001489 (SFD)44Q
��ff P.O. BOX 1504
DO
Addyjng ?9,391 H=� MIM C 18 LA.QUINOTACCALIFORNIAALLE 92253
Address .
Owner -
No. 001489
HARD COPY
BUILDING: TYPE CONST:
V N OCC: GRP. R• 3
Mailing
Address 101Aieasc*_ Ali M
A.P. Number
City Zip
Tel.
AN
Legal Legal Description
Description
Horizim •
146 Units Best iii.. .
Contra ctorProject
Address
P.O. I: 193
City _
Zip ...
Tel.
Maw
9'2Q�
340 -551i,
State Lic.
& Classif.LiC.
42 22
City
#
23? - - -- -
Sq. Ft: 1247
Sizer f= W-41
No. No. Dw.
Stories Units -
Arch., Engr:;
DesignerNew
Michael.im AEtIgw.
,0 Add ❑
Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
�Qf4 rfrussll
323-74377..
_
CityJZip
State
d ii
9226
Lic. #
K +.
T
-
_ LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I�am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of theBusinessand Professions Code; and my license in full force nd
-effect..✓( 1
SIGNATURE `-• r t ""- / - / DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law .for the following.'r!'f
reason: (Sec. 7031..5,Business and Professions Code: Any city or county which.,requires a .
pirmit 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 exeinpt 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 ($500). •' -..
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 orthrough 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
- -
PERMIT
-- AMOUNT
^ ^ '
• t
Plan Chk. Dep.=
�#1-05.72is"
Plan Chk: Bal.
202..24
COf1St. '
.00
Mech.
00
39
Electrical '{}.�
19
Plumbing
�rJ .130
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con-
- strucl- 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 contractors) licensed pursuant to the Contractor's License Law.)
O I am exempt under Sec. B. & P.C. for this reason
S.M.I.
-
15 444;
Grading
Driveway Enc.
-
Date owner
Infrastructure
DrafetTed Pavviia as $ GWt
*.th 02W_ DWA.. Directtw
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 - a
❑ Copy is, filed with the city: ❑ Certified copy is hereby furnished. .'
TOTAL
• .
REMARKS
CERTIFICATE OF EXEMPTION FROM
INSURANCE
(This
(This section need not be completed if the permit Is for one hundred dollars ($100) valuation
-or less.) ..
certify that in the performance of thg 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.
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop..Line
CONSTRUCTION LENDING AGENCY
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
FINAL DATE'
INSPECTOR
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.
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. f//
Signature of applicantl7 !1r 1 ! . - Date~
Mailing Address r r
Issued by:
Validated by:
Validation:
Date - Permit
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
2ND FL. SO. FT.
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.000L HOOD
SIGN
WASH ER(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
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/e c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
REMARKS:
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
OK'5 51GNAI UHE511NITIAL5
GARDEN WALL FINAL
LICENSED CONTRACTORS DECLARATI
(commencing with Section 7000) of Divi
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 Contractor's license Law
(Chapter 9 (commencing with section 7000) o1 Division 3 of the Business and Professions Code) or that he is exempt
therefrom and the basis for the alleged exemption. Any violation o1 Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500.):
0 1, as owner o1 the property, or my employees with wages as Meir sole compensation, will do the work, and the
structure is rat intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors 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.).
0 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.).
0 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 o1 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
PERMIT APPLICATION
City of La Quinta
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.
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be completed it
ON: 1 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
sion 3 o1 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
California.
APPLICANT NAME (L. F. MI)JL(bnstniction
L
CRY/COMAIUNITY/STAT IM
Nestor; CA 92053
JOB SITE AOORESS/SPACE
f"
BOK
LICENSED CONTRACTORS DECLARATI
(commencing with Section 7000) of Divi
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 Contractor's license Law
(Chapter 9 (commencing with section 7000) o1 Division 3 of the Business and Professions Code) or that he is exempt
therefrom and the basis for the alleged exemption. Any violation o1 Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500.):
0 1, as owner o1 the property, or my employees with wages as Meir sole compensation, will do the work, and the
structure is rat intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors 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.).
0 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.).
0 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 o1 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
PERMIT APPLICATION
City of La Quinta
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.
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be completed it
ON: 1 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
sion 3 o1 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
California.
APPLICANT NAME (L. F. MI)JL(bnstniction
ADDRESS
P.O. Box 173
CRY/COMAIUNITY/STAT IM
Nestor; CA 92053
JOB SITE AOORESS/SPACE
CITT/COMALINITY/STATE/ZIP-
La. to CA 92253
BOK
PAG
PRC
C
TNM
RHO
SE
S
TRACT
19903
LOT
Elect. Fee
60.18
MOO
SB
.Plurrbina Fee
TRACT NAME
HORIZON PALMS
OWNER NAME (L. F. MI) Gwieral Management Corp • '
CONTRACTOR -FIRM NAME "
J.L. Construction
ADDRESS
above
CITY/COMMUNITY/STATE/ZIP
PHONE .
105.72 DEP. PAID
LIDHC .
756.88
ARC/ENO FIRM NAME
Michael Buccino Assoc.
ADORM
340 S. Farrell Dr. A212
CITY/COMMUNITY/STATE/ZIP
Palm Sorinas, CA 92262
PHONE . LICNC a
323-7877
USE OF PERMIT '
Single FamilyDwelling`
Bl
TOTAL .
'FEE -
ZON,
-FSB
SSB
SSB
RSB
OFC
ZONE ORD a
LOT SZ
END
SIDE
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:
0 1 hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, w it l 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 32, Grp 2. Art 2, Sec 341, Title B,
C.A.C.)
0 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.
0 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-mentioned 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 Date
Print Applicant/Agent Name 0 Q (� [��
APPL/PRMT -
i '-,
DATE.2
5-2S.F.D.
Permit to construct
1247 sq. ft. of
livin area and 433
. ft. of age
as r a roved plans.
nech. Fee
37.00
Plan Check Fee
307.96
Const. Fee
367.00
Elect. Fee
60.18
,Zff Fee
5.46
.Plurrbina Fee
85.00
Infrastructure
862.60
105.72 DEP. PAID
756.88
*
a e�nt
with rimmmity
t De t
TOTAL .
'FEE -
.60
/i1 L U / / 5b8 8 CK
'•CTNeMec VALUATION 77,948.00