001430 (SATT)Building
Address
Owner
Mailing
Address
City
Contractor
P.O. BOX 1504
78-105 CALLE ESTADO
79-375 Itl== FalM C' I&A QUINTA„CALIF,ORNIA 92253•
No. 001430
BUILDING: TYPE CONST. OCC: GRP. R 3
St. Saite 2700 A.P. Number
Zip Tel.
1,0o0a'"361,.50 4 Legal Description
Project Description H=iAm P .
Aaaress... - , . .... .
P.O. BMC 173
. City .. .., JZip 9Tel.. .. .. -
2 3 340u"7511
State Lic. City
& Classif. 442$2 Lic. # 237_
Designer _
a
Address Tel.
..... 340 S. VatTmU Dr. 323-7677....”.
City Zip State -
p .: 33 32262 -, .Lic: # .
-, LICENSED CONTRACTOR'S DECLARATION
I hereby affirm'thatil am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division �3 of. the Business and Professions Code; and my licenseris%in full3force:and�-
effect. Ih.�:)
SIGNATURE Or DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. .703 1.5, 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 eierript 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).' — ' ' . .
4..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 oroffered_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.) - -
❑ I, as owner -of the property, am exclusively contracting with licensed contractors to con -
Sq. Ft. ME 1247
e� No.
Size -Tl-„ 4333 Stories
New= Add ❑ Alter ❑
No. Dw.
Units
Repair ❑-
Lstlmatea valuation
&.77,948.00
PERMIT -
Plan Chk. Deo'.
Plan Chk. Bal..
Const.'
Mech.
Electrical
Plumbing
struct the project. (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 contracts for S.M.1. .
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
O I am exempt under Sec. B. & P.C. for -this 'reason - 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. .
_ TOTAL
CERTIFICATE OF EXEMPTION FROM
WORKERS'. COMPENSATION 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.
REMARKS
Demolition ❑
AMOUNT
202.E
.367.00',
.37
367.00-
.37 ,Af
85.00.
5.46
���yy gY,�
ev .:.i.. �,i3.G i,,,at
a e Owner
NOTICE TO APPLICANT. If, after making this Certificate of Exemption you should become
'the
ZONE:
BY:
'subject to Workers'* Compensation provisions of the 'Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
,
Minimum Setback Distances:
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
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.
Issued by:
Date Permit
1 agree to comply with ali,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. �
✓
-_Valibated by:
Signature of applicant ! ivy �f �f !d i , : Date -1/ `' — 4
Mailing Address r
Validation:
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SQ. FT. @
CARP. 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 APP.IEQUIP.
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.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1+/. 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
INSULATIONISOUND
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
OWNE"UILDER DECLARATION: I hereby affirm that 1 am exempt from the Contractors 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 life a signed statement that he is licensed pursuant to the provisions of the Contractor's license Law
(Chapter 9 (commencing with sect ion 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.):
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, 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 Me purpose of sale.).
❑ 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 not apply to an owner of property who
builps or improves thereon, and who contracts for such projects with a contractors) licensed pursuant to the
Contractor's License Law.).
O 1 am exempt under Sec. B. & 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.
❑ Certified copy is filed with the City Building Inspection Department or City Department.
Date Applicant
PERMIT APPLICATION
City of La Ouinta
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'COMPENSATIONINSURANCE: This section need not be completed if
ON: 1 hereby affirm that I am licensed under provisions of Chapter 9 the permit is for one hundred ($100) o, less. l 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 as to become subject to the Workers'Compensation Laws of
California.
APPLICANT NAME (L. F. MO JL Onnstruction
ilii l� r.,1 til. t../
ADDRESS
P.O. Box 173
cITY/COMMUNITY/STATE/ZIP
Nestor, CA 92053
JOB SITE ADORECSWACE
CITY/CAiM1UNITY/STATE/ZIP .
La. to CA 92253
19M
PAG
PRC
c
mech. Fee 37.00
TWN
FIND
SE
s
TRACT
19903
LOT"ZA
EM Fee 5.46
Y00
SB
TRACT NAME
HORIZON PAIMS
OWNER NAME (L. F. MI) General Management Corp. '
CONTRACTOR -FIRM NAME
J.L. Construction
ADDRESS
abmm
CITY/COeM1UNITY/STATE/ZI P
PHONE a
.
LICNC .
t Department
ARGENO FIRM NAME
Michael Buccino Assoc.
ADDRESS
340 S. Farrell Dr. A212
CITY/COMMUNITII/STATEIZI P
Palm rim s CA 92262
PHONE • LICNC
323--7877
USE OF PERMIT
Single FamilyM11in
BL
ZON,
FSB
SSB
SSB
RSB
OFC
ZONE ORD a
LOT SZ
END
SIDE
Date Applicant
NOTICE TO APPLICANT: 11, 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 32, 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.
gate 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: 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 buldling
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
APPL/PRMT
y DATE
22-85
S:F.D.
Permit to construct 1247 sq. ft.
of
livingarea and 433 . ft. of
age
as approved plans.
mech. Fee 37.00
Plan Check Fee 307.96
Const. Fee 367.00
Elect- Fee 60.18
EM Fee 5.46
Plurrbing Fee 85.00
862.60
105.72 DEP. PAID
756.88
* a eem�nt
t Department
TOTAL •
FEE
862.60
h 1 1 4 0 L� X5&88 CK
FINANCE VALUATION 77, 948.00