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001487 (SATT)P.O. BOX 1504 Building Address 79-,389 B=izm Palm CircleLA QUINTA, CALIFORNIA 92253 Owner Mailing Address "01 City SMIDlUlU Contractor Address. _ Best= State Lic. & Classif.. 442822 Arch., Engr., - - Designer g ichia Address hop St.. Suite 2700 ' Zip ♦ .� � Tel. 1-780 P 92053 I Tel. Lic # 237 Tel. CityZip State 11 i, If No. 001 87 BUILDING: -TYPE CONST.- © N OCC. GRP. R 3 A:P. Number 36754 Legal Description Project Description H=izm Palm 145 Milts'�� moi. Sq. Ft. D' 1247 No. Size -g -Stories New -2 Add ❑ " Alter ❑' e T.-Al 226 Minimum Setback'Distances: .. LICENSED CONTRACTOR'S DECLARATION Front Setback from.Center Line I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 oftthe'Business and Professions Code, and my license is in>full'force and .. effect. //! l ./ � e l) A . _ ! _) (' SIGNATURE - '+- r - < - Y DATE - - " OWNER -BUILDER DECLARATION Estimated Valuation hereby affirm that I am exempt from the Contractor's License Law for the following Issued by: reason: (Sec. 7031.5,Business and Professions Code: Any city. or county which requires a Validated by: 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 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 basis • for the alleged exemption. Any Section 7031.5 by 'any for.a Plan Chk. Dep. violation of applicant permit. ' subjects the applicant to a civil penalty of not more than five hundred dollars ($500). - Plan Chk. Bal. - •_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, Buisness and COr1St. • 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, Mech. • •.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 Electrical of proving that he did not build or improve.for the purpose of sale.). ' Plumbing ❑ 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 S.W. . • such projects with a contractor(s) licensed pursuant to the Contractor's License Law.): Grading • O Lam exempt under Sec. B. 8 P.C. for this reason Driveway Enc. Date Owner WORKERS' COMPENSATION DECLARATION 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 Q Copy is filed with the city. O 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 (3100) valuation or less.) ' I 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. 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, 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 sof this city -to enter the above- mentioned property for inspection purposes. Signature ofapplicant f !!! jf�l 1 i Date r) Mailing Address City, State, Zip ' HARD COPY Infrastructure TOTAL REMARKS No. Dw. Units Repair ❑ Demolition ❑ ,. •e 7;948.00. . AMOUNT 105.72 n202.24 357. 0 37. 00 k0*0 5.46 Ott A. Dixec M. ZONE: BY: Minimum Setback'Distances: Front Setback from.Center Line Rear Setback from Rear Prop. Line Side Street 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 IST FL. SO. FT. ® $ 2ND FL. SQ. FT. POR. SO. Ff. ® GAR. SO. FT. ® CAR P. SQ. 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. SQ. FT. ® c BATH TUB SQ. Ff. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/. c SEWAGE DISPOSAL SO.Ff.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 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 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 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) of Division 3 of the Business and Professions Code) o r 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 (E500.): 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 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 safe.). 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 rat apply to an owner o1 property who builQs or Improves thereon, and who contracts for such projects with a contraclor(s) licensed pursuant to the Contractor's License law.). ❑ 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. O 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' COMPENSATION INSURANCE: This section need not be completed if ON: I 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 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 R, F, MI) JL Construction ADDRESS P.O. Box 173 CIMCOMMUNITY/STATEIZIP Nestor, CA 92053 JOB SITE ADOREaSISPACE 0000ft CITY/COM6AUNITY/STATE/ZIP La. to CA 92253 am PAG PRC C mech. Fee 37.00 TWN RHO sE S 19903 LOT C SW Fee 5.46 MoD se TRACT NAME HORIZON HORIZON PALMS OWNER NAME (L. F. MI) Gw eral Management Co CONTRACTOR -FIRM NAME J.L. Construction ADDRESS/C aboxte CITYOMAUNITY/STATE/ZIP ahpue PHONE • LICNC 4 with Chiminity t Department ARC/ENO FIRM NAME Michael Buccino Assoc. ADDRESS 340 S. Farrell Dr. A212 CITYMOMMUNITY/STAnalP Palm rin s CA 92262 PHONE • LICHC • 323-7877 USE OF PERMIT Single FamilyDwellin BL ZON, FSB SSB SSO RSB DEC ZONE ORD • 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: 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. An 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. O Division of Industrial Safety Permit No. Date 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 Ihave 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'represenlative 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 D O ) 4 3 ri Date /P APPLRMT _ DATE 5-2-2-85 S.F.D. Permit to construct 1247 sq. ft. of livin area and 433 . ft. of age as r approved plans. mech. Fee 37.00 Plan Check Fee 307.96 Const. Fee 367.00 E-1 ect. Fee 60.18 SW Fee 5.46 -PlurnbiW Fee 85.00 862.60 105.72 DF.P. PAID 756.88 * a ee�it with Chiminity t Department TOTAL 'FEE 862.60 h i L U 3 > [S 75688 CK FINANCE VALUATION 77,948.00