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001517 (SFD)P.O. BOX 1504 No. 0015.7 Building 78-105 CALLE ESTADO Address 79-440 N. gt;F> r! me RWM flat.. LA QUINTA, CALIFORNIA 92253 Owner BUILDING: TYPE CONST. V 1d. 'OCC: GRP. Mailing' Address ]DfiI. Bisbmi, St.&tL- "DO A.P. Number City Zip Tel. Legal Description Contractor Project Description • •" Address...., City ... .. Zip Tel.' 92053 340,.-5511_ State Lic. City & Classif: 4142822 Lic. # 2371247 Sq. Ft.- No. No. Dw. Sizep MR'.• � Stories • Units ...Arch., Engr.;.. .. _ .. - Designer . New9 Add ❑ Alter ❑ Repair O Demolition ❑ Address Tel. ut! 17U7077 City _ Zip State ti2262 Lic. # LICENSED CONTRACTOR'S DECLARATION hereby affirm that I am licensed under provisions of Chapter 9 (commencing,wvith Section 7000) of Division 3 of the Business and Professions Code; and my license,is ifn+full force and - effect.. ' . - �r /2 J f l r .)"./+ ! /I }) _ SIGNATURE - ..' "/ d - _1 I DATE OWNER-BUILDER DECLARATION " -%' Estimated Valuation I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031. S,Busfness and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, of repair -any structure, prior to its, issuance' also•- requires the applicant /or 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 •ol 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 Phan Ch k.-Dep. _ .. ` ''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 Plan Chk. Bal.2 .2 do the work, and -the structure is not intended or offered for sale.�(Sec. 7044, Buisness and CohSt. �� ' 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. ws� r��e _ provided that such Improvements are not intended or offered for sale. I/, however, the building S r .0irs or improvement is sold within one year of completion, the owner-builder will have the burden EI@CtrlCdl ' �l►. of proving that he did not build or improve for the purpose o/ sale.) _ _ . _ " ' O I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 85.00 slruct 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 contractor(s) licensed pursuant to the'Contractor's License Law.) Grading O I am exempt under Sec. 8. & P.C. for this reason Driveway Enc. Date Owner Infrastructure Wfervali mmme it as amt 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 Copy is filed with the city. .O Certified copy is hereby furnished. TOTAL € 62_ A 7rA_S, 12 CERTIFICATE OF EXEMPTION FROM ' REMARKS. WORKERS' COMPENSATION INSURANCE - (This section need not be completed i/ 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 N employ any person in any manner so as to become. subject to the Workers', Compensation Laws of California. Date Owner" NOTICE TO APPLICANT:If, alter making this Certificate of Exemption you should become ZONE: BY: ' subject to the Workers' Compensation provisions- of the Labor Code, you must forthwith MinimURl.Setback Distances: 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 i- 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, 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, and'is subject to FINAL'DATE INSPECTOR expiration it 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 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 inspection purposes. f r r Validated by: Signature of applicant1 ft��" j Dater +'��f 7 Mailing Address ref ' f r Validation: City, State, Zip ' HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SQ. FT. @ $ 2ND FL. SQ. FT. @ POR. SQ. FT. @ GAR. SQ, FT. @ CAR P. SQ. FT. @ WALL SQ. FT. @ SQ 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 WASH ER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APPJEQUIP. 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/a c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER REMARKS: VENTILATION 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 APPJEQUIP. 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 APPLICANT NAME (L. F. MI) JL (bnstruction ADDRESS P.O. Box 173 CITY/COMMl1NITY/STATE/ZIP Nestor; CA 92053 JOB SITE ADDRESS/SPACE CITY/COMMUNITY/STATE/ZIP La.Quinta CA 92253 am •' 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 of 180 days. SE CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be completed it LICENSED CONTRACTORS DECLARATION: 1 hereby affirm that I am licensed under provisions of Chapter 9 the permit is for one hundred ($100) o. less.) certify that in the performance o1 the work for which this permit is (commencing with Section 7000) 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 asto become subject tothe 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 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 5.46 construct, after, 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 Contra ctor'sLicense Law ❑ 1hereby certify that noexcavation five (5)ormore feet indepth intpwhichaperson isrequired todescend, will be (Chapter 9(commencing with section 7000) o1 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 o1 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 2. Art 2, Sec 341. Title 8, subjects the applicant to a civil penalty of not more than live hundred dollars (5500.): C.A.C.) O I. as owner of the property, or my employees with wages as Meir sole compensation, will do the work, and the ❑ 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 of property who builds, or improves thereon, and who does such work himself or ❑ Division of Industrial Safety Permit No. through his own employees. provided that such improvements are not intended or offered for sale. It. however, the OFC building orimprovemntissold within oneyearofcompletion. theowner-builder will havetheburden o_fproving that 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: of 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 builds or improves thereon, and who contracts for such projects with a coniractor(s) licensed pursuant to the Contractor's License Law.). Lender's Address O 1 am exempt under Sec. B. R 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 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 certificate o1 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. 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 Signature of Applicant or Agent Date APPLICANT NAME (L. F. MI) JL (bnstruction ADDRESS P.O. Box 173 CITY/COMMl1NITY/STATE/ZIP Nestor; CA 92053 JOB SITE ADDRESS/SPACE CITY/COMMUNITY/STATE/ZIP La.Quinta CA 92253 am PAG PRC C _ TWIN! AND SE S 19903 LOT l� Plan Check Fee Moo sa Const. Fee TRACT NAME ,AIM HORIZON P Val OWNER NAME Il. F. MI) Ganerti anal ag7ement Corp. ' CONTRACTOR -FIRM NAME J.L. Construction ADDRESS abcve CITY/COMMUNITY/STATE/ZIP ' PHONE 0 5.46 LICHC Plurrbijig Fee ARC/ENG FIRM NAME Michael Buccino Assoc. ADDRESS 340 S. Farrell Dr. A212 Cm/COMMUN ITY/STATE/ZI P Palm Springs. CA 92262 PHONE LICHC • 323-7877 USE OF PERMIT ' Single Family Dwelling OL ZON, (105.72)DEP. PAID FSB I SSB SSB RSB = atureembnt OFC t Department ZONE ORD / LOT SZ END SIDE Print Applicant/Agent Name (Do 1 C) r7 APPUPRMT • '�' > DATE 5-2-2=85 S.T.D. Permit to construct 1247 sq. ft. of living area and 433 sq. ft. of gaage as pgr approved.plans. Mech. Fee 37.00 Plan Check Fee 307.96 Const. Fee 367.00 Elect- Fee 60.18 SME Fe I e 5.46 Plurrbijig Fee 85.00 862.60 (105.72)DEP. PAID 756.88 *neferred paymaut as = atureembnt with Ckimmit;y t Department TOTAL FEE 862.60 H 1 L 3 7 7 L / j& 8 8 CK !F VALUATION 77,948.00