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001537 (SFD)Building Address Owner Mailing Address City P.O. BOX 1504 No. 001537 79-252 S. � D,. 78-105 CALLE LA QUINTA, CALIFORNIAORNIA 92253 •- • . - (Zip Tel Contractor J.L. CmstntftJ ! Address s�.y .._ . P.O. 3.6.E City JZio - .- Tel BUILDING: TYPE'CONST. V V OCC: GRP. R,3 ,. A.P.,Number - r �.37,.�,51DS4 Legal Description Project Description Harizim State Lic. & Classif.F City Lic. # 7, 1249 Size -=. _4 Stories .. " .. Units Arch., Engr.; _ DesignerMidk-101- CiM �. Y New [ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. } ....340 S. - ll St. -.323,14877 City iZip State Dat i f Q122 Lic. # ' LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am,licensed under provisions of Chapter 9 (commencing with Section _7000) of Division 3 of the BBusin�ress and Professions, Code, and my license is -in full force•and� effect.}_ / 1P e� 1? ! f. f ! of ' SIGNATURE - 1 DATE OWNER•BUILDER DECLARATION . 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, 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 ' Division 3 of the Business and Professions Code, or that, he is exempt therefrom,, and'the*basis' for the alleged exemption. Any• violation. o/ Section .7031.5 by"any-applicant for a.permit - 'subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ' '--' "•. • p 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 o/•property who 'own �7 �j��{ �/y. Estimated Valuation., O I pTd•Did 0 � _ - - AMOUNT PERMIT .+ .a - . Plan.Chk. Dep: 3M.72 • Bal. 4q� Plan Chk: Ba� 2a24A*C COrist. �� • Mech. yy q - 3 .00 builds, or improves thereon and who does such work himself or through his employees, provided that such improvements are not intended .or offered for sale. I/, however, the building -Electrical—* f�tJ. ida or improvement is sold within one year of completion, the owner -builder will have the burden, -, o/ proving that he did not build or improve for the purpose of sale.). Plumbing O 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:) O I.am.exempt under Sec. B: 8 P.C. for this reason " S.M.I.' - G�',wy� Grading_ .. . Driveway Enc. Date owner. Infrastructure n0fi=Vldat��� as �yem WORKERS' COMPENSATION DECLARATION hereby affirm that'( 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. I' Company ❑ .Copy,is filed with the city. O.Certified copy is hereby furnished.. TOTAL - �;i 716.88 _ 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 certify4hat in the performance of thg work for which this permit is issued; I shallnot• employ any -person in -any -manner so -as to become subject to the Workers'•Compensation Laws of California. ... Date ' ' ' ' Owner " NOTICE TO APPLICANT: ff,•after making this -Certificate of Exemption you should become ' 'subje6i' to the Workeis' 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.. hereby affirm that there is'6 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. 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 abode. • mentioned property for ifispe[ction purposes. d% } Signature of applicant>�A' f %T'! Dae / , ` �_S 7 t • Mailing Address �� i ,` Issued -by'. Date Permit Validated by: Validation: City, State, Zip _ HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBINP FEES IST FL. SO. FT. ® $ UNITS SLAB GRADE 2ND FL. SO. FT. BONDING YARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO, FT, p POWER OUTLET ROOF DRAINS CAR P. SO. FT. ® GAS (ROUGH) DRAINAGE PIPING WALL S0. FT. OTHER APP./EOUIP. DRINKING FOUNTAIN SO FT ® TEMP. POLE URINAL ESTIMATED CONSTRUCTION VALUATION $ GROUT WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SYSTEM WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM 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. SO. FT. ® c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL GAR. FIREWALL SO.FT.GAR ® 3/4c HOUSE SEWER LATHING GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE M'ECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE TLUMB. 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 I NSU LATION/SOU N D FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL PERMIT APPLICATION City o1 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. LICENSED CONTRACTORS DECLARATION: 1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division Sof the Business and Professions Code, and my license is in full force and effect. License Class Lic. Number Date Contractor OWNER -BUILDER DECLARATION: 1 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, 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 3of 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.): 0 1. 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. Business 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 improvemni 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.). 0 I, as owner of the property, am exculsively contracting with licensed contractors to construct the project (Sec. 7044. Business and Professions Code: The Contractor's License Law does riot apply to an owner o1 property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.). 0 1 am exempt under Sec. B. 8 P.C. (Attached Certificate) Date Owner 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.)• Policy No. Company 0 Certified copy is hereby furnished. 0 Certified copy is filed with the City Building Inspection Department or City Department. Date Applicant APPLICANT NAME (L. F. Mo JL Construction ADDRESS P.O. Box 173 CITY/COMMUNITY/STATE/ZIP Nestor; CA 92053 JOB SITE ADDRESSISPACE - - CITY/COMMUNITY/STATE/ZIP La. to CA 92253 BOK PAG PRC C TWN RNO SE S TRACT 19903 LO�� Pleat, Fee 60.18 MOD SB Tlurrbiw Fee 85.00 TRACT NAME HORIZIM PALMS OWNER NAME (L. F. MI) General Management Corp. n^ CONTRACTOR -FIRM NAME J.L. Construction ADDRESS CITYR'.OMMUNITY/STATE/ZIP PHONE O 756.88 LICNC * a eemlint ARC/ENG FIRM NAME Michael Buccino Assoc. ADDRESS 340 S. Farrell Dr. A212 CITY/COMMUNITY/STATE21 P Palm Sminds, CA 92262 PHONE LICNC / 323-7877 TOTAL FEE USE OF PERMIT Sin le Family Dwelling BL ZON, FSB SSB SSB RSB I OFC ZONE ORD 0 LOT SZ END - SIDE CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be completed if the permit is for one hundred ($100) o, less. I certify that in the performance o1 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 Applicant NOTICE TO APPLICANT: It. 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. DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: 0 1 hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thiny-six (36) feet high. (Chap 3.2, Grp 2, Art 2. Sec341, Title B, C.A.C.) 11 As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from that division. 0 Division o1 Industrial Safety Permit No. Date Applicant CONSTRUCTION LENDING AGENCY: 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name Lender's Address 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 county to enter upon the above-mentioned property for inspection purposes. Signature of Applicant or Agent Date CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify 1 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 0 o, APPL/PRMT DATE Pennit 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 Pleat, Fee 60.18 cmr Fee 5.46 Tlurrbiw Fee 85.00 862.60 105.72 DEP. PAID 756.88 * a eemlint with rimminity t Department TOTAL FEE 862.60 A1LDY D z 5 75&88 CK CINANf_F VALUATION F77,948.00