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001466 (SATT)r P.O. BOX 1504 No, 001466 BuildingY 78-105 CALLE ESTADO Address X479 Iii Palms Circle LA QUINTA, CALIFORNIA 92253 Owner Mailing " Address 1001 Aig!W St. omits City Zip %'., dlj w1ulu 9 Contractor Address ..city - .. _... .Zip z 92053 State Lic. & Classif.442922 Arch:, Engr., - • - Designer niC_l Atilw&' moo BUILDING: TYPE CONST. '� OCC: GRP., R 3 A.P. Number E,--800_367 5()5 • Legal_ Description Project Description lA6 omits Tla i AI DeVel. Tela �340­5511 City Lic. # 237 Sq. Ft. • DM 1247 No. No. Dw. Size - GM 433 Stories Units New Add ❑ Alter ❑ Repair ❑ Demolition ❑. Address Tel. 340 K'i. paxTell fto 323--7877 City Zip State >1tawftl►31ww1F� . Lic..#. LICENSED CONTRACTOR'S DECLARATION I hereby affirm hat I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3%of-the Business and Professions Code, and my license is in full force and ,. effect. ...- ! r Ir i SIGNATURE f- P .Y 1 f DATE OWNER -BUILDER DECLARATION Estimated Valuation I hereby affirm that 1 am exempt from the Contractor's License law for the following yq nn reason: -(Sec. 7031.5,Business and Professions Code: Any -city, or county which requires a •' F T .•7 i. 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, Chapter9 (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, 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). ❑ 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 BY: . Plan Chk. Dep. - Plan Chk. Bal. ~ COnSt ., ' ' 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. It, however, the :building Electrical 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.) - - 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 S.M.I. - does notapplyto 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 Lam exempt under Sec. B. 8 P.C. for this reason Grading Driveway Enc. Dale - _owner Infrastructure DIS &'5 Validation: with Q6 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. 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 ame 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 -of this city to enter the above- mentioned property for inspection, %purposes. Signature of applicant 4 1 f/ Date Mailing Address Jr / r City, State, Zip HARD COPY t AMOUNT .7 .. 367.00 0{ 37.00 601.18 85.00 K46 ivent • a i8 756.88 REMARKS 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. SO. FT. @ $ 2ND FL. SQ. FT. POR. SO. FT..@ GAR. SQ. FT. @ CAR, P. SQ. FT. WALL SQ.lFT. 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.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT- WALL FLOOR SUSPENDED _ 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 APPJEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAMS 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 PERMIT APPLICATION City of La Duinta Department of Building and Safety This permit becomes void if work not commenced within 180 days from date of issuance. OR. It work has been suspended or abandoned for a period of 180 days APPLICANT NAME (L, F. MI) JL Construction CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be completed if LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions o1 Chapter 9 the permit is for one hundred (S1g0) o, less. I certify that in the performance of the work for which this permit is (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my licem 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 tic: 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 1 am exempt from the Contractor's license Law for the 'following Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. reason (Sec. 7031.5• Business and Professions Code: Any city or county which requires a permit to 19903 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 signedstatementthatheislicensedpursuanttotheprovisionsoftheContractorsLicenseLaw ❑ 1 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 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 Art 2, Sec 341, Title B. 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 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 ARC/ENO FIRM NAME ' Michael Buccino Assoc. 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. Q. 7044. Business and Professions Code: The Contractor's License Law does rat 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 ZONA Contractor's License Law.). Lender's Address ❑ 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 OFC 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. 3600. Lab. C.). Signature of Applicant or Agent Date Policy No. Company CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify l 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 . 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 APPLICANT NAME (L, F. MI) JL Construction ADDRESS P.O. Box 173 CITYrCOMM(1N ITY/STATEQIP Nestor; CA 92053 JOB SITE ADORECS/SPACE CITY/C4)MMUNITY/STATE/ZIP - La. to CA 92253 SOK PAG PRC C mech. Fee 37.00 TWN RNO SE s 19903 LOT /QST Mr PP -P 5.46 SB 7��M�D+D TRACT NAME HORIZON PALMS OWNER NAME (L. F. MI) .Gm al Management Corp • ' CONTRACTOR -FIRM NAME J. L. Construction ADDRESS above CITY/COMMUNITY/STATE/ZIP PHONE . LICNC . with Oniminity t Departnient ARC/ENO FIRM NAME ' Michael Buccino Assoc. ADDRESS 340 S. Farrell Dr. A212 Cif Y/COMMUNITY/STATE/ZIP Palm Springs, CA 92262 PHONE • LICNC . 323-7877 USE OF PERMIT Single Family Diaellinct BL ZONA 'FSB SSB SSB RSB OFC ZONE ORD • LOT SZ END SIDE Print Applicant/Agent Name Qo 1_� /4 APPL/PRMT NMI, ; 5 2 2=85 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 Wnst. Fee 367.00 Mect- Fee 60.18 Mr PP -P 5.46 PlumbiM Fee 85.00 862.60 105.72 DEP. PAID . 756.88 * aareentint with Oniminity t Departnient TOTAL . FEE 862.60 c� /76x88 CK VALUATION ���948.00