001516 (SFD)'a T4 hf
P.O. BOX 1504 No.. 041516
Building 79—A 78-105 CALLE ESTADO
Address � rr. LA QUINTA, CALIFORNIA 92253
Owner
Mailing BUILDING: TYPE CONST.- : OCCGRP.' 3.
Address 1A01 RiAcp St. fRA to 2700 A.P. Number
City zip Tel.
Legal Description
Contractor
+� Project Description 2i?1:2%as>
ll olt.��%i' �+
Address 3A6 .yrs. CA AmAiemgtiai k .
City Zip Tel.
State Lic. City DM 1247
& Classif.�� Lic. #� Sq. Ft: No. No. Dw.
:.
Size • GVH:• 433 - Stories Units
. Arch., Engr.,
DesignerAcbael Damm q . - N^, New 91 Add ❑ Alter ❑ Repair ❑ Demolition El
Address Tel.
34 S. ��L. 323-7877
City Zip State
Lic. #
•, _ .. ,LICEN'SED CONTRACTOR'S DECLARATION: '
I hereby affirm that I arii_licensed under provisions of Chapter 9 (commencing with'Section' >
7000) of Division 3 of th---e B'us'ness and Professions Code, 'and my license is in full>force and'
effect. /�ij
SIGNATURE "'-! / 1' DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from'the Contractor's License Law for the'following Estimated Valuation ` ��4�
reason: (Sec. 7031. S,Business and, Pro/essions Code: Any city or county which requires a - ..• , •+ .00 -
�peimit,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
Division 3 o/ the Business and Professions' Code, or thathe is -e'xempt therefrom,and the basis -• .. -
for the alleged exemption. Any violation of. Section 7031.5, by 'any applicant for a permit •_ _.Plan Chk: Dep. - 105.72 -
' subjects the 'applicant to a civil'penalty of not more than five hundred'dollars ($500):
2
❑ I, as owner of the property, or my employees with Plan Chli. wages as their sole compensation, will Bal. +w - 4
do the work, and the structure is not intended or offered for sale. (Sec. 7044;'Buisness and Const. '
Professions Code: The .Contractor's License Law does- not apply to, an owner o/ property who .
00
builds or'improves' thereon and who does such work himself 'or through his own employees, -
provided that' such ,improvements are not intended or offered for sale. If,, however, the. building .37100n '
or improvement is sold within one year Mech.
ar or completion,. the owner -Builder will have the burden EIBCtrICdl �V `i,$
of proving that he did not build or improve for, the purpose of sale.)
O I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing M00
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.1. - - •�.*,
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)'
Grading
... .❑ I.am exempt under. Sec.- B. 8 P.C. for this reason ...
Driveway Enc.
Date Owner Infrastructure
Desumd 1a s - t
WORKERS' COMPENSATION DECLARATION
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 No: Company
O; Copyis filed with the city. O Certified copy is hereby -furnished. '
TOTAL 8 s�.' 756.88
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This, section need not be completed i/ the permit is for one hundred dollars (Stool valuation ' - or less.)
I certify that in the performance of thg 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: It, 'after making this Certificate of Exemption .you should become, -ZONE: BY:.
'
'subject to the Workers' Compensation provisions o/ the -Labor Code; you 'must forthwith Minimum Setback Distances:
with such provisions or this permit shall be deemed revoked.
Front S,e.tback. f.rom.Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY v - Side Street Setback.from Center Line
Thereby affirm that there is a construction lending 'agency for.the performance of the
work for 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.l 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, this city to- enter . the above
mentioned property for inspecttiion/purposes. r Jk Validated by:
Signature of applicant1F ? h 'i r Date /i
Mailing Address - J, Validation:
City, State, Zip
HARD COPYI _
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
2ND FL. � SO. FT. ®
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. I S0. FT.
WALL S0. FT.
SO 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.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP.IEOUIP.
LAUNDRY TRAY
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.
SO. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ao
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
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
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
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS.
GARDEN WALL FINAL
PERMIT APPLICATION
City of La Ouinta
Department of Building and Safely
This permit becomes void if work not commenced within 180 days from date o1 issuance, OR. If 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 it
LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions o1 Chapter 9
the,permit is for one hundred ($100)o. less. I certily lhat in the performance of the work for which this permit is
lcommencing with Section 7000) of Division 3 of the Business and Professions Code. and mylicense is in full force
issued. I shall not employ any peison in any manner so asto beconve subject to the Workers'Compensalion Laws of
and effect.
California.
License Class Lic. Number
Date Applicant
Date Contractor
NOTICE TO APPLICANT: If, after making this Certificate o1 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
Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall
be deemed revoked.
following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to
SE
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 pursuanttotheprovisions ofthe 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 3 of 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 3.2. Grp Z. Art 2, Sec 341, Title B.
subjects the applicant to a civil penalty of not more than five hundred dollars (5500.):
C.A.C.)
0 I, as owner of the property. or my employees with wages as their sole compensation, will do the work, and the
0 As owner -builder, I will not employ anyone to do work which would require a permit from the Division o1
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 himself or
LICNC .
through his own employees, provided that such improvements are not intended or offered for sale. If, however, the
0 Division of Industrial Safety Permit No.
building orimprovemntissold within one year ofcompletion. theowner-builder will have the burden of proving that
Date Applicant
he did not build or improve for the purpose of sale.).
CONSTRUCTION LENDING AGENCY: 1 hereby affirm that there is a construction lending agency for the performance
0 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 rat 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
Contractor's License Law.).
Lender's Address
0 1 am exempt under Sec. B. 8 P.C. (Attached Certificate).
I 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
'SSe I
of this county to enter upon the above-mentioned property for inspection purposes.
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure, or a
7T
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 l have read this application and state that
O Certified copy is hereby furnished.
the information given is correct.) agree to comply with all state laws and county ordinances relating to buidling .
0 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
SIDE
upon the property for which I have applied for this permit for the purpose of making inspections.
Date Applicant
APPLICANT NAME (L. F. M1)
JL Construction '
ADDRESS
P.O. Box 173
CITY/COMMUN ITY/STATE/ZI P
Nestor; CA 92053
JOB SITE ADDRESS/SPACE
CITYICOWUNITY/STATE/ZI P
La. to CA 92253
eOlt
PAG
PRC
c
Mech. Fee 37.00
TWN
RING
SE
s
TRACTI-,
19903
Rlec+_ Fee 60.18
SMI Fee 5.46.
MOD
I Sa
TRACT NAME
HORIZON PALMS
OWNER NAME (L. F. AII) Caneral Management Corp. '
CONTRACTOWFIRM NAME
J. L. Construction
ADDRESS
ahmrn
CITY/COMMUNITY/STATE/ZIP
PHONE .
LICNC .
t Department
ARC/ENO FIRM NAME
Michael Buccino Assoc.
ADDRESS
340 S. Farrell Dr. A212
Cm/COMMUNYTY/STATE/ZI P
Palm Springs, CA 92262
PHONE •
LICNC .
323-7877
USE OF PERMIT
Single Family Dwelling
eL
ZON,
FSe
'SSe I
SSS I
RS8
7T
7D
ZONE ORD .
LOT SZ
END
SIDE
Signature of Applicant or Agent Date
Print Applicant/Agent Name /) o , 5 1
APPLNRMT .� 5-2-2-8 5
S.F.D.
Permit to construct 1247 sq. ft.
of
living area and 433 sq. ft. of garage
as per appircmed.plans.
Mech. Fee 37.00
Plan Check Fee 307.96
Const. Fee 367.00
Rlec+_ Fee 60.18
SMI Fee 5.46.
Plimbing Fee 85.00
Tnfrastructure
862..60
105.72 DEP. PAID
756.88
* agreentint
t Department
TOTAL
FEE
2.60
H 1 L D b D L D / j G 8 6 GK
FINANCE VALUATION 77, 948.00 ,