001403 (SFD)P.O. BOX 1504 N 0 ••
Building 78-105 CALLE ESTADO
Address 70—Ala yz_ ch-jm-J;uk D's rjr LA QUINTA, CALIFORNIA 92253
..Owner
G•Valagmmt C=P' BUILDING: TYPE CONST. V 'OCC: GRP:. _ R__3,
Mailing`
AddressRM 3-40. MAW S. Suite 2700 A.P. Number
City Zip Tel. -
••..l u'. �; 96813 �.-8%j-367" Legal Description
Contractor f
Project Description HOS
'R' 3,_:
.. _
Address-146-yy�j.... �.
♦�ls 173
....City. Zip .. Tel:...
> 92053 340-55n
State Lic. City 2247
& Classif...,2 Lic. # Sq. Ft.' No. No. Dw.
442R2_
Size- - -433. -Stories. A Units
Arch., Engr:, '
Designer Ne a • Add ❑ Alter ❑ Repair O. Demolition 0
Address Tel.
.340 ftX-7R Dr. .. 323.78'3'7.
City Zip State
t),s`+Ra,*'esuxr� 'J:22,62 Lic:
LICENSED CONTRACTOR'S DECLARATION
hereby affirm thattl am licensed under provisions of Chapter9'(commencingwith Section
7000) of D'vision 3 of the Business and Professions Code, and my license is in full force and
effect. }
%GNATD E 7 DATE
OWNER -BUILDER DECLARATION • ` ' •' Estimated Valuation
l
I hereby affirm that I am exempt from the Contractor's License Law for. the following y} 'dAt9lf
reason:.(Sec. 7031.5,Buslness. and Professions Code:. Any .city o[. 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 - PERMIT AMOUNT -
the provlsions o/ 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 there/rain, and 'the basis'
for the alleged exemption. Any violation 'of Section 7031.5 -by. any applicant lora-.permit; PIan:Chk.,Dep. - 165.72 '
subjects the applicant to -a civil penalty'of not more than five hundred dollars (3500).
.
0 I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk! Bal.� � a ,
do the work; and the structure is not intended or offered for sale. (Sec: 7044; Buisness and Const. `3,
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, Mech. '- - `3;; '
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 • EIQCtfICdl
of proving that he, did not build or improve for the purpose of sale.) _ _ _' �•
❑ 1, 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. 5.46
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
O.I am exempt under Sec. - B. 8 P.C..for this reason
Driveway Enc.
Date owner Infrastructure'j PAM M AS PM AMS:
\ % WORKERS' COMPENSATION DECLARATION i
/j1�` I 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 No4..�' IJ ;Company.
❑ Cops filed with the city. .El Certified copy is hereby furnished.
r9 TOTAL r ?a 756.88
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 t
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 o/ *'the Labor Code, you roust forthwith
comply with such provisions or this permit shall be deemed revoked: ' Minimum Setback Distances: _
Front Setback..from.Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCv- _ Side Street Setback from Center.Line
I hereby, affirm that there is a construction lending agency for the performance of the .
. work for which this,permit.is issued. (Sec. 3097, CivilCode.)•• - - Side Setback from Property Llne`•
Lender's Name
Lender's Address
This is'a building permit when'properly filled out, signed and validated, and is subject to FINAL DATE INSPECTOR. -
expiration if work thereunder is suspended for 180 days.:
J certify that I have read this application and state that the above information is correct. ISSUed'by- Date- Permit:
agree to comply with 'all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives' -of athis city to enter the above•.
mentioned property for insspec!ion,purposies. ( Validated by:
Signature of applicant X J ff I o .1 :y/ +"f .f - Date
Mailing Address Validation:
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
2ND FL. SO. FT.
BONDING
YARD SPKLR SYSTEM
POR. SO. FT. p
MOBILEHOME SVC.
BAR SINK
GAR. SO, FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT.
GAS (ROUGH)
DRAINAGE PIPING
WALL SO. FT.
OTHER APP./EOUIP.
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.COOL 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, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. p c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 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
SWFFEi---j 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./EOUIP.
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
PERMIT APPLICATION
City of La Ouinta
Department of Building and Safety
This permit becomes void if work not commenced within 160 days from date of issuance. OR, If work has been suspended or abandoned for a period of 180 days.
CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATIONINSURANCE: 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 3of 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 of the Contractor's License Law
(Chapter 9 (commencing with section 7000) o1 Division 3of 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.):
0 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 o1 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.).
0 1, 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
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. 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. Q.
Policy No. Company
O Certified copy is hereby furnished.
D Certified copy is filed with the City Building Inspection Department or City Department.
Date Applicant
APPLICANT NAME (L. F. MI)
JL (brLstruction
ADDRESS P.O. Box 173
CITY/COMMUNITY/STATE/ZIP
Nestor; CA 92053
JOB SITE ADDRESS/SPACE '
CITY/COIMM IINITY/STATE/ZIP
lia.Quinta, CA 92253
apt(
PAG
PRC
C
I
TWN
I AND
SE
I S
19903
LCT
O.
I
Moo
SB
TRACT NAME
HORIZIM PALMS
OWNER NAME (L. F. MI) Goneral Management Corp. '
CONTRACTOR -FIRM NAME
J.L. Construction
ADDRESS -_
above
CITY/cp►MUNITY/STATE/ZIP
PHONE a
LICNC e
with Gintmmity t Department
ARC/ENG FIRM NAME
Michael Buccino Assoc.
ADDRESS
340 S. Farrell Dr. A212
• CITY/COMMUNITY/STATE/ZIP
Palm Springs, CA 92262
PHONE . LtCNC e
323-7877
USE OF PERMIT
Single Family Dwelling
aL
ZON,
'FSB
SSB
SSB
RSB
I
OFC
.-
ZONE ORD a
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 to the 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:
O 1 hereby certify that no excavation live (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 12, Grp Z 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.
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. 3091, Civ. C.).
Lender's Name
Lender's Address
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 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. I agree to comply with all state laws and county ordinances relating to bufdfing
,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 06 rv^ 3
Date
APPL/PRMT . �� DATE '
5-2-2=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
F-lect- Fee 60.18
54 -off Fee 5.46
.plimbing Fee 85.00
862.60
105.72 DEP. PAID
756.88
* agreembnt
with Gintmmity t Department
TOTAL
FEE
862.60
A 1 1 1. 0 7 L L / 7 6, 8 8 CK
`• FINANCE VALUATION 77, 948.00