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