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001446 (SATT)r. Building Address %9' Owner Mailing Address City Contractor . Address P.O. BOX 1504 No., 78-105 CALLE ESTADO riz= raln g CiXrle LA QUINTA, CALIFORNIA 92253 _ BUILDING: TYPE CONST. V.. N OCC: GRP. it 3 4r` s p- 27W A.P. Number Zip 5pc Tel. L 9203 .1,800-367-:5054, Legal Description ProjectDescriptionTkW Pal 3.xu�t3 $46 i'tS HARD COPY Zip TeL ftst= 92053 340-55n State Lic. & Classif. 442822 City Lic. # 237 Sq. Ft.r*r 1247 No. No. Dw. Size • I - 433 Stories Units . :Arch.; Engr., .. _ • Designers New ® Add ❑ Alter ❑ ' Repair ❑. Demolition ❑ Address Tel. City Zip State Palm -S�winqs -=2 Lic. # _. 'ti LICENSED CONTRACTOR'S DECLARATION Ahereby affirm that I'am licensed under provisions of Chapter 9 (commencing. with Section 00) of Division 3 of IHe BUsilness and Professions Code, and my license is in full force and - effect. y ' SIGNATURE DATE - 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 sthe provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of, "Division 3 o/ the Business'and Professions Code, or that he is exempt therefrom, and the basis ./or thealleged exemption. Any violation o/ Section 7031.5 by 'any applicant for a permit ' subjects the applicant to a civil penalty of not more than live -hundred dollars ($500). •• ' c 0 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- 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 X949.0 . 1. - - - PERMIT +•- - AMOUNT • Plan-Chk..Dep.' - 105.72. Plan Chk. Bal. 202.24 Const. , "`� r 001 ME'CII. �.}� 37.00, . Electrical ��..�yy. 6�r f.?CT ■�I Plumbing - 1�:■7 0"1, as owner of the property, am exclusively contracting with licensed contractors to con- struct -the project. (Seca 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 contractor(s) 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 nafe=ed onawl: an + aem=* with f 1ir't • I Dimbabl= 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.) a Policy No. ­ .Company ❑ Copy is filed, with the city. ❑ Certified copy.is hereby furnished. TOTAL- 262.60 '756.8': CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE REMARKS - (This section need not be completed it the permit is for one hundred dollars' ($100) valuation or less.)- - - .. certify that in the performance of tha work for which this permit is issued, 1 shall -not - employ any IF in any manner so as'to become subject to the' Workers' Compensation Laws of California. ._ I " 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 =- 1 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 Street Setback from Center Line 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 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. 1 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 therabove- mentioned property for inspectionn,'`purposes. , Signature of applicant �f.{ 7%� i M Date f 7 Issued by: - Date Permit Validated by: Mailing Address `r 7 f Validation: City, State, Zip r HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ 2ND FL. `� SO. FT. s POR. SO. FT. ® GAR. SO. FT. ® CARP. SO. 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.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER . GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT - WALL FLOOR SUSPENDED OTHER APP.IEOUIP. 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 WATER HEATER MAX. HEATER OUTPUT, B.T.U. ' SO. FT. RESID ® 11/a 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 ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IEOUIP. 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 Ouinta Department of Building and Safety This permit becomes void i1 work not commenced within 180 days from date o1 Issuance. OR, if work has been suspended or abandoned for a period of 180 days. LICENSED CONTRACTORS 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. License Class Lic: Number Date Contractor OWNER -BUILDER DECLARATION: 1 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 ($500.): 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 safe. 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 1, as owner of the property, am exculsively contracting with licensed contractors to construct the project (Sec. 7144. 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 contractor(s) licensed pursuant to the Contractor's License Law.). O 1 am exempt under Sec. B. 8 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. 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. Mil JL Construction ADDRESS P.O. Box 173 CITY/COMMtMITY/STATMIP Nestor, CA 92053 JOB SITE ADDRESS/SPACE U CITY/CO W LMITY/STATE/ZIP La. to M 92253 BOK I PAG PRC C Trifrastructure THIN I RNG SE S 1 03 1LOw TOTAL - FEE 86 I -OD TRACT NAME HORIZON PAIMS T OWNER NAME (L. F. MI) Gw eral Management Co CONTRACTOWFIRM NAME J.L. Construction ADDRESS above CITY/COMMLINITY/STATE/ZIP PHONE • LICNC • ARC/ENG FIRM NAME Michael Buccino Assoc. ADDRESS 340 S. Farrell Dr. A212 CITY/CO. MrMITY/STATE/ZIP Palm Sminas, CA 92262 PHONE . LICNC e 323-7877 1 USE OF PERMIT Single Farni1v Dwelling BL zow. FSB SSB SSB RSB OFC ZONE ORD a LOT SZ END SIDE CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATION INSURANCE: This section need not be completed if the permit is for one hundred ($100) o. less.) 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 live (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, 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. 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. 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=mentioned property for inspection purposes. Signature of Applicant or Agent Date CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: 1 certify I have read this application and state that the information given is correct. l 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 QO/ APPL/PRMT' t� DATE 2-2-85 S.F.D. Permit to construct 1247 sq. ft. of living area and 433 sq. ft. of gaage as ver appricived plans. Mech. Fee 37.00 Plan Check Fee 307.96 Const. Fee 367.00 Elect. Fee 60.18 cm Fee 5.46 .PlixTbing Fee 85.00 Trifrastructure 862.60 105.72 DEP. PAID 756.88 * a eemtnt t Departwnt TOTAL - FEE 86 3 5 23 75 FINANCE VALUATION 77, 948.00