001435 (SFD)',city Zip
I a ITel.
Contractor.
J.
Address...
p. N0, in A 4 A 42 M
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
BUILDING: TYPE CONST: V. 9- OCC; GRP. R 3
A.P. Number
Legal Description
Project, Description Rwi=_ palm..
P.O. B= 171t
CitY
Building
Address
79-305 N.
Owner
Guaml. ran
Mailing
.Address
ion nistm
',city Zip
I a ITel.
Contractor.
J.
Address...
p. N0, in A 4 A 42 M
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
BUILDING: TYPE CONST: V. 9- OCC; GRP. R 3
A.P. Number
Legal Description
Project, Description Rwi=_ palm..
P.O. B= 171t
CitY
Zip p
State Lic.
City
VW -1247
'
& Classif.Lic.#
2922
44A
217
Sq. Ft
Size m, R_ .433...
No No. DIN.
Stories
ories Units
-Arch.-, Engr.;
Designer.
N e w )_D Add 0 Alter 0 Repair 0 -Demolition 0.:
Address
Tel.
340- q. Eai=1, -
]
171-7977
City
State
JZip
-92262
Lic.-#
UCENSE.D.CONJ1JAC:rOR'S DECLARATION
1 hereby affirm that'l-ii'm licensed under provisions of Chapter 9 (commencing with Section,
• 7000).of Division 3 of th'bAusiness and Professions. Code, and my license is in -full force and'
effect.
SIGNATURE 'p- IF DATE
.............
OWNEO-BUILDER'DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031 5Business and Professions Code:.Any city or county which requires'a
permit to construct, improve, demolish,.or repair an . y structure, prior to its I I Issuance also.
requires !�e applicant 4or. 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,
• Divi&fon 3f fhd'-Businbss and Piofesiiori§ Code; or that. he is exempt therefrbm,' and the basis
for the alleged g exemption. Any.violalion of Section 7031.5 by.any applicant for a permit
subjects. the applicant to a'civil penalty -of not more than -five hundred dollars ($500).
0. 1 as - owner of the property, or my. employees with wages as their sole compensation, will.--
do iheF.work, and the structure is not -intended or offered for sale., (Sec. 7044,, Buisness and:
Professions Code: The Contractor's Li enso� Law does .not. apply to an- owner of
-c property Who.
Esti mated. Valuation
77 '94846.
-PERMIT,
AMOUNT
; 'iDIan.Chk.Dep. -
105-72
P . lain Chk."Bal.'.
202-24
Con..St-,
Mech.
MAO
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 improvement is sold within one year of completion, the owner -builder will have the burden
of proving that he did no ' t build or improve for the purpose of sale.). , . 1 . :_ , .
Elettrical
-Plumbing
0 1, as owner of the property, am exclusively contracting with licensed contractors to con-
struct 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 projects with a contractor(s) licensed pursuant to the Contractor's License Law.) - - -
0 .1 am,exempt. under Sec. B. & P.C. for this reason.
S.M.I.
Grading
Driveway Eric.
Date Owner
Infrastructure
MfdrMid call, ;-a-s PW qq�llll;
Pay
with- ammmitv, I eml. Direcb=.,
WORKERS' COMPENSATION DECLARATION
I hereby affirm, thait I have'a certificate of consentto s6lf-finsure, or a certificate of
Worker's Compensation Insurance, or a certified copy there6f.-(Sec. 3800, Labor Code.)
Policy No. Company
Ei Copy is filed with the city.. 0 Certified copy is hereby furnished.'
TOTAL
062.60, T56.188
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
REMARKS-.
(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 thp 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 whei
• NOTICE TO APPLICANT., If, after making this Certificate of: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. -
ZONE:. BY:
Minimum Setback Distances:
Front Setback from.Center Lin
Rear Setback from,8ear.Prop. Line
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, CiviI.Code.)
Side, S.treet.Se.tback from Center.Line
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
expiration it work thereunder is suspended for 180 days.
FINAL.DATE
—INSPECTOR,
I certify that. 1 have read this application and state'that the above information is correct.
agree to comply with' all city.and county ordinances and state laws relating to building
construction, and hereby authorize representatives- •of this city to. enterth
7above-.
purposes.
mentioned property for insoectloffAl
Signature of applicant Ali, J! i I • Date, I I
Mailing AddressIt
City, State, Zip
..ISstied stied by'
Validated by:
Validation:
Date' Permit
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. (off
GAR. SQ. FT. ®
CAR P. S0. 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.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEQUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
I
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 ® 1+/a 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 —ANK
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
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURE311NITIALS.
GARDEN WALL FINAL
APPLICANT NAME (L. F. Mil -
JL C li nstruction
ADDRESS .
P.O. Box 173
CITY/COMMUNmBTATE21 P -
• Nestor; CA •92053
-JOB SITE'ADORESSISPACE -
l.
�
r.-.
.� __ .....,.. � .. �-' -^"__ ._... ., t.. _. _ ate..•._ .. _._ _.,_ <�-:._ _. • - � .^.._ „
_. _. ..._ _.� ._-.._ � _ ,._ v .. _ - ,... _._ „ __. ... -Y--
PAG
PRC
PERMIT APPLICATION
City of La Ouinta
`
Department of Building
and Safety
This permit becomes void It work not commenced within 180 days from date of issuance, OR. if work has been suspended or abandoned for a period of 180 days.
S
CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATIONINSURANCE: This section need not becompletedif
'LICENSED CONTRACTORS DECLARATION: 1 hereby affirm that 1 am licensed under provisions of Chapter 9
the,permit is for one hundred ($1013)o, less. I certify that In the performance of the work for which this permit is
^(commencing with Section 70M) 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: It, after making this Certificate of Exemption, you should become subject to the Workers'
;OWNER�UILDER DECLARATION: 1 hereby affirm that I am exempt from the Contractor's License Law for the
OWNER-BUILDER
Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall
be deemed revoked.
reason (Sec. 7031.5. Business and Professions Code: Any city or county which requires a permit to
LICNC 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 to file a signed statemeni'thal 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 which a person is required to descend, will be
(Chapter 9(commencing with section 7000) o1 Division 3 of 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, Sec 341: Title 8.
subjects the applicant to a civil penalty of not more than five hundred dollars ($500.):
C.A.C.)
0 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the
0 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
`FSS
through his own employees, provided that such improvements are not intended or offered for sale. If, however, the
0 Division of Industrial Safety Permit No.
buildingorimprovemntissoldwithinoneyearofcompletion•theowner•builderwillhavetheburdenofprovingthat
DateApplicant
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
0 1, 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.).
7004. Business and Professions Code: The Contractor's License Law does not apply to an owner of property who
Lender's Name
buifps or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the
-END
Contractor's License Law.). ,
Lender's Address
0 1 am exempt under Sec. B. 8 P.C. (Attached Certificate).
I certify that I have read Misapplication and state that the above information is correct. I 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 abovem:nentioned property for inspection purposes.
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure. or a
'N
certificate of Workers' Compensation Insurance , or a certified copy thereof (Sec. 3800. Lab. C.).
Signature of Applicant or Agent Date
Policy No. Company i
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify l have read this application and state that
0 Certified copy is hereby furnished.
the information'given is correct. I agree to comply with all state laws and county ordinances relating to buidling . .
0 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 1 have applied for this permit for the purpose o1 making inspections. .
Date Applicant
Signature of Applicant or Agent 'Date
• f
Print Applicant/Agent Name
APPLICANT NAME (L. F. Mil -
JL C li nstruction
ADDRESS .
P.O. Box 173
CITY/COMMUNmBTATE21 P -
• Nestor; CA •92053
-JOB SITE'ADORESSISPACE -
l.
CITY/COMMUNITY/STATE/ZIP
la.Quinta, CA 92253.'_
BOK
PAG
PRC
C '
TWN
RNO
SE
S
19903.
; LOT
MoD
BB
TRACT NAME HORIZON PA�IMM,S �
l�-IiGJ.
Corp. OWNER NAME (L. F. MI) C�neral Management Corp.
CONTRACTOf1•FIRM NAME .
J. L. Construction
ADDRESS ..
above
CITY/COMMUNITY/STATE/ZIP
abQue
PHONE I
LICNC 1
-
ARC/ENG FIRM -NAME ' ..
Michael Buccino Assoc.
ADDRESS -
' 340 S. Farrell Dr. A212'
CIT//COMMUNITY/STATE/ZIP (•- -
_: Palm Sorincrs, CA 92262. -
PHONE'. } LICNC . -
323-7877.."
USE OF PERMIT •• .
Single Familv Dwelling
BL
ZON,
`FSS
SSB
SSB ;'RSB
-
OFC
ZONE ORD •
LOT SZ
-END
SIDE
APPUPRMT DATE - -
5-2-2=85 S.F.D.
Pennit to construct 1247 sq. ft. of
} FllNAN
area and 433 sq. ft. of.garage
a�oroved plans .
i
*' Tbfomo
37.00
307.96.
60.18 '
5.46
85.00 .
862.60:
105.72DEP. PAID
.756.88
TfFEE 2.60
-7.5G88 UK
a VALUATION ]7,948.00