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001532 (SFD)ti P.O. BOX 1504 NO. . 001532 Building78-105 CALLE ESTADO Address 79.3.4 N. SUnMt-Rid= jtrrLA QUINTA,,CALIFORNIA 92253 Owner Via' ��t Caro. BUILDING: TYPE CONST: - V 11 - OCC: GRP. Mailing - Address 1001 Bighop s,, SmitP_ 2700 A.P: Number• - City Zip Tel. M`W,54 Legal Description Contractor Project Description .' x46 *Mit Off. . Td—dress. ..... ..... _ -7 P.O. Bm 173 Zip Tel.. . NaskW 92053340-5511 State Lie. City I= 1247 & Classif.. 442822 Lie. # 237 ,Sq. Ft. w 433 No. No. Dw. Size. Stories Units Arch., Engr.;. DesignerNew.[It Add O Alter O Repair 0 : Demolition 0. - Ideva �: Pi M. ff. 's . _.. -. Address Tel. 340 S Fa%ry023-•7877 CityZip State 'Yk .�at31e'3FI .. Lie. # -N. LICENSED CONTRACTOR'S DECLARATION I hereby affirm that yam,licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the�Business and Professions Code, and my license is in fulCforce,,and' effect.. ���!>ir.') >/ SIGNATURE DATE t .. .... .. . • .. OWNER -BUILDER DECLARATION iy ` Estlrnated Valuation �f �pp y� I hereby affirm that 1 am exempt from the Contractor's License Law for the following $., i i,e�"u8*40. reason: -(Sec. 7031.5,13usiness and Professions Code:, Any, city or county which. requires a, permit to construct, atter, improve, demolish, .or repair any structure, prior. to its issuance 'also ' . requires the applicant for such permit to rile a signed statement thafhe•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 Professions Codi, -,or that. he.Is exempt thereliom,' and the. basis 7 for the alleged exemption. Any violation of Section 7031.5 by. 'any applicant for a' permit Plan Chk. Dep.. - � � -subjects the applicant to a civil penatty'of not more than five hundred dollars ($500).- 0 I, as owner of the property, or my employees with wages as their. sole compensation, will Plan Chk. Bal. 202.24 do the work, and,the structure is not intended or offered -for sale: (Sec. 7044, Buisness and q a� Professions Code: The .Contractor's License Law does, not p p Const, 7 - 36'! 00 apply to an owner of,property erty .who . builds or improves thereon and who does such work himself or through his own employees, ._ Mech.' 37 .40 provided that such improvements are not intended or offered for sale. If,• however, the building .7% sOi7 or improvement is sold* within one year of completion, the owner -builder will have the burden Electrical -of proving that he did not build or improve for the purpose of sale.) 4s'e+lam 0 1, as owner of the property, am exclusively contracting with licensed contractors to con-' Plumbing 85.00struct 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.) • 0 I am exempt -under Sec. B. t% P.C. for this reason • Grading Driveway,Enc. Date owner Infrastructure Mtayya� — Z. WORKERS' COMPENSATION DECLARATION I hereby affirm that Ihave a certificate'of consent to self•insuie, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800,.Labor Code.) Policy No Company . 0 Copy is filed with the city. 0 Certified copy is hereby furnished. , TOTAL 962.060 756.88 CERTIFICATE OF EXEMPTION FROM I REMARKS WORKERS'COMPENSATIONINSURANCE (This section need not be completed if the permit is for one hundred' dollars (S 1.00) . valuation _ - ., or 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_LL• Owner .NOTICE TO APPLICANT: N,. ager making this Certificate of Exemption you should become ZONE: 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 Minimum Setback Distances: ' Front Setback from.Center. Line Rear Setback from. Rear Prop. Line CONSTRUCTION LENDING AGENCY Side Street -Setback from Center Llne - 1 hereby affirm that there I.),.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 *•. rf This.is a -building permit when properly filled out, signed and validated; and-is'sublect to FIN AL.DATE . INSPECTOR expiration if work thereunder is suspended for 180 days. 1 certity that.l have read this application and state thaf.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, andherebylauthorize representatives iof this city to enter the above: mentioned property for inspecttifion purposes. _ —Validated by: Signature of appltcany'/in�///4, Date Mailing.Address �' ✓T. 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. @ CARP. SO. 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 WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APP./EOUIP. 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. SQ. FT. @ c BATH TUB SO. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID @ 11/4 c SEWAGE DISPOSAL SQ.FT.GAR @ 3/ac 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./EOUIP. 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 I NSU LATION/SOU N D FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL / APPLICANT NAME,(L. F. MI) " JL Construction ADDRESSP.O. Box 173 - CITY/COMMINITY/STATE21P Nestor; CA 92053 JOB SITE ADDRESS/SPACE CITYPCO�UNITY/STATMIP-~ La . ta• CA 92253 BOK PAG _� PRC C . 'TNM • PERMIT APPLICATION City of La Oulnta, .• Department of Building and Safety 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. 1 CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATIONINSURANCE: This section need not be completed if - LICENSED CONTRACTORS DECLARATION: I hereby aflirm'that I am licensed under provisions of Chapter 9 the permit is for one hundred ($100) It. less. I certify that in the performance of the work for which this permit is -(commencing with Section 7000) of Division Sol the Business and Professions Code, and my license is in lull force , :Issued. I shall not employany person inanymannersoasto become subject to the Workers'CompensationLaws of and effect. California. y License Class Lic: Number Date Applicant Date Contractor 'I 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. 1 following reason (Sec. 7031.5. Business and Professions Code: Any city or county which requires a permit to ADDRESS - - ..• 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 asigned statement that he islicensed pursuant to the provisions of the Contractor's License Law 01 hereby derlify 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 Sof 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 2, Art 2, Sec341, Title 8. subjects the applicant to a civil penalty of not more than five hundred dollars ($500.): C.A.C.) ❑ I, as owner of the property, or my employees with wages as their 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 D Division of Industrial Safety Permit No. through his own employees, provided that such improvements are not intended or offered for sale. If, however, the DEC '- T building orimprovemntissold within one year ofcompletion, 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 perlormance O 1, 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 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 O t 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. l agree to comply with all DateOwner 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 1 have a certificate of consent to self -insure, or a certificate of Workers' Compensation Insurance • or a certified copy thereof (Sec. 3800. Lab. C.). Signature of Applicant or Agent t Date , Policy No. Company CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I 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 Ouinla 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 1 r i Print Applicant/Agent Name l lJ / APPLICANT NAME,(L. F. MI) " JL Construction ADDRESSP.O. Box 173 - CITY/COMMINITY/STATE21P Nestor; CA 92053 JOB SITE ADDRESS/SPACE CITYPCO�UNITY/STATMIP-~ La . ta• CA 92253 BOK PAG _� PRC C . 'TNM • RNO SE S TRACT 19903 LDT� / Plan Check Fee 307.96 MOD I SB . 367.00 TRACT NAME - HORIZON PALMS OWNER NWE (L. F. MI) General Management Corp-rp- CONTRACTOR-FIRM NAME J.L. Construction ADDRESS CITY/COMMUNITY/STATE/ZIP V ° • PRONE . LICNC . 85.00. ARC/ENG FIRM NAME , Michael Buccino Assoc. ADDRESS - - ..• 340 S. Farrell Dr. A212 CITYMOMMIMITY/STATE/ZIP Palm cin s ` CA 9If. PHONE • - LICNC A 323-7877 r USE OF PERMIT Single Familv Dwelling BL ZON• as pgr agreemknt FSB SSB SSS -RSO � DEC '- T ZONE ORD I LOT SZ END - SIDE APPL/PRMT-- f �, DATE 5-22-85 ' S:F'.D.- Permit to construct 1247 sq. ft. of living area and 433 sq. ft. of!'garage as per appraved,plans. • e• Mech. Fee 37.00.,, Plan Check Fee 307.96 Const. Fee 367.00 iFee 60.18 SMT Fee- 5.46.' 85.00. Trifras;trUCtUre 862.60' 105 M DEP. PAID 756.88 ' *neferred pa=mt as pgr agreemknt t Department TOTAL FEE 862 60 -M 1 L J 4 J. L D 75&88 CK VALUATION .,'77, 948.00