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001441 (SFD)4, : i • 44 P.O. BOX 1504 .N o . Building�,g �,�, 78-105 CALLE ESTADO Address 79-307 So �. M". LA OUINTA, CALIFORNIA 92253 Owner Mailing ' Address ion Bid=st$� 27oo City Zip Tel. alQ Contractor e T. frllaiarratyta4t5re Address. .. _. .... q Pao. 173 City JZi0 Tel. - State Lic. & Classif.:,AAW Arch.; Engr., Designer MiAt Address _ .. 340 City !Aa 4tts? 4�r I hereby affirm that I. 7000) of Division 3 of t effect... .. , BUILDING:•TYPECONST•. OCC:GRP. ,.R.'3 A.P. Number ;367�-SOLegal Description Project Description Horizon Pal r .146 MAto ReSid2ntiAl Duml- I City . I Lic. # 237 -1 $IMIXiM, ASSoaa Tel. 17 -.. 323-7877 Zip State i 4".'%�� Lic..# .. .. CENSED CONTRACTOR'S DECLARATION under provisions of Chapter 9 (commencing with Section and Professions Code, and my license. is%in full force and Sq. Ft.= 1247• No. No. Dw. Size • 41,%k Stories Units ' New T -Add ❑ Alter ❑ . ' Repair ❑_ - Demolition ❑ . •. OWN EA. BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the followings Estimated Valuation t3�e �A 7�t8�11tJ reason: (Sec.-Z031:5.,By iness and Professions Code: Any•clty or county; which requires a - PERMIT - .. - •' AMOUNT - permit to construct, alter, improve, demolish, or repair any structure, prior Wits 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 withv Section 7000) of ' Division 3 of.the'Business and Professions' Code, or that. he is exempt therefrom;- and'tne 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'thanfive hundred dollars ($500): •' "' ' . - p p y, or my employees'with as their sole compensalion,:will.Q ❑ 1, as owner of the property, 016n,Chk: Dep.' J05.72 Plan Chk. Bdl. - C6'hst.' - ' do -the work, and the structure isnot 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 - MBCh ., builds. or improves thereon and who does such work himself or throughhis own employees, provided that' such improvements are .not intended. or offered: for sale: If, however, the building _ Electrical' — orimprovement 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.) , , _ _ _ Plumbing- Art - (10 O 1, 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 1 am exempt under Sec. B. & P.C. for this reason S.M.1.- _46 - Grading Driveway Enc. Date Owner, _Infrastructure yf. `0n1C^m°«3'•^ 10 Bi` tV WORKERS' COMPENSATION DECLARATION ' Thereby' 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 Qr. - em . REMARKS 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. - ZONE: - BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop.. Line ..CONSTRUCTION LENDING AGENCY Side Street Setback from Center-Llne Ihereby 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 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. agree to comply with all.city, and county ordinances and state laws relating -to building. construction, and hereby authorize representatives of this city to enterthe above. mentioned property for insfctiopnpurposes. f # Signature of applicant Date TT Issued by: Validated by: Date Permit Mailing Address "� / Validation; City, State, Zip HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES' IST FL. SO. FT. ® $ UNITS SLAB GRADE 2ND FL. SQ. FT. BONDING YARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. SQ. FT. GAS (ROUGH) DRAINAGE PIPING WALL SQ. FT. OTHER APPJEQUIP. 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.000L 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, TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SQ. FT. ® c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1 % c SEWAGE DISPOSAL GAR. FIREWALL SO.FT.GAR ® 3/ac HOUSE SEWER LATHING 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 APPJEQUIP. 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 .r S Ie. PERMIT APPLICATION City of La Dulnta Department of Building and Safety This permit becomes void if work not commenced within 180 days from date of issuance. OR, II work has been suspended or abandoned for a period of 160 days. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: 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 ($100) o, less. l certify that In the performance o1 the work for which this permit is (commencing with Section 70DO) of Division 3 of the Business and Professions Code. and my license Is In full force Issued. I shall not employ any person Inany manner so as to become subject tothe Workers'Compensation Laws of and ellect. California. License Class Lic. Number Date Applicant Date Contractor NOTICE TO APPLICANT: IL 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 revolted. reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to I AND construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law 01 hereby 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 Sof 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 of Section 7031.5 by any applicant for a permit demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap 32, Grp 2. Art 2. Sec 341, Title 8. subjects the applicant to a civil penalty of not more than five hundred dollars ($500.): C.A.C.) O I, as owner of the property, 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 of property who builds, or improves thereon, and who does such work himsell or *neferred pa=mt as Re=r ggremtnt through his own employees, provided that such improvements are not intended or offered for sale. If, however, the O Division of Industrial Safety Permit No. building orimprovemntissold within oneyearofcompletion, the owner -builder will havetheburden ofprovingthat Date Applicant he did not build or improve for the purpose of sale.). CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance O I, as owner of 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 not 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 USE OF PERMIT Sin le Fami1v Dwellincr Contractor's License Law.): Lender's Address O 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. I agree to comply with all ' Date Owner `city and county ordinances and state laws relating to building construction, and hereby authorize representatives SSB 01 this county to enter upon the above-mentioned property for inspection purposes. WORKERS' COMPENSATION DECLARATION: 1 hereby affirm that I have a certificate of consent to self -insure, or a DEC 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 1 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 Signature of Applicant or Agent Date Print Applicant/Agent Name APPLICANT NAME (L. F. MI) JL Construction ADDRESS P.O. Box 173 CITY/COMMM ITY/STATE/ZIP Nestor; CA 92053 JOB SITE ADDRESS/SPACE Lv CITYPCOMMLRIITY/STATE/ZIP - La. Qainta, CA 92253 am PAG PRC I C TWN I AND SE L 1TRACT 3 LDT/]�/ SMI Fee 5.46. MOD so Tnfrastructure TRACT NAME HORIZONtPtt��lN.l.',S . OWNER NAME lL. F. MI) Gwie ,,al 1•JanagP.Il mt Coif • ' l�liGl CONTRACTOR -FIRM NAME J.L. Construction ADDRESS abimm - CITY/COMMLINITY/STATE/ZIP abQm PHONE . *neferred pa=mt as Re=r ggremtnt LICNC e ARC/ENG FIRM NAME Michael Buccino Assoc. ADDRESS 340 S. Farrell Dr. A212 CITY/COMMUNITY/STATE/ZIP Palm Springs, CA 92262 PHONE . LICNC . 323-7877 _ USE OF PERMIT Sin le Fami1v Dwellincr BL ZON, Fsa Sao SSB RSO DEC ZONE ORD . LOT SZ -ENO SIDE APPL/PRMT,,DATE ,; ��� 5-22=85 S.F.D. Permit 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 Elect - Fee 60.18 SMI Fee 5.46. .Plunbing Fee 85.00 Tnfrastructure 862.60 105.72 DEP. PAID 756.88 *neferred pa=mt as Re=r ggremtnt t Departnent TOTAL `. FEE 862.60 N 1 1 7 7 7 L FINANCE VALUATION 77, 948.00