001527 (SFD)P.O. BOX 1504 No. 01527
Building78-105 CALLE ESTADO
Address '79o-447 S. SWWiS'8- Rkte Dr. LA QUINTA, CALIFORNIA 92253
Mailing.
AddressIMI Ri s
hm 4240- qp"P, 2700
City Zip .. Tel.
1 ,u %813' 1-800. 505
Contractor ;
t3 s�ts ��jl�>E1a
_..:Address......... ... - :. .. ... -
BUILDING: TYPE CONST. • M N. OCC: GRP. R. 3
A.P. Number
Legal Description
Project Description
P.01 173
.. City. .... . _ ...
..
Tel.. ...
..
flip
92053
340-5%,1
State Lic.
City
1247
& Classif: 442
Lic. # 237,,--,-.
Sq. Ft. 4G&R -No. No. Dw.
Size Stories -Units =
Desigher,' - Uhg>.
New Add ❑ Alter ❑ Repair ❑- - !._ Demolition ❑-
Address .r
Tel.
- . _._.. U13 .fes. rA
.12-1-7977. .
City
Zip
State
ou:� -
Lic. # ..
. , .
LICENSED CONTRACTOR'S DECLARATION
.~ I hereby affirm that)I am licensed under provisions of Chapter 9 (commencingrwith Section
7000) of Division 3/oof€the Business Professions Code,
• - -
'
and and my license,is in full force and
effect. ?fw, �•j ...
SIGNATURE DATE-
OWNER=BUILDER DECLARATION' r
Estimated Valuation
" I hereby affirm that I am exempt from the Contractor's License Law for the following
Any
7i: A o
reason:, -(Sec.. 7031.5,Business and Professions Code: 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 lila 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 of the Business and' Piofessions 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
- '
Plan. Chk.' Dep.. - 105.72
subjects the applicant to a'civil penalty of not more than five hundred:dollarr(3500).
my_employees
Plan Chk. Bal. .�y�.e� ryg ..
M2.24
❑ I, as owner of the property, or with wages as their sole compensation,.will
do the work, and the structure is not intended or offered for sale.'(Sec. 7044, Buisness and
Professions
Const. ��'�
Code: The Contractor's. License Law does.:not. apply to an owner of property who ,
builds of improves thereon and who does such work himself or through his own employees,
' Improvements intended
- . ;
•Mach. - �+y "� .
- - d
provided that such are not or offered for sale. If, however, -the building'
. or improvement is sold within one year of completion, the owner -builder: will 'have the burden
. •,
Electrical' - - - �'�i. 12
. of proving that he did not, build or improve. for the purpose of sale.) -_ -
- ..
❑ l,; as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing ��
. struct the -project. (Sec. x7044, Business and Professions -Code: The Contractor's License Law -
- ..
.00
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
Infrastructuret as
f za.�.a�.� t
W�sya�tt
WORKERS' COMPENSATION DECLARATION
I hereby affirm•tliat I'have at *certificate of consent. to'self-insure, ora 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.. ❑ Certified copy is hereby furnished.
TOTAL 1162.60 7.%.88
CERTIFICATE OF EXEMPTION FROM
REMARKS
WORKERS'..COMPENSATION-INSURANCE
(This section need not be completed if the permit is- for- one hundred dollars (S 100) valuation
.
or less:) .. .. .. .. _.._. ... _
f l 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: If, alter making 'this Certi/icate of Exemption you should become
BY: - -
', subject to' the Workers' 'Compensation provisions 'of '-the Labor Code, you .must forthwith
comply with such provisions or this permit shall be deemed revoked.
,ZONE:'
Minimum Setback', Distances:
Front Setback from.Center Line
Rear. Setback from Rear -Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback. from Center Line
I hereby afiirm 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
This is a building permit when'properly filled out, signed and validated; and is subject to
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 10 comply with all city and'county ordinances and statelaws-relating to building
construction, and hereby authorize representatives -of this city to enter the, above-. '
mentioned property for inspection purposes. k -
Validated by:
Signature of applicant 11v !!� i ,l s .! i Date -.f
Mailing Address ��. W a' ' ' /
Validation:
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. @ $
2ND FL. SO. FT. g
POR. SO. FT. @
GAR. SO. FT. @
CARP. SO. 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 APPJEOUIP.
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 p 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 BANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
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
- •.t`• tic+, �l'.:�. '-"i� . r�•.'•.ie'. I�j "i� ":t
' •' . " ..7, i f -«�i�l }.- q` f. �J �.Hjt/ j,r `rr, 'f 2 :` . r :. F 7
ti
PERMIT APPLICATION
City of I- 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
certificate o1 Workers' Compensation Insurance , or a certified copy thereof (Sec. 3800. Lab. C.).
Policy No. - Company '
O Certified copy is hereby furnished.>
4.
O Certified copy is filed with the City Building Inspection Department or City Department.
Date Applicant
APPLICANT NAME (L. F. MI)
JL Construction '
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 of Chapter 9
the permit is for one hundred ($100) o, less. l certify that in the performance of the work for which this permit is
(commencing with Section 7100) of Division 3of the Business and Professions Code, and my license is in full force
issued. I shall not employ any person inanymannersoasto become subject to the Workers'CompensationLaws 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'
: -BUILDER DECLARATION: 1 hereby affirm that I am exempt from the Contractor's license law for Me
Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall
be deemed revoked:
'OWNER
following reason (Sec. 7031.5. Business and'Professions Code: Any.city or county which requires a•permit to
�1-
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 tofile asigned statementthatheislicensedpursuanttothe provisionsofthe Contra ctor'sLicense Law
0 1 hereby certify that no excavation five (5) or more feet in depth into which a iIerson is required to descend, will be
(Chapter 9(commencing with section 7000) of Division 3 o1 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 32, Grp 2, Art 2. Sec 341, Title 8,
subjects the applicant, to a civil penalty of not more than five hundred dollars ($500.):
C.A.C.)
O I. as owner of the properly, 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 riot 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
'
through his own employees. provided that such improvements are not intended or offered for sale. If, however, the
O Division of Industrial Safety Permit No.
building orimprovemntissold within one year ofcompletion. the owner -builder will havethe burden of provingthat
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 1, as owner o1 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.).
7004. 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
PHONE F - UCNC •
Contractor's License Law.). !
Lender's Address
O 1 am exempt under Sec. B. & 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
ZOIC,
of this county to enter upon the above mentioned property for inspection purposes.
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a ceitificate of consent to self -insure, or a
SSB
certificate o1 Workers' Compensation Insurance , or a certified copy thereof (Sec. 3800. Lab. C.).
Policy No. - Company '
O Certified copy is hereby furnished.>
4.
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/COMMUNITY/STATE/ZlP
Nestor; CA '92053
JOB SITE ADORESS/SPACE
CITY/COkB/UUTV/STATE/ZIP- ,
La ta, 'CA 92253
BOK
PAG
PRC
I C•.
-
TNM
RNG.
SE.
S
L
5.46.
MOD
so
19903
862.60
i
105.72 DEP. PAID
756.88,
TRACT NAME HOPJiON PALMS
OWNER NAME (L. F; MI) Caneral Management Corp.
CONTRACTOR -FIRM NAME
J.L. Construction
ADDRESS
boye
CITY/COMMUNITY/STATE/ZIP 11' -
PHONE .
LICNC F
.
ARC/ENG FIRM NAME -'
Michael Buccino Assoc.
ADDRESS - -
340 -Se Farrell Dr. A212
CITY/COMMUNITY/STATE/ZIP
Palm Springs. CA 92262
PHONE F - UCNC •
.
323-7877
7`
USE OF PERMIT
Sin le Family Dwelling•
SL
ZOIC,
so.
SSB
SSB
RSB
-
DEC
ZONE ORD •
LOT SZ
'END
SIDE
I
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 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 Date
Print Applicant/Agent Name 0d -)r7
APPL/PRMT - _ t6 _ _ _ DATEU IL
5-2- -85
S.F.D.
Permit to construct 1247 sq. ft.
of
living area and 433 sq. ft. of
age
as mr approved plans.
Mei Fee 37.00":
Plan Check Fee 307.96"
Const. Fee 367.00.
Elect. Fee 60.18 .
5.46.
Plunbing Fee 85.00
Trifrastructure
862.60
i
105.72 DEP. PAID
756.88,
*nef ent as ggreentint
t Di6partment
TOTAL
'FEE • '
2.60
H 1 L 4 7 L 5 / 5& 8 8 1 CK
E VALUATION Fi548 . 00