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001538 (SFD)Qum&, P.O. BOX 1504 No. 00153 Building 78-105 CALLE ESTADO Address 79'272. S• S=Sft Rieq8 rX• LA QUINTA, CALIFORNIA 92253 Owner _ Corp. Mailing Address W01 aish= st. ' fit tA 27N City Zip Tel. uin 948 1-80€-s67--504 Contractor . . J.Is. ...Address P.O. E= 313 City Zip Tel.' . g V. 1 a7roa u93•Avt i BUILDING:' TYPE CONST. V O.CC: GRP. ' A.R. Number Legal Description Project Description HoAzr t 146 hits X14 State Lic. City XM'IZ4 & Classif.: 4428 Lic. # 237 " Sq, Ft, 433 No. No. Dw. Size • - - .. Stories - -Units • Arch.; Engr., _ ... , ' Designer ,New ® Add ❑ Alter ❑ Repair ❑.. Demolition ❑ •- Address Tel. 340.. ; . ' Fairp-U• -qt-* 323t787._... City Zip State Lic: # "L`ICENSED CONTRACTOR'S DECLARATION I hereby affirm that 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 a � s.r DATE SIGNATURE ___4r !�' i- �,!'? .. .. _ .. .. _ _ .. ... - OWNER -BUILDER DECLARATION Estimated Valuation 1 hereby affirm that I am exempt from the Contractor's License Law for the. following Any ' (r �+t�,Adrt e�[y reason: (Sec. 7031.5,Business and Professions Code: city or.county which requiies a permit to construct, alter, improve, demolish, or repair any structure,.'prfor to its issuance also .- / ,fl�i�i4CD'«[!Ci -i.•• requires the applicant.for such permit to rile a signed statement that he is1censed pursuant to PERMIT' - .. AMOUNT 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 Section 7031.5 by 'any for -a - Chk. Dep: - e 105.72 - of applicant permit.- ' subjects the applicant to a civil penalty of not more than five -hundred dollars (S500).' .Plan - Plan Chk. Bal. ; .. - 202.,2,4 ❑ 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, Buisness and t CO nS. . p� • ._ Professions Code: The Contractor's License Law does'not apply to an owner,ofproperty who • -36.0 •. builds or improves thereon and who does such work himself or through his own employees, Mech' _ +� fit► .- provided that' such. Improvements, are not. intended or offered. for, sale. If, however, the,building .. or improvement issoldwithin one year of completion, the owner -builder will'have the'. burden - Electrical dT .� of proving that he did not build or improve, for the purpose of sale.) . . _. . . • 0.1, as -owner of the property, am exclusively contracting with -licensed contractors to con- Plumbing 85.00 struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law doesnot apply to an owner of property who builds :or improves thereon, and who contracts for • .' S.M.I.- - such projects with a contractor(s) licensed pursuant to the Contractor's License Law:) - - Grading O I am exempt under Sec.. B. 8 P.C. for this reason Driveway Enc. Date Owner WORKERS' COMPENSATION DECLARATION I •hereby: affirm'that I have a certificate of consent to selYinsure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. - ­ Company O Copy, is filed with the city... O Certified copy is hereby furnished. 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 tfiere 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 slate laws relating to building construction,. and hereby authorize representatives sof this city to .enter the'above-. ' mentioned property for inspection purposes. -(j jt ri Signature of applicant a/..:f F' +° i I I ! Date �f ! Mailing Address —4'/ City, State, Zip rlAKL) L;VYT Infrastructure Pam = aaarsgme^ig Tga TOTAL 962.60 756.38 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. SO. FT. ® POR. SO. FT. @ GAR. SO. FT. ® CAR P. SO. FT. Q WALL SO. FT. ® SO FT ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK I 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 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, TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. p c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR Q 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 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 SIGNATURES'INITIALS GARDEN WALL FINAL PERMIT APPLICATION City of 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 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. Number 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 3 of the Business and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation o1 Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500.): O 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, 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 improvemnt 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.). O 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 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.). ❑ 1 am exempt under Sec. B. & P.C. (Attached Certificate). Date Owner 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. 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 M ITY/STATE/ZI P Nestor; CA 92053 JOB SITE ADDRESS/SPACE CITY/COMMUNITY/STATE/ZIP La. to CA 92253 BOK PAG PRC I C TWIN RNG SE S TRACT 19903 L OZ 1 'Plect- Fee 60.18 MOO SS -Plurrbing Fee TRACT NAME HORIZON PALMS OWNER NAME (L, F. MI) Gmeral Management Co CONTRACTOR -FIRM NAME J.L. Construction ADDRESS abave CITYM.OMMUNITY/STATE/ZI P PHONE a 105.72 DEP. PAID LICHC 1 756.88 ARC/ENG FIRM NAME Michael Buccino Assoc. ADDRESS 340 S. Farrell Dr. A212 CIT WCOMMLINITY/STATE/ZIP Palm Sorinas, CA 92262 PHONE 1 LICNC • 323-7877 USE OF PERMIT ' Single Famil Dwellin BL TOT FEE ZDN, FSB SSB SSB RSB OFC ZONE ORD 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: 11, after making this Cerlificateol 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: o 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 thirty-six (36) feet high. (Chap 3.2, Grp 2, Art 2, Sec341, Title 8. C.A.C.) O 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. D Division of Industrial Safety Permit No. Date Applicant 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, Civ. C.). Lender's Name Lender's Address 1 certify that I have read this application and state that the above information is correct. l 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. l agree to comply with all state laws and county ordinances relating to buidling . 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. Signature of Applicant or Agent Date Print Applicant/Agent Name 601533 APPL/PRMTI y' �. 5 2�-8 Permit to construct 1247 sq. ft. of living area and 433 sq. ft. of qarage as per approved plans. mech. Fee 37.00 Plan Check Fee 307.96 Const. Fee 367.00 'Plect- Fee 60.18 M Fee 5.46 -Plurrbing Fee 85.00 Tnfrastructure 862.60 105.72 DEP. PAID 756.88 * s pgr agreentmt with CYxminity t Department TOT FEE 2.60 ` FINANCE 3 75&88 CK VALUATION 77,948.00