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001471 (SATT)Building Address P.O. BOX 1504 78-105 CALLE ESTADO CJe LA QUINTA, CALIFORNIA 92253 Mailing Address Inns City Zip C�1� Tel. Contractor Address.. /� .. - .. P.O. 173 City Zip Tel." I No. 001471 BUILDING: TYPE CONST. -OCC: GRP. R 3 A.P. Number Legal Description Project Description SCM 7>A1M_i TMX*r 92053 340 -SM- _ State Lic. & Classif.x� City Lic. # �7 1247 Sq. Ft. �" No. No. Dw. Size , • •Stories Units Arch'., Engr., ' - - ... ... . Designer New Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. _ 340 S. Fax%vU M...... 323--7877 .., ,.. CityZip State -. Fall 51:1�iV!€�3 ��?�.. Lic: # LICENSED CONTRACTOR'S DECLARATION . I hereby affirm thatd am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 off'tthb Business and Professions Code, and my license is in full force and effect.. /!A I(/I i _. %Nf SIGNATURE +!."'1 Y r t..�i r i J!- !DATE'- OWNER•BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following -00 reason: (Sec. 7031. S, Business and Professions Code: Any city or county.which requires a permit to construct, after, 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 ekampt 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).' 01 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 Estimated Valuation "f'7�� f i7 - - AMOUNT - .PERMIT - : Plan Chk. Dep. - . •'.��, Plan Chk. Bal. 202,.24 Const. M7.00V �+ Mech. 37.00 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 Electrical •1-0n or improvement is sold within one year of completion, the owner -builder will have the burden . of proving that he did not build or improv -e for the purpose of sale.) .. Plumbing 85.00 O I, as owner of the property, am exclusively contracting with licensed contractors to con- structAhe 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 contractor(s) licensed pursuant to the Contractor's License Law.) - O I -am exempt under Sec. B. & P.C.- for this reason S.M:I. - _ 5*46 - Grading Driveway Enc. Date Owner py��,,t s � 3t Infrastructure Defwith . yyd i. rectm WORKERS' COMPENSATION DECLARATION hereby affirm that "I have a certificate of consent to self -insure, ora 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 W.60 756.138 CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE REMARKS (This section need not be completed if the permit is for one hundred dollars (5100) 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. ZONE: BY: - -Minimum Setback Distances: ' Front Setback from Center Line Rear Setback from Rear Prop.. Line 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.) • 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. 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. j Signature of applicant }, 1 7 f 1 �� • i .y ! - Date' f Mailing Address r: f Issued by: Date Permit Validated by: ) Validation: City, State, Zip HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ 2ND FL. SQ, FT, ® POR. SO. FT. ® GAR. SO. 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.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. 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: 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 � ` ' , ., n - •w .J ��r-1'4Y+. I� 1, .IBJ ' • ', • �` `.� . r. r.w. �t • •. r. r.. � .. _. L � � - �� .-- t M n .- . _. rte.-.� -�. ._ . • .... �. .- n .+..- .� a .. m - � . � � _�. _ � _ � -. .. .� PERMIT APPLICATION City o1 La Ouinta Department of Building and Safety This permit becomes void it 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 it LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 the permit is for one hundred (5100) o. less. I certify that In the performance of the work for which this permit is (commencing with Section 7000) of Division 3ot the Business and Professions Code, and my license is in full force .Issued, Ishall not employany person inanymannersoasto become subject tothe Workers'Compensation Laws of and effect. California. . License Class Lic. Number Date Applicant Date Contractor NOTICE TO APPLICANT: 11, 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 oftheContra ctor'sLicense 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 7000) of Division Sof 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 32, 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 o1 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 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 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 safe. It, however, the O Division of Industrial Safety Permit No. building or ImprovemnI is sold within one year of completion, the owner -builder will have the burden ofprovingthat 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 O 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 builQs 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. 1), P.C. (Attached Certificate). I certify that I have read this application and state that the above information is correct. I agree to comply withal[ 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 1 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: 1 certify I have read this application and state that O Certified copy is hereby furnished. the information given is correct.) agree to comply with all state laws and county ordinances relating to buidling . O Certified copy is filed with the City Building Inspection Department or City Department. construction, and authorize a' representative o1 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. Dale Applicant Signature of Applicant or Agent Date APPLICANT NAME (L, F. MI) JL Construction ' ADDRESS P.O. BOX 173 ' CITY/COMMUN ITY/STATE/ZI P Nestor; CA 92053 JOB SITE ADDRESS/SPACE .. CITY/COM LONITY/STATE/ZIP La. to CA 92253 BOK PAG PRC C TWN PING SE S TRACT 19903 LOT CC�-YY"'// Elect- Fee 60.18 MOD MOD SB .Plumbing Fee 85.00 TRACT NAME HORIZON PALMS OWNER NAME (L, F. MI) G neral Management Corp. ' CONTRACTOR -FIRM NAME J.L. Construction ADDRESS above CITY/COMMUNITY/STATE/ZIP ahipm PHONE a 756.88 LICNC e . ARC/ENG FIRM NAME Michael Buccino Assoc. ADDRESS 340 S. Farrell Dr. A212 CIT/COMMUNITY/STATE/ZIP Palm Springs. -CA 92262 PHONE • LICNC / 323-7877 TOTAL `. T USE OF PERMIT Single Fwdly Dwellin BL ZON. FSB SSB SSB -RSB OFC ZONE ORD • LOT SZ END SIDE F Print Applicant/Agent Name (� h 14 / 1 APPL/PRMT Un -T :> __CIA2-2=85 1 S.F.D. Permit to construct 1247 sq. ft. of living area and 433 sq. ft. of garage ,as Per approved Plans. mech. Fee 37.00 Plan Check Fee 307.96 Const. Fee 367.00 Elect- Fee 60.18 SW Fee 5.46 .Plumbing Fee 85.00 Trifrastimicture 862.60 105.72 DEP. PAID 756.88 * agreembint t Department TOTAL `. T 2.60 /111 0 7 c / 5 b 8 8 CK FINONCE VALUATION 77,948.00 ••