001485 (SATT)Bl Iding
Address
Owner
Mailing
Address
City
Contractor
Address.
T4'ht 4 4 Qu&ro
79-'397 11=MIm WW
01 &W= .f,. Suite 2700
Zip /"r t'1, 3 Tel.
3.L. CMWhUqt1=
P.O. B= 373
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
No. 001485
BUILDING: TYPE CONST.- V Vr, OCC. GRP. R 3
A.P. Number,
Legal Description
Project Description "art IDAI fm. ,
"Zip
"City' '- - �Vei�'
BY:
Tela
Front Setback from Center Line
152453
3460 -SM
Side Street Setback.from Center Line
State Lic.
City
1247
INSPECTOR
& Classif. 442822
Lic. # 237 w
Sq. Ft.
4R '433
No. No. Dw.
Arch:, Engr., -
Size
Stories Units
Designer michm3 DXCAW Asme..
New fl Add ❑
Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
. 340 S. - ill St.
323-787?
City
Zip
State
_ .,.-)d
. 922
Lic. # -
_„`LICENSED CONTRACTOR'S DECLARATION ,"ti_
hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section'
70 0) of Division 3 of the Business and Professions Code, and my license its inr,full forpce and
effect. 3 / / / - %i -/? i. - . . / J I
- SIGNATUDATE
=' OWNER -BUILDER DECLARATION-
Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following
7031.5,Business Any
reason: (Sec._ and Professions Code: city or county which _requires a$.77049.00
• 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
AMOUNT
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section .7000).of
•c
'Division3 of the Business ad Professions Code, or that. -he is exempt therefrom, and the basis
exemption. Any violation of S6clion 7031.5 by *any applicant for �-permil
Plan Chk. Dep.
d.i�.70 �wlleged
105.72
' • subjects -the applicant to a civil penalty of not more than five hundred dollars ($500).
❑ I, owner the
Plan Chk. Bal.
20 2_4
as of 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 -.property
Const.
Law does not apply to an owner of who .
builds or improves thereon and who does such work himself or -through his own employees,
that improvements intended
Mech.
7
provided such are not 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
or proving that he did.not.build.or Improve for the purpose of sale.)
❑ I, as owner of the property, am exclusively contracting wilh•licensed contractors to con-
Plumbing
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.M.1. -
AA
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) -
_
Grading
.11I•am exempt under. Sec.- - B. 8 P.C.-for this reason
Driveway Enc.
Date owner.
Infrastructure;.
#
WORKERS' COMPENSATION DECLARATION
hereby affirm that I have'a certificate of consent to self:insure, bra 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. ❑ Certified copy is hereby furnished....
TOTAL
00;7 Plq
• CERTIFICATE OF EXEMPTION FROM
REMARKS
'WORKERS' COMPENSATION INSURANCE
(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.
DM—'
a e 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
Ihereby 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 end validated,'and is subject to
expiration it 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 inspectioh/purpposes. tj
Signature of applicant �- /J �i�f F a If A • Date
Mailing Address
City, State, Zip
. HARD COPY
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
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SQ. 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 APPJEQUIP.
LAUNDRYTRAY
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 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 FEEPLUMB. 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
1 UK'J WUNA 1 UKtb11N1 I IALJ
GARDEN WALL FINAL
PERMIT APPLICATION
City o1 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 WORKERSTOMPENSATION INSURANCE: This section need not be completed if
LICENSED CONTRACTORS DECLARATION: 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
(commencing with Section 7000) o1 Division 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
and effect.
California.
License Class Lic. Number
Date Applicant
Date Contractor '
NOTICE TO APPLICANT: It, after making this Certificate of Exemption, you should become subject to the Workers'
OWNER -BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractor's License Law for the
Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall
be deemed revoked.
following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to .
S
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
such permit to file a signed statement that he is licensed pursuant to the provisions of the Contra ctorsLicense Law
01 hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be
(Chapter 9(commencing with section MOD) o1 Division 3 o1 the Business and Professions Code) or that he is exempt
made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or
therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap 3.2, Grp Z An 2, Sec341, Title 8.
subjects the applicant to a civil penalty of not more than five hundred dollars (5500.):
C.A.C.)
O 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the
❑ As owner -builder, I will,not employ anyone to do work which would require a permit from the Division of
structure is not intended or offered for sale (Sec. 7044. Business and Professions Code: The Contractor's License
Industrial Safety, as noted above, unless such person has a permit to do such work from that division.
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
❑ Division of Industrial Safety Permit No.
building orimprovemntissold within one year ofcompletion. the owner -builder will have the burden of proving that
Date Applicant
he did not build or improve for the purpose of sale.).
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance
❑ I, as owner of the property, am exculsively contracting with licensed contractors to construct the project (Sec.
of the work for which this permit is issued (Sec. 3097, Civ. C.).
7044. Business and Professions Code: The Contractor's License Law does not apply to an owner of property who
Lender's Name
builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the
-SSB
Contractor's License Law.).
Lender's Address
O 1 am exempt under Sec. B. 8 P.C. (Attached Certificate).
I certify that I have read this application and state that the above information is correct. I agree to comply with all
Date Owner
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.
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell -insure, or a
certificate of Workers' Compensation Insurance , or a certified copy thereof (Sec. 380D. Lab. C.).
Signature of Applicant or Agent Date
Policy No. Company
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify 1 have read this application and state that
O Certified copy is hereby furnished.
the information given is correct. I agree to comply with all state laws and county ordinances relating to buidling
D Certified copy is filed with the City Building Inspection Department or City Department.
construction, and authorize a' representative of the City of La Ouinla Department of Building and Safety to enter
upon the property for which 1 have applied for this permit for the purpose of making inspections.
Date Applicant
Signature of Applicant or Agent Date
Print Applicant/Agent Name OO,q gc�
APPLICANT NAME (L. F. MI)
ITL Cjonstruction
ADDRESS
P.O. Box 173
CITY/COMMUN ITY/STATE21 P
Nestor, CA 92053
JOB SITE ADDRESS/SPACE
CITY01COMMLINITY/STATE/ZIP
La-Quinta, CA 92253
BOK I
PAG
PRC
I C
M Fee 5.46
TwN I
RNG
I se
S
TRACT
19903
LOT/
(/fJ
t Department
MOD
I S8
TRACT NAME
HORIZON PALMS
OWNER NAME (L. F. MI) Gw eral Management Corp • '
CONTRACTOR -FIRM NAME
J.L. Construction
ADDRESS
above -
CITY/COMMUNITY/STATE/ZIP -
PHONE I
LICNC /
ARC/ENO FIRM NAME
Michael Buccino Assoc.
ADDRESS
340 S. Farrell Dr. A212
CITY/COMMUN ITY/STATVZIP
Palm Sminas, CA 92262
PHONE a LICNC .
323-7877
USE OF PERMIT '
Sin le Fandlv Dwelling
BL
ZON.
FSB
-SSB
SSB I
RSB
OFC
ZONE ORD •
LOT SZ
END
SIDE
APPL/PRMT -]1:3'R r -2L7=85 S.F.D.
Permit to construct 1247 sq. ft. of
living area and 433 sq. ft. of gaage
as per approved plans.
Yiech. Fee 37.00
Plan Check Fee 307.96
Const. Fee 367.00
Elect, Fee 60.18
M Fee 5.46
.Plimbina Fee 85.00
Infrastructure
862.60
105.72 DEP. PAID
756.88
* a eemtint
t Department
TOTAL
FEE
862.60
HILUS 7 LJ /j6.68 CK
FINANCE VALUATION F77,948.00