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001540 (SFD)Building Address 79-292 S. I Owner CityZip _...�� 5 State 92222Lic.#. Mailing Address _ LICENSED, CONTRACTOR'S DECLARATION . hereby affirm -that I am licensed under provisions of Chapter 9 (commencing wilh•Section 7000) of Division 3"of,tthle Business and Professions Code, and my license`is in full force and effect-.....�f City Zip .., .• - _ . SIGNATURE.: �'.✓ - / 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, !;fly ocounty which requires a ' perrnit to construct, alter, improve, demolish, or'iepair 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 - 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• exeriipt 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 ($500): ' -" .. .- '. _ ❑ I, as owner of the property, or. my employees with wages,as. their -sole compensation, will, do tfie work, and the structure is not intended or offered for sale. (Sec:-7044,'Buisness and `. Professions Code: The Contractor's License Law does not apply to an owner.of property who builds or improves thereon' and who does such work himself or through his own employees,, provided that' such improvements are', not intended or -offered for sale. If,. however, the building • or Improvement is sold within one year of- completion, the owner -builder will have the burden of proving that he did not, build or improve, for, the purpose of sale.) , .' ❑.I, as owner of the property, am exclusively contracting with.licensed contractors to con- struct the project. (Sac: 7044, Business and Professions Code: The Contractor's License Law - - does not apply to an owner of property who builds or improves .thereon, and -who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) .. . 0 lam exempt unSec. - B.-8 P.C.-for this reason - Contractor rs$o - - PERMIT J.L. Address, . "5.72, -City I State Lic. & Classif.... 442822 Arch:; Engr., ---- • • - Designer, M P.O. BOX -1504 N0.- 001540 78-105 CALLE ESTADO M.'.Rjda= Dr. LA QUINTA, CALIFORNIA 92253 ' S°.' .te 2700: Tel. 813 1-900-367-5054 Zip - Tel." 92053 1 340, -SSU Lic. # 237, BUILDING TYPE CONST. V N OCC: GRP.- R A:P. Number Legal, Description Project Description 14.6 ii tS Ra'." idenWal Dowl. M. 3247 Sq. Ft. Size- ._. = 433 No. ' - Stories No. Dw. ,Units New 9 Add ❑ Alter ❑. Repair ❑ Demolition ❑ Address Tel. 323-7877 BY: Minimum Setback Distances: CityZip _...�� 5 State 92222Lic.#. Rear Setback from Rear.Prop. Line Side Street Setback from.Center Line _ LICENSED, CONTRACTOR'S DECLARATION . hereby affirm -that I am licensed under provisions of Chapter 9 (commencing wilh•Section 7000) of Division 3"of,tthle Business and Professions Code, and my license`is in full force and effect-.....�f Side Setback from.Property Line FINAL DATE .., .• - _ . SIGNATURE.: �'.✓ - / 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, !;fly ocounty which requires a ' perrnit to construct, alter, improve, demolish, or'iepair 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 - 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• exeriipt 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 ($500): ' -" .. .- '. _ ❑ I, as owner of the property, or. my employees with wages,as. their -sole compensation, will, do tfie work, and the structure is not intended or offered for sale. (Sec:-7044,'Buisness and `. Professions Code: The Contractor's License Law does not apply to an owner.of property who builds or improves thereon' and who does such work himself or through his own employees,, provided that' such improvements are', not intended or -offered for sale. If,. however, the building • or Improvement is sold within one year of- completion, the owner -builder will have the burden of proving that he did not, build or improve, for, the purpose of sale.) , .' ❑.I, as owner of the property, am exclusively contracting with.licensed contractors to con- struct the project. (Sac: 7044, Business and Professions Code: The Contractor's License Law - - does not apply to an owner of property who builds or improves .thereon, and -who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) .. . 0 lam exempt unSec. - B.-8 P.C.-for this reason - Estimated Valuation rs$o - - PERMIT - AMOUNT P68 Chk: Dep. "5.72, - ?Ian Chk.. Bal. - - - 202.24. COflat.I .- �� ` Mech.,��� - Electrical - '. P� ' 60.18 Plumbing -�. 00 -• - S. M.I: - �.� A & 40 Gradingder. Driveway Enc. Date ' Owner Infrastructure De - as n*` t %Vd pay�.�.� 3�� p WitLVCtZW WORKERS' COMPENSATION DECLARATION I'hereby affirm that I have a certificate bf consent io self -insure, or a.ceitificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800; Labor Code.) Policy No. Company ❑ Copy is.filed with,the city. • . 0 Certified copy is•hereby furnished. TOTAL 7e` . 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 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: • 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 there' is a construction lending agency for the performanceof 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 Xhealbov!: mentioned property for inspec'on purposes. Signature of applicant lt {.G� !; Date'7t Mailing Address r y City, State, Zip HARD COPY 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. ® CARP. SO. FT. WALL SO. FT. ® SO. 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.COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APPJEOUIP. LAUNDRYTRAY 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. ®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 ® 3/4c 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 t 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 INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL ' INSPECTOR'S SIGNATURES/It11TIALS, GARDEN WALL FINAL r PERMIT APPLICATION City o1 La Ouinta Department of Building and Safety This permit becomes void if work not commenced within 180 days from date o1 issuance. OR, If work has been suspended or abandoned for a period of 180 days. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 o1 the Business and Professions Code, and my license is in full force and effect. License Class Lic. Number Date Contractor 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 requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions at the Contractor's License Law (Chapter 9 (commencing with section 7000) of Division 3 o1 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.). O 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 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 Onnstruction ADDRESS P.O. Box 173 CITYICOMMUNITY/STATE/ZIP ' Nestor; CA 92053_ JOB SITE ADDRESS/SPACE CITY/COMMUNITY/STATE/ZIP La. to CA' 92253 BOK PAG PRCC Plan Check Fee 307.96 TWN ANG SE S 19903 LD%� -Plunbing Fee 85.00 Yo0 sa TRACT NAME HORIZON PALMS OWNER NAYS (l. F. Mn (mneral Management Corp. ' CONTRACTOR -FIRM NAME J.L. Construction ADDRESS above CITY/COMMUNITY/STATE/ZIP atimm PHONE • with ccmmmitzZ t Department LICHC . - ARC/ENG FIRM NAME Michael Buccino Assoc. ADDRESS 340 S. Farrell Dr. A212 CITYICOMMUN ITY/STATEaI P Palm rin s CA 92262 PHONE . LICNC a 323-7877 1 1 USE OF PERMIT ' Single Familv Dwelling BL I ZON. FSB SSB SSB RSB OFC ZONE ORD • LOT SZ END SIDE 5� CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be completed it the permit is for one hundred ($100) o, 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 o1 California. Date Applicant 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. 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 32, Grp 2, Art 2, Sec 341, 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. O Division of Industrial Safety Permit No. Date Applicant CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance o1 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. 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 I 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 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 Print Applicant/Agent Name O Date APPUPRMT DATE _ T - 5-2-2-_8 5 S:F.D. Permit to construct 1247 sq. ft. of —livincr area and 433 sq. ft. of garcage as per appirmed plans. mech. Fee 37.00 Plan Check Fee 307.96 Const. Fee 367.00 Meat, Fee 60.18 cZff Fee 5.46. -Plunbing Fee 85.00 Tnfrastructure 862.60 105.72 DEP. PAID 756.88 * ggreembnt with ccmmmitzZ t Department TOTAL EE 862.60 FINANCE 75688 CK VALUATION F77,948.00