001529 (SFD)P.O. BOX 1504 N O .. - 001529
Building78-105 CALLE ESTADO
Address 79-280 N. Stn RLdgS Dr. LA QUINTA, CALIFORNIA 92253 _
Owner
.agemmt s
Mailing " BUILDING: TYPE CONST. OCC: GRP. --3
Address 1 BiShop Mo &dta 2700
• A.P. Number -
City Zip Tel.
96813 Jrg000.,36ga,SQr4 Legal Description
ContractorProject Description
J.L.qq. . s�
6�iX i .. ...,
Address. . , _....'... , . .....:. .. .. - '
-146 WtS DUMI.
.ii. PAMlyn
..City ..._ .. Zip Tela�ypy�� �Y
92053 d''40���d t :.
State,Lic. City M 1247 ._
Lic. # ' 23,7 Sq. Ft.GM No. No. Dw.& Classif. Size"282
.4.33 Stories Units -
Arch:; Engr.;
Designer New Add• ❑ Alter ❑ Repair ❑ Demolition ❑'
Address Tel.
... 340 S. =L-.0 St, 323-7,977 .
City Zip State
palm i
gs 922Q " Lic. #
LICENSED CONTRACTOR'S.DECLARATION
�I hereby affirm;tha41 am licensed under provisions of Chapter 9 (commencing'with Section
7000) of
Divisiion 3 of the Business and Professions Code, and my license is in full force and'
.effect._ . r.f ✓� �. 7
SIGNATURE r f ,/ DATE '
OWNER -BUILDER DECLARATION `
I hereby affirm that I am exempt from the Contractor's License Law for the following Estimated ValuationF� pp��e�ec 'n1�n•
reason:.(Sec. 7031.5,Business and Professions Code: Any city or county which requires •a a. .94st,..4.3i1 '
permit to construct, attereirimprove, demolish, or repair any structure, prior to its issuance also
AMOUNT
requires. the applicant for such -permit to file a signed statement -that, is licensed pursuant to PERMIT
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 theiefrom, and the basis ' -
for the alleged .'exemption. Any violation, or Section 7031.5. by any applicant for -a permitPlari Chk. Dep:�,a,
subjects the applicant'to a civil penalty of not more than five'hundred dollars ($500): - `
Plan, Chk. Bal. RRt�+f
❑ I, as owner of the property, or my employees with wages.as.their sole compensation, will GSSA�
do the 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 o/ property who, COf1St._:.. ,� 0
builds or improves tliereon.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,.ahe. building. • al eBiJ
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.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con Plumbing��
•• 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 S.M.I.
such projects with a -contractors) licensed pursuant to the Contractor's License Law.) - -
Grading
O 1 am exempt under Sec. B. & P.C. for this reason
Driveway Enc.
.. Date : .'Owner - Infrastructure Daefyo�n' ,,,,��� s ia1', ,
WORKERS' COMPENSATION DECLARATION
'1'hereby 'affirm 'that I have a certificate of consent to.self-ihsure; or a certificate of -
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company . .
b Copy is filed with the city. . ❑ Certified copy is hereby furnished. +q��
TOTAL P-62.60 F3€mi.W
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 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 ZONE: BY:` "
subject to' the" Workers' Compensation 'provisions 'of 'the Labor Code, you• must forthwith-
comply
orthwith Minimum Setback•DistaflCeS:
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
I hereby affiim 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 FINAL.DATE INSPECTOR
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: Issued by: Date permit
construction,
to comply with all city and county ordinances and state laws ielating to building
construction, and hereby authorize representatives of this city to enter the/above-.
mentioned property for inspection purposes. Validated by:
� 3y.
Signature of applicant ✓fj ✓f �,�� r Date 21"It. '!
Mailing Address 7 Validation'
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SQ, FT. ®
CAR P. SQ. FT.
WALL SQ. FT. p
SQ 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
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP.IEQUIP.
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.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 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
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEQUIP.
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 SIGNATURESIINITIALS
GARDEN WALL FINAL
LICENSED CONTRACTORSDECLARATI
-(commencing with Section 7000) of Divi
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 ($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. It, 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 o1 sale.).
❑ 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 o1 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. 31)00. 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
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 o1 180 days.
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be completed if
ON: 1 hereby affirm that I am licensed under provisions of Chapter 9 the permit is for one hundred ($100) o, less. I certify that in the performance of the work for which this permit is'
sion 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 to the Workers'Compensation Laws of
California.
APPLICANT NAME (L. F. MI)
JL Onnstruction
ADDRESS
P.O. Box 173
CITY/C XWLFNITY/STATMIP
. Nestor; CA 92053
JOB SITE ADDRESS/SPACE
CITY/COM LINITY/STATE/ZIP
La• to CA 92253
BOK
PAG
PRC
C
TNN
RNG
SE
S
TRACT 3
1990TRACT
LD��p
Elect- Fee 60.18
MOO
I SS
.plimbing Fee 85.00
NAME
HORIZON PALMS
OWNER NAME (L, F. MI) Garteral Management Corp. '
CONTRACTOR -FIRM NAME '
J.L. Construction
ADDRESS
ahmm
CITY/COAM4UNITY/STATE/ZIP
PHONE 0 '
756.88
LICNC /
* a eentint
ARC/ENG FIRM NAME '
Michael Buccino Assoc.
ADDRESS
340 S. Farrell Dr. A212
CiITYMOMMUNITY/STATE/ZIP
Palm Springs, CA 92262
PHONE LICNC
323-7877
TOTAL
FEE
USE OF PERMIT
Single Famil Dwelling
el
ZON,
FS8
'SSB
SSO
RSB
OFC .
ZONE ORD •
LOT SZ
END
SIDE
L
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, fafsework, or
'demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap 3.2, 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 do such work from that division.
0 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.) 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 a pplicatioin and state that
the information given is correct. I 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 Date
'Print Applicant/Agent Name oo I c 2 q
APPLNRMT r ? - - `
S.F.D.
Perimit to construct 1247 sq. ft.
of
livingarea and 433 . ft. of
age
as r approved plans.
h. Fee 37.00
Plan Check Fee 307.96
Const. Fee 367.00
Elect- Fee 60.18
Fee 5.46
.plimbing Fee 85.00
Infrastructure
862.60
105.72 DEP. PAID
756.88
* a eentint
t Department
TOTAL
FEE
2.60
A i L D i L-) / 7 6 8 8 R
FINANCE VALUATION 77,948.0