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001495 (SATT)r • ii Ij 4 P.O. BOX 1504 No. 001495 Address 78-105 79-335 - LA QUINTACCALIFORNIA92253 Address ' Owner _ magg=M$ Corp. BUILDING:'TYPE CONST. V E OCC. GRP. Mailing Address 1601 Rim St. Snag 27k'10 A.P. Number City Zip Tel. - Legal Description Contractor. Project Description ;kwi=m �I1 W ails _ Address.. - .. # R.aidM*A*1 13911111al. .-. City Zip. - Tel. -92053 Distances: Nest=.-... 340-55n Side Street Setback from Center Line State Lic. City MM1247 FINAL DATE & Classif. Lic. # Sq. Ft. No. No. Dw. Size Stories Units Arch., Engr.; Designer V ti l .EXICiM AMOCID New Egg Add ❑ Alter ❑� ' Repair ❑ Demolition ❑ Address Tel. . ftrzv- , St— 323-7877. _ City�� State - P. wn lZip . 92262 Lic. # y • • _ �UCEN$ED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of thle Business and Professions Code, and my license is in full force and r effect _SIGNATURE •�:,✓ r / r C'- .•[ ' .r J i • ,/ / f DATE ' OWNER -BUILDER DECLARATION Estimated Valuation I hereby affirm that I am exempt from the Contractor's License Law for the following 77P948.00 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 signedstatement that he is licensed pursuant to PERMIT. - AMOUNT ' •i• the provisions of the Contractor's License Law, Chapter.9 (commencing with Section 7000) of •r ._ Division 3 of the Business and Professions Code, or thabheis•'exernpl therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit. PlanChk. Dep. 105y.72 subjects the applicant to a civil penalty of not more than'live hundred dollars ($500). Plan ChkBal 24 01 1 I, as owner o 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, Suisness and Professions • • Const. Gf • � � - 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,• ••Meeh.. • - ' 3 • provided that such improvements are not, intended or offered for sale. If, .however, the building j •00 _ or Improvement is sold within one year of completion, the owner -builder will have the burden ' Electrical 60.18 A 8 ., 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 5•iJ 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.1.• 46 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 Defe=ed mt as age 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 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 California. Date Owner NOTICE TO APPLICANT. If, after making this Certificate of Exemptionyou 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 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 city to enter the .above-' mentioned property for inspection purposes. Signature of applicant �! l —Date Mailing Address =� ' City, State, Zip HARD COPY TOTAL 862.450 756.8E REMARKS ZON E: 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: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ 2ND FL. S0. FT. POR. SO. FT. ® GAR. SO, FT. @ CAR P. S0. 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.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APPJEOUIP. LAUNDRY TRAY 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. SO. FT. ® c BATH TUB SO. FT. ®c IWATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR ® 3/.c 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 APPJEOUIP. 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 APPLICATION City o1 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 LICENSED CONTRACTORS DECLARATION: 1 hereby affirm that I am licensed under provisions o1 Chapter 9 the permit is for one hundred ($100) o. less. l certify that In the performance of the work for which this permit is -(commencing with Section 7001)) of Division 3 of the Business and Professions Code. and my license is in full force issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of and effect. California. License Class Lic. Number Date Applicant Date Contractor NOTICE TO APPLICANT: It. after making this Certificate of Exemption, you should become subject to the Workers' OWNER -BUILDER DECLARATION: 1 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 -following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to be deemed revoked. 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 which a 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 32, 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 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the 0 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. 7004, 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 of property who builds, or improves thereon, and who does such work himself or 0 Division of Industrial Safety Permit No. through his own employees. provided that such improvements are not intended or offered for sale. If, however, the ADDRESS 340 S. Farrell Dr. A212 building orimprovemntissold within one year ofcompletion. theowner-builder will have the 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 0 I, as owner of the property, am exculsively contracting with licensed contractors to construct the project (Sec. o1 the work for which this permit is issued (Sec. 3097, Civ. Q. 7004. Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Lender's Name builds or improves thereon, and who contracts for such projects with a contractors) licensed pursuant to the SS13 Contractor's License Law.). Lender's Address 0 1 am exempt under Sec. B. 8 P.C. (Attached Certificate). I certify 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: 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. 3800. Lab. C.). Signature of Applicant or Agent Date Policy No. Company CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have read this application and state that 0 Certified copy is hereby furnished. the information given is correct.) agree to comply with all state laws and county ordinances relating to buldling 0 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 I have applied for this permit for the purpose of making inspections. Daie Applicant Signature of Applicant or Agent Date APPLICANT NAME (L, F. MI) JL Cjonstruction ADDRESS P.O. Box 173, C1TY/COMMUNITY/STATE/ZIP Nestor; CA 92053 JOB SITE ADDRESS/SPACE 11 CITY/COMMUNITY/STATE/ZIP La. to CA 92253 am PAG PRC C WT Fee 5.46 T" RNG SE S TRACT 19903 I LOT with OmmmitzZ t Department MOD I SB TRACT NAME HORIZON PA,I,MS OWNER NAME IL F. MI) G�11C/ al M.emmt Corp. CONTRACTOR -FIRM NAME J.L. Construction ADDRESS above CITY/COMMUN ITY/STATUZI P PHONE • LICNC ARC/ENG FIRM NAME Michael Buccino Assoc. ADDRESS 340 S. Farrell Dr. A212 CITY/COMMUNITY/STATE/ZIP Palm Springs. CA 92262 PHONE • LICNC • 323-7877 USE OF PERMIT ' Single Family Dwelling BL ZON.FSS SS13 SSB RSB DEC NE OR ZOD LOT SZ END SIDE Print Applicant/Agent Name flml9 APPL"MT DATE 5-2.2 S:F.D. Permit to construct 1247 sq. ft. of living area and 433 sq. ft. of gaage as per approved plans. mech. Fee 37.00 Plan Check Fee 307.96 Const. Fee 367.00 Elect, Em 60.18 WT Fee 5.46 Fee 85.00 —.21urrbing Infrastructure 862.60 105.72 DEP. PAID 756.88 * ggreentint with OmmmitzZ t Department TOTAL : FEE 862.60 H 1 L 1 D D z S 7 5br 8 8 CK FINANCE VALUATION F77,948.00 '