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001439 (SFD)•. ... fir. .. .. • _�� . _ - ^ ' . -•- _ .. , P.O. BOX 1504 No. � Building 78-105 CALLE ESTADO Address 79-312 q.. SNvmao4f.1110mi Tlfy_ LA QUINTA, CALIFORNIA 92253 } Owner BUILDING: TYPE CONST. V N OCC:.GRP. R:3 Mailing .. AddressUIR Rifft- 27011 A.P. Number City Zip %!r^::�%ij� Tel. ��, zi Legal Description Contractor -• - ' p ... ... .' .. • . Project Description •. Z' 2_ ±'lr�e;lr'sys+a�r�i:^x3n t46 Wifts pye,,,,ikD,,,,��,�.��, _ . Address.... P.0. 17.3City . .. Zip .... _.. - . ... Tel.' ' 92053 340--W11 State Lic. City & Classif.: 4421822 Lic. # 237 Sq. FLOW .1247 No.-No. Dw. Arch:, Engr., Size, C .433... -..Stories Units Designer • ' BWMLMNew,© Add ❑ ' Alter ❑' ' Repair ❑. Demolition ❑.. Address Tel. City Zip State P� 0 ?.262 Lic. # LICENSED CONTRACTOR'S. DECLARATION. I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section- 7000) ofDivisio'n'3'of the Business and Professions Code, and,my license•.is in full force and effect.i ..y'�f' .7 r.;fn .� SIGNATURE--,,IV - ✓` DATE -- _ - - - OWNER-BUILDER DECLARATION EStlmated Valuation I hereby affirm that I am.exempt from the Contractor's License.Law.for the following. - reason: (Sec. 7031..S,Business and Professions ,Code: Any. city_ or. county, which requires a .moi. `_4A' Af 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 _ PERMIT­ AMOUNT - - - =:: - - the provisions of. the Contractor's .License Law, Chapter 9 (commencing with Section 7000) of ,w' Division 3 of the Business 'and Professions Code, or thathe is . ezempf'therefrom,-'and the' basis - - - :r - for the alleged exemption. Any violation of Section 7031:ra permit Plarl.Chk. 5 by 'any applicant for Dep..... .. .€5_72 subjects the applicant to a civil penalty of not more than five:hundr"ed:dollars ($500).' '- - - Plan Chk.`Bal. . ' O I, as owner of the property, or my employees with .wages astheir-solecompensation, will - 202 -.24 do the work, and the structure is not intended or offered for sale: (Sec. 7044, Buisness and'"CnSt.' �M nw Professions Code: The Contractor's License Law does not apply.-to an owner of property who 7ga-1...M builde or improves thereon and who does such work himself or through his own employees, Mech. ' - + provided that' such improvements are. not intended or offered for,sale. If, however, the building W-c "!f or improvement is sold within one year of completion,. the owner-builder will have the burden Electrical' ' of proving that he did not build or improve for the purpose of sale.) . +" O .1, as owner of the property,.am exclusively contracting with licensed contractors to con- Plumbing at;. ^struct the project. (Sec. 7044, Business and Professions Code:.The Contractor's License Law 10 does not 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 L•icense.Law.) - Grading : ❑ I. am exempt under Sec.B. & P.C. for this reason Driveway Enc. Date owner Infrastructure. WORKERS' COMPENSATION DECLARATION hereby 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 O Copy is filed with the city... ❑ Certified copy is hereby furnished.'. TOTAL 362,.60 .$8 CERTIFICATE OF EXEMPTION FROM REMARKS , 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. f, employ any person-in-anymanner soas, to become subject to the Workers' Compensation - Laws of California. Date Owner ' NOTICE TO APPLICANT: If, after making this Certificateof: Exemption you should become ZONE: BY: - subject to the Workers' Compensation provisions of the Labor Code,' you must forthwith Minimum Setback Distances: comply with such provisions or this permit shall be deemed revoked. - Front Setback from Center.Line Rear Setback from Rear Prop..Line CONSTRUCTION LENDING AGENCY +° Side Street Setback from Center Line hereby 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,ffrom 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 it work thereunder is suspended for 180 days: I certify that I have read this. application and'state„that .the above information is correct. Issued by:: 'Date Permit . 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 the above-. mentioned property for inspedtion,purposes. J _ Validated by: Sic.' of a lica pp 9 Date Mailing Address ` ' i _ �/ Validation: City, State, Zip HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ 2ND FL. SO. FT. ® POR. SO. FT. ® GAR. SQ. FT. ® CARP. SQ. FT. WALL SQ. FT. ® SQ 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 APP./EQUIP. LAUNDRY TRAY AIR HANDLING UNIT CFM TEMP. POLE 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 ® 1114 c SEWAGE DISPOSAL SQ.FT.GAR ® 3/4c HOUSE SEWER REMARKS: GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE IVECH.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 APP./EQUIP. 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 . PERMIT APPLICATION City of La Duinta Department of Building and Safety �.. ADDRESS P.O.-Box 173 1Z JOB SITE ADDRESS/SPACE CITY/COMMUIITY/STATE/ZIP La: to CA 92253 BOK PAG PRC I C SMI Fee 5.46 This permit becomes void if work not commenced within 180 days from date of issuance. OR, it work has been suspended or abandoned for a period of 180 days. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be completed if 'LICENSED CONTRACTORS 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 lull 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 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 of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500.): 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, acid 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 1, as owner of the property, am excufsively 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 builQs 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. 6 P.C. (Attached Certificate). Date Owner WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell -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. MI) JL Construction ADDRESS P.O.-Box 173 CITY/COMMIJINITY/STATE/ZIP Nestor; CA 92053 JOB SITE ADDRESS/SPACE CITY/COMMUIITY/STATE/ZIP La: to CA 92253 BOK PAG PRC I C SMI Fee 5.46 TWN MG SE I S 9199 903 LO%/ with Crimmuni±y t Department MOD' S13 TRACT NAME _ HOPJZCN P IM i�r111 Val1Y OWNER /MME IL. F. Mq Management Corp. ' CONTRACTOR -FIRM NAME J.L. Construction ADDRESS above CITY/COMMUNITY/STATE/ZIP PHONE . LICNC • ARC/ENG FIRM NAME ' Michael Buccino Assoc. ADDRESS 340 S. Farrell Dr. A212 CITY/COlMMUN ITY/STAUaI P Palm SiDrincts. CA 92262 PHONE . LICNC • 323-7877 USE OF PERMIT Single Family Dwellin BL ZON. FSB SSB SSB I "RSI DEC ZONE ORD • LOT SZ END SIDE 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 tothe Workers' Compensation Laws of 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: 0 I 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 a2. Grp Z 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. 0 Division o1 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 I certify theft 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 Ihave read this application and state that the information given is correct. I agree to comply with all state laws and county ordinances relating to buidlicg . 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 101/f,3 r% APPL/PRMT i- DATE 5-2J2=85 S.T.D. Permit to construct 1247 sq. ft. of living area and 433 sq. ft. of garage as per approved plans. Me -ch. Fee 37.00 Plan Check Fee 307.96 Const. Fee 367.00 Elect- Fee 60.18 SMI Fee 5.46 .P1 imbi ng Fee 85.00 Tnfrastructure * 862.60 105.72 DEP. PAID • 756.88 * gqreerrdmt with Crimmuni±y t Department TOTAL- FEE 2.60 A i i D /. D LS /5IS88 CK FINANCE VALUATION '77548.00