001522 (SFD)4 44
hf -
r J.
P.O. BOX 1504 No. 001522
Building 78-105 CALLE ESTADO
Address 79-445 bl• S=riSe Ridgr_- Dr. LA,QUINTA, CALIFORNIA 92253
Owner _. .
- -
Mailing BUILDING: TYPE CONST. Q W.. -OCC: GRP. : P. 3 .
Address 1001 B . 21 A.P..Number
City Zip Tel. _
969.113 1-$32-361054 Legal Description
Contractor Project Descriptiong*'S?3 '
:E�' t`�evnl�t�1 ,
Address .. .... .. X46 �. . M aftWl EMVI.
P.Q. Bc 173 .
City Zip' . Tel.
92053 34512 .
State Lia City �»�
& Classif. Lic. # Sq. Ft. No. No. Dw.
2'17 Size,. CM - Stories --Units
Arch.; Engr., .... _
Designer Ildchimi M A.l=. New R. Add ❑ Alter ❑::. .Repair.❑ Demolition ❑
Address Tel.
City Zip State
Ott!; '.�`f'SY:7t 9
Lic. #
LICENSED CONTRACTOR'S DECLARATION..
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 full force and
effect.
SIGNATURE 7 Y i! ,!_ ,A ' DATE .. - .. ... ..
OWNER -BUILDER DECLARATION y'.. EStlmatt?d ValUatlOn �9 �atf �,�}
I hereby affirm that I am'exempt from the Contractor's License Law for the following [ f r�°24bs+��a e.
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 dts•'issuance also - requires the the applicant for -such permit.lo filea 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'of the Business and Professidns Code, 'or.lhaG he is exempt therefrom, and the basis ,
for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit Plan Chk. Dep. 1015.72
.'subjects the -applicant to a civil penalty of not more than five hundred dollars ($500).' • ' '
O Ias ownecof the property;.or my employees with wages as their sole compensation, will' Plan. Chk.. Bal...
- _
107 714
do the
work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Cohst. +��p y�
• Professions Code: The Contractor's License Law does not apply to an owner of property who 6 .00
builds'or improves thereon and who does such work himself -or through his own employees,. - 63�!
_ .provided that' such improvements are not intended or offered for sale. If,: however, the.. building Mech. � 3«� .00
or. improvement is sold within one year of completion, the owner -builder will'have the burden "EI2CtrIC1I 60.19-
of proving that he did not, build or improve for the purpose or sale.) • . . . _ . . - -
[1-1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing a!;.00
strucl 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. �:��
such protects -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 bafemed vaawnt at g mire
With
WORKERS' COMPENSATION DECLARATION
1 hereby'af firm '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. O Certified copy is'hereby furnished.
TOTAL �.
CERTIFICATE OF EXEMPTION FROM REMARKS.
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one -hundred dollars ($100) valuation -
or less.) .. .. .,
I certify that in the performance of thg work for which this permit isissued, I'shall not
employ any person -in any manner so as to become subject to the Workers' Compensation - -
Laws of California.
' 'Date 'Owner -
NOTICE TO APPLICANT.- If, after making this Certificate of Exemption you -should become, ZONE: BY:
subject 'lo the Workers' Compensation provisions' of -the Labor code, you. must- forthwith Minimum Setback Distances:
comply with such provisions or this permit shall be deemed revoked.
Front ,$etback.fro.m Center Line
- . Rear Setback from. Rear Prop. Line
CONSTRUCTION LENDING AGENCY. Side Street Setback from Center Line'
hereby affirm that tlie�e is a construction leriding agency for the performance of the
work forwhich, this permit is issued. (Sec.:3097, Civil Code.) . Side Setback from Property Line
Lender's Name
Lender's Address
This is a building permit when properly filled out, 'signed and validated,'arid is subject to FINAL DATE INSPECTOR
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
I agree to comply with all.cityiand county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to -enter the' above-.'
mentioned property for inspeyyc"'tio1%n//pu,rposes.* 1 �° t Validated by:
Signature of applicant t' .!l�Jf L !rI J i'+ Date °r J
Mailing Address r �r _Validation:
City, State, Zip
rIMMU 6VYT
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. @ $
UNITS
SLAB GRADE
2ND FL SQ. FT. @
BONDING
YARD SPKLR SYSTEM
POR. SQ. FT. @
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. @
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT. @
GAS (ROUGH)
DRAINAGE PIPING
WALL SQ. FT. -90
OTHER APP.IEQUIP.
DRINKING FOUNTAIN
SQ. FT. g
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.
ITEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HF
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
GAR. FIREWALL
SQ.FT.GAR ® 3/4c
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
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 SIGNATURE311NITIALS.
GARDEN WALL FINAL
/
PERMIT APPLICATION
City of La Ouinta
Department of Building and Safety
This permit becomes void if work not commenced within 180 days from date o1 issuance, OR. It work has been suspended or abandoned for a period of 180 days
APPLICANT NAME (L. F. MI)
JL Onnstruction
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 (5100) It. less. I certify that in the performance of the work for which this permit is
(commencing with Section 70DO) of Division 3 of the Business and Professions Code. and my license is in full force
issued. I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of
and effect.
California.
License Class Lic. Number
Date Applicant
Date Contractor
NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to the Workers'
OWNER BUILDER DECLARATION: I hereat' affirm that 1 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.
fallowing reason (Sec. 7031.5. Business and Professions Code: Any city or county which requires a•permit to
LOT /7
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 pursuant to the provisions of the Contractor's License Law
01 hereby certify that no excavation five (5) or more feet in depth into whicha person is required to descend, will be
(Chapter 9(commencing with section 7000) of Division 3 o 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 An 2, Sec 341. Title 8.
subjects the applicant to a civil penalty of not more than five hundred dollars (5500.):
C.A.C.)
O 1, as owner of the property, or my employees with wages as their sole compensation• will do the work, and the
O As owner -builder. I will not employ anyone to do work which would require a permit from the Division of
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 o1 property who builds. or improves thereon, and who does such work himself or
ADDRESS
340 S. Farrell Dr. A212
through his own employees, provided that such improvements are not intended or offered for safe. If. however. the
O Division of Industrial Safety Permit No.
building or improvemnt is sold within one year of completion. the owner -builder will have the burden ofprovingthat
Date Applicant '
he did not build or improve for the purpose of sale.).
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance
O I, as owner of the property, am exculsively contracting with licensed contractors to construct the project (Sec.
o1 the work for which this permit is issued (Sec. 3097. Civ. C.).
7044. Business and Professions Code: The Contractor's License law does not apply to an owner o1 property who
Lender's Name
builQs or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the
RSB
Contractor's License Law.).
Lender's Address
O 1 am exempt under Sec. B. 6 P.C. (Attached Certificate).
I cerlify 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
of this county to enter upon the above-inentioned property for inspection purposes.
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure, or a '
SIDE
certificate of Workers' Compensation Insurance , or a certified copy thereof (Sec. 3800. Lab. Q.
Signature of Applicant or Agent Date
Policy No. Company
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify Ihave read this application and state that
O Certified copy is hereby furnished:
the information given is correct. I agree to comply with all state laws and county ordinances relating to buidling .
O 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
upon the property for which I have applied for this permit for the purpose of making inspections.
Date Applicant
APPLICANT NAME (L. F. MI)
JL Onnstruction
ADDRESS
P.O. Box 173
CITY/COMMUNITY/STATFJZI P
Nestor, CA 92053
JOB SITE ADDRESS/SPACE
CITYICOMMUNITY/STATE/ZIP '
La. to CA 92253
8CW I
PAG
PRC
I C
I
TWN
RNO
SE
S
19903
LOT /7
Elect- Fee 60.18
MOD
I SO
.Plurrbi= Fee 85.00
TRACT NAME
HORIZON PAIMS
OWNER NAME (L. F. MI) Garieral Management Corp. '
CONTRACTOWFIRM NAME
J.L. Construction
ADDRESS
above
CITI/COMMUN ITY/STATE/ZI P
PHONE a
756.88
LICNC .
* agrewhnt
ARC/ENO FIRM NAME
Michael Buccino Assoc.
ADDRESS
340 S. Farrell Dr. A212
CITY/COMMUN ITY/STATE/ZI P
Palm Scirin s CA 92262
PHONE LICNC •
323-7877
TOTAL •
FEE'
USE OF PERMIT
Single Familv Dwellin
BL
ZON,
•FSB
SSB
SSB
RSB
OFC
ZONE ORD 0
LOT SZ
END
SIDE
k
Signature of Applicant or Agent
*Print Applicant/Agent Name 0 1 15
d
Date
APPIJPRMT ;y 5-2-2-85
S.Y.D.
Permit to construct 1247 sq. ft.
of
livin .area and.433 sq. ft. of garage
as per approved plans.
Mech.-Fee 37.00
Plan Check Fee 307.96
Const. Fee 367.00
Elect- Fee 60.18
SMI Fee 5.46
.Plurrbi= Fee 85.00
Tnfrastructure
862.60
105.72 DEP. PAID
756.88
* agrewhnt
t Department
TOTAL •
FEE'
862.60
NIL44 D ZS 75688 CK
FINANCE VALUATION 77,948.00