001432 (SFD)Building
Address 41
Owner .
IV
P.O. BOX 1504 N O .0,0132
>
10.105 CALLS ESTADO
SINXIMM(,. . LA, QUINTA, CALIFORNIA 92253
�.=-MKIMMt Cbro. BUILDING: TYPE CONST. gl OCC: GRP.- R 3
Mailing
Address 1001 Bishm St. 61ite 2700 A.P. Number.
City Zip Tel.
92M J—,000-,-367 -,-367 5054 Legal Description
Contractor I�dc
Project Description
J.L. kt - :.... _ ... - 146 MAts nwidmtial Dimel. . .
Address _
City". r
asbor
State Lic.
& Clas.sif.. 442822
Zip .. `.�'r- - Tel:. . ..,
City -
Lic'. # 237
Sq. Ft. 1247 No.
Size A -,a,2 -• - Stories
No: Dw.
Units
Designer utdoler Bulocim ASSOC* Newf Add ❑ . • Alter ❑... Repair ❑•
Address Tel.
City Zip State
Paku- '92262 Lic. #
• • LICENSED CONTRACTOR'S DIE
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with'Section
7000) of Division 3 of th (Business and Professions Code, and my license iisiin•fulhforce and
effect..!
SIGNATURE - d- - i DATE
OWNER -BUILDER DECLARATION' " EStlmated Valuation_
I hereby affirm that I am exempt from.the Contractor's License Law for the following-. `948;0 .- .
reason: (Sec. 7031.5, Business and Professions Code: Any. city or• county. which requires 'a permit.'to construct, alter, impiove, demolish, or repair. any structure, prior to its!'issuance also
requires the applicanb for such permit to file a signed statement that. he is licensed: pursuant to .. PERMIT
the provisions of the Contractor's.License Law, Chapter 9 (commencing with Section 7000), of -
Division 3 of the'Business-'arid Professions Code, of 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.•.Q6p..
' subjects the applicant to:a civil penalty of not more than five'hundred dollars (S500).. '. ' '..
- ❑ I, as owner of the property, or my employees with wages as, their -sole compensation, will
,
Plan Chk..Bal.
COr1St. -
do the work, and the structure is not intended or offered forsale. (Sec. 7044; Buisness and
Professions Code: The Contractor's License Law does not apply to an owner of property who
-own
Mech-'' '
builds or improves.thereon and* who -does such work himself or- through his employees,
provided that such improvements are not intended or offered, for sale. If, .however, the building
Electrical
or. improvement 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.) . -.
Plumbing
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct• the project�:(Sec. 7044, Business and Professions' Code: The Contractor'sLicense 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.) -
•
❑ I arlm.exempt .under .Sec. B. 8 P.C. for this reason
Grading
Driveway Enc.
Issued by-
Date Owner
Infrastructure Ell re
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, oi'a'Certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. . • Company "
.❑ Copy is•filed with the.city. O Certified copy is hereby furnished. .. ..
CERTIFICATE OF EXEMPTION FROM
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, I shall not
employ any person in any manner so as to become subject'to the Workers' Compensation'
Laws of California.
Date Owrier•••
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.
CONSTRUCTION LENDING AGENCY
I hereby affirm that tfie�e. is a construction lending agency for the performance'of the
• . work for which this permits issued. (Sec. 3097, Civil Code.)•
Lender's Name
Lender's Address
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' II certify that I 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 enter the above-.
mentioned property for inspectio%n-pu}rposes. t
Signature of applicant � ! I,tf i %tl f }. Date1 .+r✓ r�:•
Mailing Address e
City, State, Zip r
HARD COPY
TOTAL,_
REMARKS
Demolition ❑,
AMOUNT
ZONE:
BY:
Minimum Setback
Distances:
Front Setback .from -Center. Line
Rear Setback from Rear Prop, Line
Side Street Setback from Center Line '
Side Setback from. Property Line
FINAL DATE
INSPECTOR
Issued by-
' Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
2ND FL.SQ. FT.
POR. SO. FT. ®
GAR. SQ. FT. ®
CAR P. SQ. FT.
WALL SO. 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
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.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. 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
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 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 SIG NATURESIINITIALS
GARDEN WALL FINAL
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. If 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 it
LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
and effect.
License Class tic. 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 f ile 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 of not more than five hundred dollars ($500.):
O 1, as owner o1 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 of 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 o1 sale.).
O 1, 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 rat 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.).
O 1 am exempt under Sec. B. b P.C. (Attached Certificate).
Date Owner
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. C.). '
Policy No. Company
O 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 C wtstruction
ADDRESS
P.O. Box 173
CITY/COMx1UNITY/STATE/ZIP'
Nestor, CA 92053
JOB SITE ADDRESS/SPACE
CITY/COMM UNITY/STATE/ZI P
La.Quinta, CA 92253
BOK
PAG
PRCC
Elect. Fee 60.18
-
TWN
RING
SE
.S
TRACT
19903
OT
t Department
MOD
SB
TRACT NAME HORIZON P,ATMc .
OWNER NAME (L. F. MI) Gme al Mamge mnt Corp• '
CONTRACTOWFIRM NAME '
J.L. Construction
ADDRESS
above
CITY/COMMUNITY/STATE/ZIP
PHONE .
LICNC
ARC/ENO FIRM NAME
Michael Buccino Assoc.
ADDRESS
340 S. Farrell Dr. A212
CITY/COMMUNITY/STATE/ZIP
Palm rin•s CA 92262
PHONE a LICNC 1
323-7877
USE Of PERMIT
Single Familv Dwellin
BL
ZON,
FSB
SSB
SSB
RSB
'OFC
ZONE ORD a
COT SZ
END
SIDE
the permit Is for one hundred ($100) o. less. I certify that In the performance o1 the work for which this permit is
Issued. I shall not employ any person In any manner so a s to become subject to the Workers' Compensation laws of
California.
Date Applicant
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.
'DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
O 1 hereby certify that no excavation five (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 2 Art 2, Sec 341. Title8,
C.A.C.)
O As owner -builder, I will not employ anyone to do work which would require a permit from the Division of
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: 1 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 certify 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 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 j2 ^14V Fl_;�
APPL/PRMT00 DA
_ �52-2=85 J . S.T.D.
lop -
Permit to construct 1247 sq. ft. of
living area and 433 sq. ft. of garage
as M approved plans.
mech. Fee 37.00
Plan Check Fee 307.96
Const. Fee 367.00
Elect. Fee 60.18
5.46.
.Plimbin- Fee 85.00
Tnfras *
862.60
(105.72)DEP. PAID
756.88
* ggreernhint
t Department
TOTAIL
•
FEE2
60 -
H 1 1 D U D L 7 / 5 br 8 CK
FINANCE VALUATION 77, 948.00