001445 (SATT)P.O. BOX 1504
Building79.353 � ,.M � 78-105 CALLS
Address SLA QUINTAL CALIFORNIAORNIA 92253
No. 00.445
Owner _ .. .
J
Mailing
Address I Tka `, _Ond#sn 3711 C
City Zip t/+�1(j Tel.
Ir S%1.367 -5054t
Contractor
J.L.
Address _
BUILDING: TYPE CONST. V 2;
A.P. Number
Legal Description
Project Description -Railzim Palm
.1.46 Wt8
OCC: GRP.
R 3
p
' City ..
Nestor
Zip
32053
Tel. -
340'551.
ZONE:
BY:
State Lic.
& Classif. 422
City
Lic. #
q . V� 1247
S . Ft.
Size. • -CM 433
No. No. Dw.
Stories Units
. Arch.,-Engr:, - .. ,..
DesignerNew:W
Add ❑
Alter ❑ Repair ❑ Demolition ❑
Address
340• S. Farze
Tel.
_' 323�i77.
FINAL DATE
City
Palm i
Zip
�'��'
State
Lic. #
Validated by:
Validation:
_ LICENSED CONTRACTOI, s DECLARATION _
• I hereby affirm,th'gt I+am licensed under provisions of Chapter 9 (commencing with Section
70 00) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.�-7 a
_
_SIGNATURE %' d - f J X DATE
' OWNERsBUILDER DECLARATION r
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 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 (8500). • ' • . . •
• ❑. , 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,nol 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 /or the purpose of sale.)
❑ 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 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. 8 P.C.-for this reason
Estimated Valuation
• -..;PERMIT -
«-
AMOUNT
Plan Chk: Dep.
-
'
Plan Chk. Bal.
-
Const.
Mech. -
-
Electrical
-
.
PlumbingAqJ1�.
S.M.I.
_ ._ .
-
Grading
Driveway Enc.
Date Owner
Infrastructure
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 (8100) 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 or 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 whic
work for chthis 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/,pyurpose s.
Signature of applicant Date �
Mailing Address
City, State, Zip f
HARD COPY
uo# t t �S> tPl�it tia IN xr^t r
TOTAL 862AU
REMARKS
h
ZONE:
BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
SideStreet 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
1ST FL. SO. FT. ® $
2ND FL. SQ. FT. ®
POR. SO. FT. ®
GAR. Sp, FT, ®
CAR P. Sp. FT.
WALL SO. FT. ®
Sp 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.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
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.
SO. FT. RESID ® 11/. c
SEWAGE DISPOSAL
SQ.FT.GAR ® Y4c
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 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
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
LICENSED CONTRACTORS DECLARATI
(commencing with Section 7000) of Divi
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, 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 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 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, Business and Professions Code: The Contractor's License
Law does not apply to an owner o1 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 improvemni 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.
7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who
builQs 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. 8. 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. C.).
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
PERMIT APPLICATION
City of La Duinta
Department of Building and Safety
This permit becomes void if work not commenced within 180 days from date of Issuance. OR, It work has been suspended or abandoned for a period o1 180 days.
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be completed if
ON: 1 hereby affirm that 1 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
sion 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 asto become subject tothe Workers' Compensation Laws o1
California.
APPLICANT NAME (L. F. MI)JLConstruction
ADDRESS
P.O. Box 173
CITY/COMMUNITY/STATE/ZIP
Nestor; CA 92053
JOB SITE ADORESS/SPACEMMU
CITY/COeNITY/STATE/ZIP - -
La. to CA 92253
BOK
PAG
PRC
C
T"
RNG
SE
S
TRACT
19903
LOT
00
Elect, Fee 60.18
MOD
SB
.Plumbin- Fee 85.00
TRACT NAME
HORIZON PALMS
NAME ME (L, F. MI) Ganeral Management Corp. '
CONTRACTOR -FIRM NAME
J.L. Construction
ADDRESS
above
CITY/COMMUNITY/STATE/ZIP
PHONE •
756.88
LICHC e
.
ARC/ENG FIRM NAME
Michael Buccino Assoc.
ADDRESS
340 S. Farrell Dr. A212
CIT V ICOMMUNITY/STATE/ZIP
Palm rims CA 92262
PHONE LICNC e
323-7877
TOTAL •
'FEE
USE OF PERMIT
Sin le Famil Dwelling
BL
ZON,
FSB
SSB
SSB
RSB
OFC
ZONE ORD •
LOT SZ
END
SIDE
Date Applicant
NOTICE TO APPLICANT: It, 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:
❑ 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.)
❑ 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 airm 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 herebyauthorize 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. 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 /jn/ el9 4/
APPU"MT DATE '
5-2J2-85
S.F.D.
Permit to construct 1247 sq. ft.
of
livingarea and 433 . ft. of
age
as r approved plans.
mech. Fee 37.00
Plan Check Fee 307.96
Qori�t- Fee 367.00
Elect, Fee 60.18
WT Fee 5.46
.Plumbin- Fee 85.00
862.60
105.72 DEP. PAID
756.88
* a eefint
t Department
TOTAL •
'FEE
2.60
ti l L 1 L
FINANCE
VALUATION 77,948.00