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001492 (SATT)P.O. BOX 1504 No. 001492 Building78-105 CALLE ESTADO �.� )( Address LA QUINTA, CALIFORNIA 92253 Owner Mailing Address City .Contractor _ Address GMIMMI ftragamo COW. , BUILDING: TYPE CONST. • y N OCC. GRP. -LZ 3 p 2700 A.P. Number Tel. ,00_367,6 Legal Description Project Description HOMIZOn PC%I= 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 O Copy is filed with.the city...❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COM PENSATI ON 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 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 - r 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 it work thereunder is suspended for 180 days. ' I cartify'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,pu}rposes. Signature of applicant/ ` �/ " r' ,r Da e., "I f Mailing Address / City, State, Zip HARD COPY TOTAL i3> . Eii 756.a8 REMARKS ZO N 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: City .. _ zip-•- Tela 92 333 340n-554 . State Lic. City Mks 12A7 & Classif.Lic. � # 237 Sq. Ft. �� 41 No. No. Dw. Size Stories Units Arch., Engr., - Designer Higbmil BWCiM AMC- New:X Add ❑ Alter ❑, Repair ❑ Demdition ❑ Address Tel. .340-S. � 1.ft. 323--78r, .. . City Zip State alt �� 92 Lic. # w . 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 ism full force and •� effect.. SIGNATURE DATE ' OWNER -BUILDER DECLARATION ' I hereby affirm that I am exempt from the Contractor's License Law for the following Estimated Valuation Estimated - 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 Isalso requires the applicant for such permit to file a signed statement that he is licensed pursuant to PERMIT - •..i ' AMOUNT . the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of 'c . •'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 Plan Chk. Dep. -V. 'subjects the applicant to a civil penalty of not more than five hundred dollars ($500). " '•. •'�' I, Plan Chk• Bal. ��f}�j 2o2.24 ❑ 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 . C011St. ' Q 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, - Mech. ' e��} 37.00 provided that such. improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, theowner-builder will have the burden ' of proving that he did not build or improve for the purpose of sale.) • - Electrical .�:►8� -❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbingi�. - 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..w . such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) •- Grading 0 1 am exempt under Sec. B. & P.C. for this reason Driveway Enc. Date Owner Infrastructure Deffwivid mvix as a=eem` 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 O Copy is filed with.the city...❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COM PENSATI ON 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 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 - r 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 it work thereunder is suspended for 180 days. ' I cartify'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,pu}rposes. Signature of applicant/ ` �/ " r' ,r Da e., "I f Mailing Address / City, State, Zip HARD COPY TOTAL i3> . Eii 756.a8 REMARKS ZO N 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. SQ. FT. POR. SQ. FT. ® GAR. SO. FT. ® CARP. SQ. FT. WALL SO. 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 APP.IEQUIP. 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 SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID @ 1114 c SEWAGE DISPOSAL SQ.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.IEQUIP. 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 INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL s fr PERMIT APPLICATION City o1 La Duinta 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' COMPENSATION INSURANCE: This section need not be completed it LICENSED CONTRACTORS DECLARATION: 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 (commencing with Section 7000) of Division 3 of the Business and Professions Code. and my license is in full force - Issued. I shall not employ any person inany manner so asto become subject lothe Workers'Compensation Laws of and effect. California. License Class Lic. Number Date Applicant Date Contractor NOTICE TO APPLICANT: If, after making this Certifirate 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 19903 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 Contra ctor'sLicense 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 3 o1 the Business and Professions Code) orthat he is exempt made in connection with work authorized by this permit, and that no building structure, scaffolding, lalsework, 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, Sec341, Title 8. subjects the applicant to a civil penalty of not more than five hundred dollars ($50(k): C.A.C.) O I, as owner of the property, or my employees with wages as their 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 o1 structure is not intended or offered for safe (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 of property who builds, or improves thereon, and who does such work himself or ARC/ENO FIRM NAME ' Michael Buccino Assoc. 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 oneyearofcompletion. theowner-builder will have the burden of proving that Date Applicant he did not build or improve for the purpose of sale.). CONSTRUCTION LENDING AGENCY: 1 hereby affirm that there is a construction lending agency for the performance O 1, as owner of 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. 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 LOT SZ 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 END 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 l have read this application and state that O Certified copy is hereby furnished. the information given is correct. l agree to comply with all state laws and county ordinances relating to buidling . O 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. Date Applicant APPLICANT NAME (L. F. MI) JL Gnnstruction ADDRESS P.O. Box 173 CITYICOMMLNIITY/STATE/ZIP Nestor; CA 92053 JOB SITE ADDRESS/SPACE CITY/COM/LINITY/STATERIP La. to CA 92253 BOK I PAG PRC I C TWN RNG SE s 19903 LD� 60.18 MDD CM F01P 5.46. TRACT NAME HORIZON PAINTS OWNER NAME (L. F. MI) Ganeral Managenent Corp. ' CONTRACTOR -FIRM NAME . J.L. Construction ADDRESS above CITY/COMMLIN ITY/STATE/ZI P PHONE . 105.72 DEP. PAID LICNC . ARC/ENO FIRM NAME ' Michael Buccino Assoc. ADDRESS 340 S. Farrell Dr. A212 CITYICOMM LIN I TY/STATE/ZI P Palmrin s CA 92262 PHONE I I LICNC 323-7877 USE OF PERMIT ' Single Familv Dwelling BL 862 60 ZONA FSB SSB SSB RSB OFC ZONE ORD • LOT SZ END SIDE Signature of Applicant or Agent Print Applicant/Agent Name 6 0 I-11,251 Date APP MT +; DATE S.-F.D. Permit to construct 1247 sq. ft. of livinct area and 433 sq. ft. of gaage as pgK approved plans. Mech. Fee 37.00 Plan Check Fee 307.96 Const. Fee 367.00 60.18 CM F01P 5.46. .P11 Fee 85.00 Tnfrastructure 862.60 105.72 DEP. PAID .756.88 * ggreemignt t Deparftnent TOTAL • FEE 862 60 H 1 L l U 7 L 7 / j Q 6 8 CK CINAN[ F VALUATION 77,948.00.