, Grp 2 Art 2, Sec 341, 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. O 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 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 buidling construction, and authorize a' representative of 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 Lo n a APPUPRMT �.-' DATE ": == 5-2-2-85 S.F.D. Permit to construct 1247 sq. ft. of living area and 433 sq. ft. of Twaip as per approved plans. mech. Fee 37.00 Plan Check Fee 307.96 ClInst. Fee 367.00 Plect. Fee 60.18 .Mr Fee 5.46 .21imbing Fee 85.00 Tnfra e 862.60 105.72 DEP. PAID 756.88 * ggreeirifint t Department TOTAL • FEE 862.60 AIL1/ 5 Z3 75688 CK FINANCE VALUATION 77,948.00