001463 (SATT)r,
Building
Address
Owner
40
4
P.O. BOX 1504
79-4913=izOn Palms CiXCle LA QUINTACCALIFORNIA 92253
Mailing
Address
City U izip+
1,0will,
U t.$
Contractor
J.L. stzU-A&M -
.Address
P.O* B= 373
' City .. _ _... Zip
No. 001463
BUILDING: TYPE CONST. V 1 OCC. GRP. R 3.
Mn A.P. Number
Tel.
E— Legal Description
Project Description
146 Ph%tstjal aiml. '
Tel:
State Lic.
& Classif. 4�
City
Lic. # 23
'"
q M 1247
Sq, Ft. No. No. Dw.
Size 433. -.-.Stories Units
Arch., Engr.;
Designer�..p
New l Add ❑ Alter ❑ Repair ❑ . Demolition ❑
Address
Tel.
223--7&'
City Zip
State
-
VWM �'t ... 922
Lica#
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencingwith Section
7000).of Division t3'o1f the }Business and Professions -Code, and my license is in.•full force and
effect.
-
-
SIGNATURE a A"! i f R 4 i r+ i !' Y y DATE
'' ' OWNER -BUILDER DECLARATION
.l 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, after, 'improve, demolish, or repair any structure, prior to its issuance also
r.. 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
'DiviSton 3 of the Business and `Piofessioos Code, or thabhe'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-
,of proving that he did not build or improve for the purpose of sale:)-'.._ - - -
Estimated Valuation �t•� -
s, AMOUNT'
- PERMIT- -
- • - x
Plan Chk. bep."«�.,.
Plan Chk. Bal. 232.24
Const. 1..
'Meeh. .
1' 7.00
Electrical 64C.32
• ,
Plumbing 85.00
❑ 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
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. - - 6..46
-.
Grading
Driveway Enc.
Date Owner
Infrastructure it ax acreomimt
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. O Certified copy is hereby furnished.
TOTAL 756.,R
-._
CERTIFICATE OF EXEMPTION FROM
WORKERS'. COMPENSATION INSURANCE
REMARKS.
(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
employany 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 mast 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
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.'
FINAL DATE INSPECTOR
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 �•!� i ± r -Date:/ // y
Mailing Address ` ` /
Issued by: Date Permit
Validated by -
Validation:
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. 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
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEOUIP.
LAUNDRY TRAY
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/. 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 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 APPJEOUIP.
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
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
APPLICANT NAME (L. F. MI) JL WC mstruction
117 L.L Ll
ADDRESS
P.O. Box 173
CITY/COMMUNITY/STATE/ZIP
Nestor; CA 92053'"
JOB SITE ADDRESS/SPACE
CITY/COMMLINITY/STATE/ZIP '
La. to CA 92253
•
PAG
PERMIT APPLICATION
City o1 is 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.
RNG
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 ($1OD) It. 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 license Is In full force
Issued. I shall not employ any person in any manner so asto 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 I 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
PHONE e 1
construct. alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
such per mit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law
0 thereby 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 o1 Section 7031.5 by any applicant for a permit
demolition or dismantling thereof. will be more than thirty-six (36) feet high. (Chap 12. 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.)
0 I. as owner of the properly, 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 o1 property who builds, or improves thereon, and who does such work himself or
ZON,
through his own employees• provided that such improvements are not intended or offered for sale. If, however, the
0 Division of Industrial Safety Permit No.
building or improvemnt 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: 1 hereby affirm that there is a construction lending agency for the performance
❑ 1, as owner o1 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 rat 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
❑ 1 am exempt under Sec. B. 8 P.C. (Attached Certificate).
1 certify 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 above4nentioned 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. 3800. Lab. C.).
Signature of Applicant or Agent Date
Policy No. 'Company
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I 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 I have applied for this permit for the purpose of making inspections.
Date Applicant
APPLICANT NAME (L. F. MI) JL WC mstruction
117 L.L Ll
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
PAG
PRC
I C
mech. Fee 37.00
TNM
RNG
SE
S
19903
LOT
Moo
sa
TRACT NAME
HORIZON PALMS
OWNER NAME (L. F. MI) Gamral Management Corp. '
CONTRACTOR -FIRM NAME
J. L. Construction
ADDRESS
abcve
CITY/COMMLINITY/STATE/ZI P
PHONE e 1
,
LICNC e
t
with reimmity De
ARC/ENO FIRM NAME
Michael Buccino Assoc.
ADDRESS
340 S. Farrell Dr. A212
CITY/COMMUNITY/STATElZI P
. Palm SDrinas. CA 92262
PHONE a LICNC t
323-7877
USE OF PERMIT '
Single Fandly Dwellincr
BL
ZON,
FSB
SSB
SSB
RSB
OFC
ZONE ORD 0
• LOT SZ
END
SIDE
Signature of Applicant or Agent Date
Print Applicant/Agent Name
APPL/PRMT ' DATE
5-2.2=85
S.F.D.
Permit to construct 1247 sq. ft.
of
livincr area and 433 sq. ft. of gaage
as per appraved,plarls.
mech. Fee 37.00
Plan Check Fee 307.96
Const. Fee 367.00
60.18
WT Fee 5.46.
-Plurrbj= Fee 85.00
Trifrastructure
862.60
105.72 DLR. PAID
756.88
* a eye�nt
t
with reimmity De
t
TOTAL
'FEE
862.60
A 1 1 8 1
FINANCE
5 23 75
VALUATION 77,9 .00