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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