001491 (SATT).44
P.O. BOX 1504
No.. 001491
Building 78-105 CALLE ESTADO
Address 79—_151 HW! Pal= Ct=le LA QUINTA, CALIFORNIA 92253
-+... .. e .
�. AS�iiccl� . ...
Mailing
Address TIMM_ In, ;in a Pqni a '>7
City Zip ��,�� Tel.
1-800-367-5054
-
Contractor
49t. 00hitrucRiYf
Address
P.O.
.City Zip .Tel. 4f
92053 34 6 -.551
BUIL'DING:'.TYPE CONST. V X -OCC. GRP. - R 3
A.P. Number
Legal Description
Project Description k7rir . ft, 14'.
-
1:46 'T3t-n. Wagideftial Rimm .
State Lic.
City -
1247
& Classif. •
Lic. # 2-17
Sq. Ft.
4M.
No. No. Dw.
- Arch:, Engr.; -' -
Size..
Stories Units
Designer � B=1W ASSOC.
New ® Add ❑
Alter ❑ Repair ❑ Demolition.❑
Address .
Tel.j�p�y
construction, and hereby authorize representatives of this city to enter the above -
+�� itss ��yy
•Lam. _ 340 • S. n St. �
323-29I f� . _ .. -
-
' City..
Zip
State
-
_ ..�A. $A[Z°3
-t}22ra2
Lic. # .
LICENSED CONTRACTOR'S DECLABATJON
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.
SIGNATURE 6-. 8 y !' Y - DATE
-
-OWNER-BUILDER DECLARATION
Estimated VBIUatIOn
Estimated
Y
I hereby affirm that I am exempt from the Contractor's License Law for the following
77*948.00
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which' requires ''a
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 that. he is exempt therefrom, .and the !iasis
for the alleged exemption. Any violation of Section 7031:5 by. 'any applicant for a permit'.
Plan Chk. Dep.`-
'
- ..105.v72
'subjects the applicant to a civil penalty of not more than five hundred dollars ($500).-
Plan ChkBBI
�, 7{%.
❑ 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 The Contractor's.
. .
Const.
•�
Code: 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_thatsuch improvements are not intended or, offered for sale.. If, however, the -building -
M@CII.
or improvement is sold within one year or completion, the owner -builder will have, the burden
Electrical
of proving that he did not build or improve for the, purpose of sale.)•
0 I, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing'5.��
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.
S.M,I,
>
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
lei&
vwo!h nowl,"
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.
TOTAL
_
CERTIFICATE OF EXEMPTION FROMREMARKS
WORKERS' COMPENSATION INSURANCE 'S
(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.
Dt -_
a e Owner .
NOTICE TO APPLICANT: If, after making this Certificate or Exemption you should become ZONE: BY:
subject to the Workers' 'Compensation provisions of the Labor Code, you must forthwith Minimum Setback Distances:
comply with such provisions or this permit shall be deemed revoked. '
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 is a building permit when properly filled out, signed and validated, and is subject to
FINAL DATE INSPECTOR
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 -
me . ntioned property for inspection purposes. f _
Validated by:
Signature of applicant �� 1 r! ' Date
Mailing Address r /
Validation:
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. 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 APPJEOUIP.
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 ® 11/4 c
SEWAGE DISPOSAL
SQ.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
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
PERMIT APPLICATION
City of La Oulnta
Department of Building and Safety
This permit becomes void i1 work not commenced within 180 days from date of issuance. OR, if work has been suspended or abandoned for a period of 180 days.
LICENSED CONTRACTORS DECLARATION: 1 hereby affirm that I am licensed under provisions of Chapter 9
(commencing with Section 7000) of Division 3 o1 the Business and Professions Code. and my license is in full force
and effect.
License Class Lic. Number
Dale 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, 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 the provisions of the Contractors 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 penalty o1 not more than five hundred dollars (5500.):
O 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, 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 riot 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.).
D 1 am exempt under Sec. B. 6 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. 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 Construction
ADDRESS
P.O. Box 173
CI TY/COMMUN I TY/STATE/ZI P
Nestor; CA 92053
JOB SITE ADDRESS/SPACE
CITY/COMMUNITY/STATE/ZIP
La . QlAmta CA 92253
BOK
PAG
PRCc
sm Fee 5.46
.Plimbin- Fee 85.00
TWN
RINGSE
105.72 DEP. PAID
S
CT
LOT
r-
TOTAL .
FEE
862.60
aB
19903
30-
T1m000
TRACT NAME HORIZON PALMS
OWNER NAME (L. F. MI) General Management Corp. '
CONTRACTOWFIRM NAME
J. L. Construction
ADDRESS
above
CITY/COW UNITY/STATE/ZIP
abipm
PHONE a
LICNC e
ARC/ENO FIRM NAME
Michael Buccino Assoc.
ADDRESS
340 S. Farrell Dr. A212
Cff YCOMMUNITY/STATVZIP
Palm Springs. CA 92262
PHONE . LIC14C .
323-7877 I
USE OF PERMIT '
Single Family Dwellin
L
"71
ZON,
FSB
SSa
SSB
RSB
OFC
ZONE ORD .
LOT SZ
END
SIDE
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be completed it
the permit is for one hundred (S1D0) o. less.) certify that in the performance of the work for which this permit is
issued,) 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 3.2. Grp 2, Art 2, Sec 341, Title 8,
C.A.C.)
O As owner -builder, 1 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.
❑ Division of Industrial Safety Permit No.
Date Applicant
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance
o1 the work for which this permit is issued (Sec. 3097, 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-tnentioned 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
Print Applicant/Agent Name Do } y 9
Date
APPL/PRMT :.. A f%DATE 2-2-85 S.F.D.
._
Permit to construct 1247 sq. ft. of
living area and 433 sq. ft. of garage
as per approved plans.
mech. Fee 37.00
Plan Check Fee 307.96
Const. Fee 367.00
F -lent. Fee 60.18
sm Fee 5.46
.Plimbin- Fee 85.00
Infraqtnxture
862.60
105.72 DEP. PAID
756.88
*neflarred pa=mt as = gqremtnt
with chammity t De t
TOTAL .
FEE
862.60
AlZUY 5 23 - 75&88 CK
FINANCE VALUATION 77,948.00