001483 (SATT)C&14t QuAg
4.4 V
9
op ft. Wto 2700
Zip 96 F� j Tel.
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
No. 001483
BUILDING: TYPE CONST. 11 Aat OCC: GRP. to
A.P. Number
Legal Description
Project Descriptiont i�r+r±•+v�., 9„
iA9 i'1ni+4m iac�a$ �aex4��a' f'1 aa7
City-- Zip Tel:.
State Lia City ^ • OW 1247
& Class if: 442822 Lic. # 237 Sq. Ft. No.
Ar^I% E -- -Size. �1R' -433 -stories.
c
• • Designer MiAtWl BWCiM AS=.
th
New R Add O
Building
Tel.
Address
"4-1 of P&
Owner
City Zip
A9
Mailing
q ...
Address
3002
City
Date Permit
. FJ=Olu3u
Contractor
SIGNATURE I" DATE
J.L. QMS
OWNER -BUILDER DECLARATION
C&14t QuAg
4.4 V
9
op ft. Wto 2700
Zip 96 F� j Tel.
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
No. 001483
BUILDING: TYPE CONST. 11 Aat OCC: GRP. to
A.P. Number
Legal Description
Project Descriptiont i�r+r±•+v�., 9„
iA9 i'1ni+4m iac�a$ �aex4��a' f'1 aa7
City-- Zip Tel:.
State Lia City ^ • OW 1247
& Class if: 442822 Lic. # 237 Sq. Ft. No.
Ar^I% E -- -Size. �1R' -433 -stories.
c
• • Designer MiAtWl BWCiM AS=.
th
New R Add O
Address
Tel.
,Front Setback.,from Center Line
34 r S.' Parmi1 St,--
323 -ii r t I'-
City Zip
State
. _ .. ..,.
q ...
Lic. # _
INSPECTOR-'
r.1 V LICENSED CONTRACTOR'S DECLARATION
Date Permit
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with,Section
- 7000) of Division 37oftthe Business and Professions Code, and my license is in:full,for}ce'and
effect.
SIGNATURE I" DATE
OWNER -BUILDER DECLARATION
Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: •(Sec. 7031.5,Business and Professions Pode:•Any city or county. which requires a' '
-alter,
permit'to Construct, improve, demolish, or repair any structure, prior to its -issuance also
requires the applicant for such permit to file a signed statement'thathe, is licensed. pursuant -to
PERMIT
the provisions or 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
Plan, Chk., Dep.
violation of applicant a permit
subjects the applicant to a civil penalty of not more than five hundred dollars (3500).
M I f
Plan Chk. Bal.
No. Dw.
Units -
Alter ❑ Repair ❑
Demolition ❑
as owner o e 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 Const.
Professions Code: The Contractor's License Law does not: apply to an owner or 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.) -
O I, as owner of the property, am exclusively contracting with 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.I.
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) -
Grading
❑ I am exempt under Sec. B. &-P.C. for this reason
Driveway Enc.
Date Owner
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
0 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 ($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.
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 _
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 and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
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 purposes.
Signature of applicant �:� ! �� L -2 I t Date
Mailing Address _i t
City, State, Zip
HARD COPY
Infrastructure
TOTAL
REMARKS
AMOUNT
105.72
17 _00
A.
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 PEES
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.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP./EOUIP.
LAUNDRYTRAY
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/. c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ic
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 APP./EOUIP.
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
APPLICANT NAME (L, F. MI)
JL Onnstruction
ADDRESS
P.O. Box 173
CITY/COMMUNITY/STATE/ZIP ,.
Nestor; CA 92053
JOB SITE ADDRESS/SPACE
CITY/COMMLINITY/STATE/ZIP
La. to CA 92253
BOK I
—
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.
SE I
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be completed it
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) of Division Sof the Business and Professions Code, and my license is in full force
Issued. I shall not employ any person inanymannersoasto become subject to the Workers'Compensation Laws of
and effect.
California.
License Class Lic. Number
Date Applicant
Date Contractor
NOTICE TO APPLICANT: If, 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
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 Contractor's License Law
01 hereby certify that no excavation five (5) or more feet in depth into whicha person is required to descend, will be
(Chapter 9(commencing with section 7000) of Division 3 of 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 o1 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 2 Art 2, Sec 341, Title 8,
subjects the applicant to a civil penalty of not more than five hundred dollars (5500.):
C.A.C.)
O I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the
O As owner -builder, I will not employ anyone to do work which would require a permit from the Division o1
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 of property who builds, or improves thereon, and who does such work himself or
❑ Division of Industrial Safety Permit No.
through his own employees, provided that such improvements are not intended or offered for sale. ff. however, the
building orimprovemntissold within one year ofcompletion. the owner -builder will havethe 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
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 self -insure, or a
certificate of Workers' Compensation Insurance , or a certified copy thereof (Sec. 3800. lab. C.).
Signature of Applicant or Agent Date
Policy No. 'Company
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify Ihave read this application and state that
O Certified copy is hereby furnished.
the information given is correct. I agree to comply with all state taws and county ordinances relating to Duidling
O Certified copy is filed with the City Building Inspection Department or City Department.
construction, and authorize a'representative of the City of La Ouinta 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 O) ?
APPLICANT NAME (L, F. MI)
JL Onnstruction
ADDRESS
P.O. Box 173
CITY/COMMUNITY/STATE/ZIP ,.
Nestor; CA 92053
JOB SITE ADDRESS/SPACE
CITY/COMMLINITY/STATE/ZIP
La. to CA 92253
BOK I
PAG
PRC
I C
metch. Fee 37.00
TWN
I PING
SE I
S
LOT6
cWT Fee 5.46
Moo
so
19903
J
105.72 DEP. PAID
756.88
TRACT NAME HORIZON PALMS
OWNER NAME (L, F. M) ((antral Management Co
CONTRACTOR -FIRM NAME
J.L. Construction
ADDRESS
above
CITY/COMMUNITY/STATE/ZIP
PHONE a
LICNC .
ARC/ENG FIRM NAME '
Michael Buccino Assoc.
ADDRESS
340 S. Farrell Dr. A212
CITY/COMMUNITY/STATE/ZIP
Palm Springs, CA 92262
PHONE • LICNC •
323-7877 1
USE OF PERMIT
Single Family Dwelling
BL
ZON,
FSB
SSB
SSB
RSB
OFC
ZONE ORD .
LOT SZ
END
SIDE
APPL/PRMT DATE
5-2.2-B .
S.F.D.
Permit to construct 1247 sq. ft.
of
living area and 433 sq ft. of qaage
as per approved plans.
metch. Fee 37.00
Plan Check Fee 307.96
Const. Fee 367.00
Elect, Fee 60.18
cWT Fee 5.46
.21mbin- Fee 85.00
In f ra structure
862.60
105.72 DEP. PAID
756.88
*neferred pa==t as pgr agrembnt
t Department
TOTAL .
FEE
862.60
A1LU1 7 L /j&88 CK
cllUARWIC VALUATION 77, 948.00