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001401 (SFD)Building Address Owner 4 l�GGl�GV� P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Mailing Address City Zip Tel. r.;wa__4._. ssr _.-„a n�o4� . a_�,nn_•���s�trtr;n Contractor Estimated Valuation x�•' . 1. 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 Address. . PERMIT- AMOUNT `_ice City Zip Tel. - Plan Chk. Bal. ❑ I, as. owner of the property, or my employees with wages as their sole compensatlon, will State Lic. City & Classif. Lic. # Ole Arch:, Engr., " Designer �IP'�4 - Electrical Address Tel. No. 0011*01 BUILDING: TYPE CONST. OCC: GRP. A.P. Number Legal Description Project Description�� Sq. Ft. Size - - e New_W Add ❑ - G7"ti:d p'J 1i �: iaili3L"sLd. 11:,v f ' JC�J-" ZlY f i City Zip State Daks Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that l am licensed under provisions of Chapter 9 (commencing with Section 3 7000) of Division ,of.'the, Business and Professions Code, and my, license is in full force and effect.. .. a.. SIGNATURE - DATE OWNER -BUILDER DECLARATION No. Stories .. Alter ❑ No. Dw. Units Repair ❑ Demolition ❑ srxef n,-1 /t'ri rsr rvclr rr^e -, ;Dfn I hereby affirm that I am exempt from the Contractor's License Law for the following , Estimated Valuation x�•' . 1. 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 PERMIT- AMOUNT the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 301 the Business and Professions Code, or that. he is' exempt therefrom,- and the basis for the. 'alleged exemption. Any violation o/ Section 7031.5 by 'any applicant for a permit ' Plan.Chk. Dep. F1A,d =±^ap niJP3 ,01 subjects the' applicant to a civil penalty of not more than live hundred dollars ($500). - Plan Chk. Bal. ❑ I, as. owner of the property, or my employees with wages as their sole compensatlon, will do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and_Ti Const. r, 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, that such improvements are not intended or for 11, however,: the' building Mech. provided offered sale. 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:) - ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing • 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 $, M. I. , such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) - Grading 0 1 am exempt under Sec. B. & P.C. for -this reason Driveway Enc. Date owner Infrastructurer;�, WORKERS' COMPENSATION DECLARATION y 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.° / • -o , .Company ❑ Copy is tiled with the city. ❑Certified copy is.hereby furnished. TOTAL rQt!rf?9f?s: <,.R CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE (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 thg work for.which this permit is issued, 1 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, after making this Certificate of Exemption you should become ZONE: BY: subject to the' Workers' Compensation provisions of theLabor 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 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 FINAL DATE INSPECTOR This is a building permit when properly filled out, signed and validated, and is subject to expiration 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 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. Validated by: Signature of applicant Date! -� Mailing Address r Validation: City, State, Zip HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. p $ 2ND FL. SO. FT. @ POR. SO. FT. ® GAR. SO. FT. ® CAR P. SO. FT. WALL SO. FT. ® SO. FT. ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME'SVC. POWER OUTLET YARD SPKLR SYSTEM - BAR SINK I 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 APP./EQUIP. LAUNDRY TRAY AIR HANDLING UNIT CFM TEMP. POLE KITCHEN SINK ABSORPTION SYSTEM. B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE, TEM/PERM 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 ® 3/ac HOUSE SEWER REMARKS: VENTILATION GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE M=CH.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./EQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ -Plus-X$-=$- lusx$=$ROOFING 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 SIGNATURES/It, ITIALS GARDEN WALL FINAL �► RMIT APPLICATeRnd.f.ty City of la Duin% Department of Building / 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 IBO days. BOK 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 the permit Is for one hundred ($100) o, less. I certify that in the performance of 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 as to become subject to the Workers'Compensation Laws of and effect. California. License Class Lic. Number Date Applicant Date Contractor NOTICE TO APPLICANT: IL 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 Lew 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 / 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 statement that 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, w ill 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 authorised 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 live hundred dollars ($500.): C.A.C.) O I. as owner of the property, 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 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 O Division of Industrial Safety Permit No. through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building orimprovemntissold within one year ofcompletion. theowner-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 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. Q. 7044. Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Lender's Name builQs 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 1 am exempt under Sec. B. B P.C. (Attached Certificate). I certify that 1 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 herebyauthorize representatives 862.60 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 of Workers' Compensation Insurance , or a certified copy thereof (Sec. 3800. Lab. Q. ignature 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. l agree to comply with all state laws and county ordinances relating to•Duidling . O Certified copy is filed with the City Building Inspection Department or CityDepartment. construction, and authorize a' representative of the_City of LaOuinta Department of Building and Safety to enter upo the property for which I have applied for this permit for the purpose of making inspections. Date Applicant Signature of Applicant or Agent Date Prinf Applicant/Agent Name D it APPLICANT NAME (L. F. MI) JL C mstruction ADDRESS �eoa r P.O. Box 173 GITY/COMMUNITY/STATEIZIP Nestor; CA 92053 JOB SITE ADDRESS/SPACE ARCAM FIRM NAME Midiael Bucc ADDRESS 340 S. Fam CITYIC'.OMMUNm/STATE/ZIP . Palm rj PHONE a LICNC I 323-7877 USE OF PERMIT Single Fami: BL ZON, -FSB SSB ZONE ORD I LOT SZ APPIJPRMT ME CITYICOMMUNITY/STATE/ZIP - S.F.D. La.Quinta, CA c • BOK PAG WIC C T i Mech. Fee 37.00' TRACT 19903 II -- LOT MOD:` 367.00 TRACT NAME �••� HORIZON PARIS, -'*- OWNER NAME (L. F. Mq G neral Manager . CONTRACTOR -FIRM NAME J.L. ' C7onstructic SMI Fee ADDRESS .. . above ' • GTY/COIIMUNITY/STATE/ZIP )IJ!lAftastmiature - . LIQNC I ARCAM FIRM NAME Midiael Bucc ADDRESS 340 S. Fam CITYIC'.OMMUNm/STATE/ZIP . Palm rj PHONE a LICNC I 323-7877 USE OF PERMIT Single Fami: BL ZON, -FSB SSB ZONE ORD I LOT SZ APPIJPRMT ME 5-2-2 =85 S.F.D. Pen -hit to construct 1247. sq. ft. of living area and .433 sq. ft. of garage as.,Per approved plans. Mech. Fee 37.00' II -- 307.96 Const. Fee `x-, 367.00 Elect, keel,- 60.18 SMI Fee 5.46. Fee 85..00 - )IJ!lAftastmiature 862.60 105.72 DEP.. PAID 756.88 * agrewitint t Department TOTAL , FEE 862.60 H1114 7 LL /j(a8 CK FINANCE y VALUATION 77,948.00