001523 (SFD)Building
Address 73-455 N. SM
Owner
Mailing
Address 1001 Bleboo St. Eftte 2
City._ Zip Tel.
Contractor
ate,_ mrvas $�
.Address .. ".. .. .. .... ..'.:. .:... ....
P*O* B= 1.73
City Zip Tela
4 1014
P.O. BOX 1504 -No.001523
78-105 CALLE ESTADO , a
LA QUINTA, CALIFORNIA 92253
BUILDING:` TYPE CONST. ' V IN OCC[ GRP: -R-3
A.P. Number
Legal Description
Project Description+l*�a'
192453
34.5U
State c.
1247
•
&tCla sl f: '442M2 4No.
LicY#
S.Sigze�t 43•
DW
Arch:i-Engr.; .. . .
• -Stories Units ,
Designer
. . rAphaP-OL 811malm. A
New EJ Add ❑
Alter ❑ :' : Repair ❑ .... Demolition ❑
Address
Tel.
340 SN • ii i iQe�
3 7877 ..
City
Zip
State
ft gmqwPt
92292
Lic. #
J
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that'I'a'ni ,licensed under provisions of Chapter flcommencing.with Section
and Professions Code, and my license is in full force and
7000) of Division 3 of tth/h,ir
w
effect. ,[[Business
SIGNATURE DATE
OWNER:BUILDER DECLARATION
Estimated V11UatlOtl
`
I hereby affirm that I am exempt from.the Contractor's License Law for.the following'
' �A �y
s
reason: (Sec, 7031.5,Business and Professions Code: Any city'or. county..which• requires a
e 73t�aQV
permit to construct, alter, improve, demolish, or repairany structure, prior -to its issuance•also
requires the applicant for .such permit to file a signed -statement that be 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'BLisiness and Professions' Code,`or thathe is exempt therefrom, and the'basis-
the Any Section. 7031:5 'by any fora
Plan.Chk.'Dep.
105.72
..for alleged exemption.. violation of applicant permit
subjects the -applicant to a civil penalty of not more'than live hundred dollars ($500): . • • -_
p 1, as owner of the property,,or.my, employees with wages as;their sole compensation, will
Plan Chk. Bal..
'
��� .
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness andConst.'yCp
36 -00
Professions .Code: The •Contractor's License Law does: not `apply to an, owner of property who
- i •id
builds or improves thereon 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, the' building
.3 a .00
or improvement is sold within one year -of completion,:the owner -builder will•have the burden
Electrical- - -
- j
.., of proving that he did not build or improve for the purpose of sale.). ..
.ia4- _ -
❑-I, as owner of the property, am exclusively' contracting with licensed contractors to con-
Plumbing
85. .
00
struct-the project. (Sec. 7044,• Business and Professions Code: The Contractor's License Law
does 'not builds 'or improves thereon, for
S.M.I:
_
' ' '
apply +to an owner of property who and who contracts
- such projects with a contractor(s) licensed pursuant to the Contractor's:License Law.J
.
Grading
5.4.6
❑ 1 am exempt under Sec... B:,B P.C. for this reason
Driveway Enc.
Dateowner
Infrastructure
.
as g
with 0cm.DinA., Dirs rir►.'7ii • ,
WORKERS' COMPENSATION DECLARATION
• 'Thereby affirm that.1 have a certificate of consent to -'self -insure, or a:cePtificate 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. - ..
. .
t
TOTAL
�.. 756+88
CERTIFICATE OF EXEMPTION FROM
REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed it the permit is for one hundred -dollars ($100) valuation -
or less.) - ..
.l certify that in the performance of thg work for which this permit is issued,.l'shall not
-employ any person in any manner so as to become subject to the Workers' Compen-sation
Laws of California.
`"`Date. Owner'
NOTICE TO APPLICANT: g, after making this. Certificate of Exemption you should become -
ZONE:
BY:
subject to 'the Workers' Compensation provisions of the Laboi Code, 'you must '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
coNsrRucnoN LENDING ACENcr
Side Street Setback from Center Line
1 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
'
FINAL. DATE
INSPECTOR '
This is's building permit'when properly tilled out; signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
.I certify.lhat I have read ;thisapplication and state that the above'informalion 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 theZabove-
mentioned property for inspection purposes.
.. ... ._. .. r1.
Vdlldated by`
Signature of applican /* e ) r 1r Date { + '{'r�
Mailing Address _ �-'� i, f' /
Validation:
City, State, Zip /
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. SO. FT.
POR. SQ. FT. ®
GAR. SO. FT. ®
CAR P. SQ. FT.
WALL SO. 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.COOL 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 ® 11/4 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. FEEELECT. 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 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
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
7.
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, it 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 if
LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9
(commencing with Section 7000) of Division 3 o 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) 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 o1 not more than five hundred dollars (5500):
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 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.).
O 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
builQs or improves thereon, and who contracts for such projects with a contractors) licensed pursuant to the
Contractor's License Law.).
O I 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 sell -insure, or a
certificate of Workers' Compensation Insurance , or a certified copy thereof (Sec. 3800. Lab. C.).
Policy No. Company
❑ Certified copy is hereby furnished.
O Certified copy is filed with the City Building Inspection Department or City Department.
Date Applicant
APPLICANT NAME (L. F. MI)
JL Construction '
ADDRESS
P.O. Box 173
CITY/COM%"ITY/STATE21P
. Nestor; CA 92053
JOB SITE ADDRECS/SPACE
-
CITY/COWUNITY/STATE/ZIP - - ci
La. Quinta, 92253
BOIr
PAG
PRC
I c
as per approved plans.
TWN
I RNG
S
s
TRACT
19903
19903
LOT
10
Plan Check Fee
MOO
SB
TRACT NAME
HORIZON PAUL
OWNER NAME (L, F. MI) General Management Corp. '
CONTRACTOR -FIRM NAME
J. L. Construction
ADDRESS
above
CITY/COMMUNITY/STATE/ZIP
PHONE 8 .
5.46
LICNC S
.Phmmbiag Fee
ARC/ENO FIRM NAME
Michael Buccino Assoc.
ADDRESS
340 S. Farrell Dr. A212
CITY/COMMl1NITY/STATMI P
Palm Springs. CA 922,262
PHONE a LICNC 4
323-7877
USE OF PERMIT
Single Family Dwelling
BL
ZON,
105.72 DEP. PAID
FSB
SSB
SSB
RSB
4gLreelaihnt
DEC
ZONE ORD #
LOT SZ
END
SIDE
the permit is for one hundred (S10D) 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: 11, after making this Certificate o1 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 3.2, Grp Z Art 2, Sec 341, Title B.
C.A.C.)
O As owner -builder, I will not employ anyone to do work which would require a permit from the Division o1
Industrial Safety, as noted above, unless such person has a permit'to do such work from that division.
O 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
I ceAity 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 1 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 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
Print Applicant/Agent Name n 6 ` Sa
Date
APPL/PRMT I ig
DATE
S.F.D.
Permit to construct
1247 sq. ft.
of
living area and 433
ft. of garage
as per approved plans.
mech. Fee
37.00
Plan Check Fee
307.96
367.00
Plect. Fee
60.18
r
5.46
.Phmmbiag Fee
85.00
862.60
105.72 DEP. PAID
756.88
*
4gLreelaihnt
t Department
17
TOTAL
'FEE
862.60
A 1 L 4 D D Z) /M,88 R
`FINANCE VALUATION 77,948.00