001464 (SATT)Building
Address 79-487 lkwi=
Owner
Genexal r
Mailing
Address,((,)_
City lZip
T -4 4 4Qa�&,
ITel
s
Contractor
T T._ nkYasr+A�kesn
..Address,
P.O. B= 173 k
City Zip -. Tel. '
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
\1
001464
BUILDING: TYPE CONST. V 17 OCC: GRP. R 3
A.P. Number
Legal Description
Project Description - it Pell=
State Lic.
& Classif. 442mLic..#
Jrity
237
�it•7
Sq. Ft.
Size - 433 -
No. No. Dw.
Stories Units
Arch., Engr.,
Rear Setback from Rear.Prop..Line
Designer As=.
pt Add ❑
Alter ❑. Repair ❑ Demolition ❑
Address
Tel.
FINAL DATE
INSPECTOR
y �AAy ��yy
-340 S. Ki—A: Stat .......
.�y+g n.yy
.. 323-787 -
Validated by:
City Zip
.
State
_
Lic. #
_LICENSED CONTRACTOR'S DECLARATION
.
_ K
• .1 hereby affirm that) am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 off;/th/e Business and Professions Code, and my license is/in full (force and
effect. �A7 / t ✓ ? i is �s f r7 1
.. ..
.. .. .
SIGNATURE ..+4 9 n. a . P i' DATE
OWNER -BUILDER DECLARATION r
I 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,w 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 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 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
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 Improvement- is sold within one year of completion, the owner -builder will have the burden
or proving that he did not build or improve for the purpose of sale.) ,
Estimated Valuation
ry«�A�y e�
f /.949.00
PERMIT
-' AMOUNT
Plan Chk.. Dep.'.'.
/�q -'
- 3,05.72
.,Plan Chk. Bal.:
S
,�, 24
Const.
..-
202% • 00
Mech.
"�� • 00
Electrical
-'
.
Plumbing
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
strucl4he 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.) -
❑ I am exempt under Sec: �- - B. 8 P.C. for this reason
S.M.I.-
Grading
Driveway Enc.
Date Owner
WORKERS' COMPENSATION DECLARATION
1 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..
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed it the permit is for one hundred dollars ($100) 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: It, atter 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.
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.rabove-
mentioned property for inspection purposes.
Signature of applicant ✓` J f �! i-'-- -Date,/,/ t ET
Mailing Address
City, State, Zip
HARD COPY
� • , i. # T, •
TOTAL T 852.60 756.88
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 FliES
IST FL. SQ. FT. ® $
2ND FL. SQ. FT.
FOR. SQ. FT. ®
GAR. SO. FT. ®
CAR P. SQ. FT.
WALL SQ. FT. ®
SO. FT ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM '
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.
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.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.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 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 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
insrtcwnaawnwiUnrblIN iIAw
GARDEN WALL FINAL
A
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.
I
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 ($100) o, less. I certify that in the performance o1 the work for which this permit is
(commencing with Section 700D) of Division 3 of the Business and Professions Code. and my license is In full force
-issued. I shall not employ any person inanymannerso as to become subject to the Workers'Compensation Laws of
and effect.
California.
License Class lie. 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
following reason (Sec. 7031.5. Business and Professions Code: Any city or county which requires a permit to
be deemed revoked.
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 pursuanttotheprovisions oftheContractor'sLicense Law
01 hereby certify that no excavation five (5) or more feet in depth into which aperson 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, lalsework, 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 2, Art 2, Sec 341, TitleB.
subjects the applicant to a civil penalty of not more than five hundred dollars ($500.):
C.A.C.)
O 1. 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 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, avid who does such work himself or
ADDRESS
through his own employees, provided that such improvements are not intended or offered for sale. If, 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 of provingthat
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 1, as owner o1 the property, am excutsively 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 rat apply to an owner of property who
Lender's Name
buifps or Improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the
agreentint
Contractor's License Law.).
Lender's Address
O 1 am exempt under Sec. B. & P.C. (Attached Certificate).
I cenify that I have read this application and state that the above information is correct. ) 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 o1 Workers' Compensation Insurance , or a certified copy thereof (Sec. 3800. Lab. Q.
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
APPLICANT NAME (L. F. MI)
JL Construction '
ADDRESS
P.O. Box 173
CITY/COM W MITY/STATERI P
Nestor; CA 92053
JOB SITE ADDRESS/SPACE
CITYICOM L)NITY/STATE/ZIP .. ., .
La.Quinta, CA 92253
BOK
PAG
PRC
C
-
T14N
RNO
SE
S
TRACT
19903
LOT
Plan Check Fee
307.96
MOD
I SB -
367.00
TRACT NAME
HORIZON PALMS
OWNER NAME IL. F. MI) Gwie „al �mnt Co '
��liGl
CONTRACTOR -FIRM NAME
J.L. Construction
ADDRESS
above
CITY/COMMUNITY/STATE/ZIP -
am
PHONE a '
LICNC •
85.00
ARC/ENG FIRM NAME
Michael Buccino Assoc.
ADDRESS
340 S. Farrell Dr. A212
CITY/COMMUNITY/STATE/ZIP
Palm Srxinas. CA 92262
PHONE I LICNC 9
323-7877
105.72 DF,P. PAID
USE Of PERMIT
Single Familv Dwelling
Bl
ZONA
agreentint
FSB
SSB I
SSB I
RSB
OFC
ZONE ORD -
LOT SZ
I I
t END
'SIDE
Signature of Applicant or Agent Date
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have 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'representative 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 Date
Print Applicant/Agent Name i o/ -
APPL/PRMTGATE
�l-y5
5-22=85
S:F.D.
Permit to construct
1247 sq. ft.
of
.living area and 433
sq. ft. of garage
as per approved plans.
mach. Fee
37.00
Plan Check Fee
307.96
Const. Fee
367.00
Elect, Fee
60.18
SM FPP
5.46.
-PlimbiM Fee
85.00
Tnfrastructure
862.60
105.72 DF,P. PAID
..756.88
*
agreentint
t De
t
TOTAL °.
FEE
862-60
H11iSL� L.5 /56,8 �K
FINANCE VALUATION 77,948.00