001433 (SFD)P.O. BOX 1504 No. 01I03
Building78.105 CALLE ESTADO
Address 44-071 W. CWft` Az$VeLA QUINTA, CALIFORNIA 92253
OwnerMmem.. ... ... �. ".. .. ....
al "me"Tam CmD' BUILDING: TYPE CONST: n OCC.. GRP.• 3 •.
Mailing
Address ion Bkqhap St. sa.txe _100 ' ' A.P. Number
City Zip !t'J r'' Tel. - -
�.%54Legal Description
Contractor Project Description'
3.1, ammitz"its j
A 140 ddress . ry..� ..._ _
'8� IU—
P.0. 173
City.. _. Zip - Tel.'
State Lic. City
& Classif. 4QU2 Lic. # 237— Sq. Ft. EW 7 No. No. Dw.
Size- 43 - Stories Units.
•
..._Arch., Engr., .. .. - .. _ .�..
Designer r New F Add ❑ Alter ❑ Repair ❑. Demolition.❑,
Address Tel.
City Zip . State
. _ .. 92 .... . Lic. #
LICENSED QONTRACTOR'S DECLARATION
hereby affirm that I am;licensed under provisions of Chapter 9 (commencing with'S.ection q
7000) of Division 3 of the BG/sii�np/e�spps��yyand Professions Code, and my licenyse is in full.force and
effect... �! f Ff1
_SIGNATURE 7 / DATE
OWNER -BUILDER DECLARATION Estimated Valuation
.I herebyaffirm 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 •sOAR..€1
permit to construct, alter, improve, demolish, or repair.any structure, prior. to. its. issuance* also 7 v. 7
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 rr. • -
Division '3 of the Business and Professions. Code, oithat. he Is exempt. therefrom; a'nd'the `basis' - 't
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 penalty of not more than five hundred dollars ($500).-��.e�
❑ I, as owner of the property,.or my. employees with wages as their sole compensation, will Plan Chk. Bal. - 6VLi.2'EA
do the work, and the structure is not intended or offered for sale: (Sec. 7044; Buisness and COnst.. ., v
Professions Code: The Contractor's License Law does, apply,'to. an owner of property who357,000•,
builds or improves. thereon and who does such work himself or through his own employees,Mech.,�. -
provided that such improvements are not; intended or offered for sale. If„ however, 'the building .-
or improvement is •sold .within one year of- completion, the owner -builder will'have the burden • Electrical -"
of proving that he did not build or improve for the purpose of sale:) . . .. MA
❑•I, as owner of the property, am exclusively contracting with licensed contractors to con.. Plumbing
struct the project. (Sec. 7044, Business and Professions Code: The%Contractor's License Law 85.00
does not apply to an owner of property who builds or improves. thereon, and who contracts for S.M-I. .. SAS
such projects with a contractor(s) licensed pursuant to the Contractor's -License Law.)
Grading
❑ l am exempt.under Sec: 'B. & P:C. for this reason
Driveway Enc.
Date owner. Infrastructure Defomed.raymew..as nw acmailurmt
Ath em " . Digit
WORKERS' COMPENSATION DECLARATION
u " I hereby, affirm that I have a certificate of consent to self -insure, or a certificate of '
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
O Copy is filed with the city. ❑ Certified copy is hereby furnished.. -
_ TOTAL B6�.�$
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.) _ . ..
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, after 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 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
This is a building permit when properly'filled out, signed and validated, and is'subject to FINAL -DATE INSPECTOR
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:; Data - Permit'
I 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 inspectij�p1rpj f �+" , Validated by:
te
Signature of applicant / - ��i/Ir Pry Dafy`�
Mailing Address Y �` r Validation: -
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FETS
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SQ. FT. ®
CARP. SQ. FT.
WALL SQ. 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 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, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
SQ. 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:
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
M ECH.FEE PL.CK.FEE
CONST. FEE !ELECT.EE
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
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS.
GARDEN WALL FINAL
APPLWANT NAME (L. F. MI)
JL Onnstruction -
ADOREss
P.O. Box 173
CITY/COMMUNITY/STATE/ZIP
. Nestor; CA 92053
JOB SITE ADDRESS/SPACE
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.
TNM
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
4ssued. I shall not employ any person In any manner so as to become subject to the Workers'Compensallon Laws of
and effect.
California.
License Class tic. Number
'Dale Applicant
Date Contractor
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.
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 pursuanitothe provisions ofthe Contractor's License Law
01 hereby certify 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 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 o1 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 o1 not more than five hundred dollars (5500.):
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, 1 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 rated 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
❑Division o1 Industrial Safety Permit No.
through his own employees, provided that such improvements are not intended or offered for sale. If. however. the
FSB
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 affirmthat 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. C.).
7004. Business and Professions Code: The Contractor's License Law does not apply to an owner of property who
Lender's Name
Duilps 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. 8 P.C. (Attached Certificate).
I certify that f have read this application and statethat the above information is correct. I agree to comply with all
Owner
'city and county ordinances and state laws relating to building construction,and hereby authorize representatives
Date
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 o1 Workers' Compensation Insurance , or a certified copy thereof (Sec. 3800. Lab. C.).
Signature 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. I agree to comply with all state laws and county ordinances relating to Duidfing .
O 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 I have applied for this permit for the purpose of making inspections.
Date Applicant
Signature of Applicant or Agent Date
Print Applicant/Agent Name
44/
APPLWANT NAME (L. F. MI)
JL Onnstruction -
ADOREss
P.O. Box 173
CITY/COMMUNITY/STATE/ZIP
. Nestor; CA 92053
JOB SITE ADDRESS/SPACE
CITY/COMMAUNITY/STATE/ZIP '
La. to CA 92253
BOK I
PAG. -
PRC I
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RNG
SE
S
19903
1OT
5
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S11
TRACT NAME i1V�rL.ION PAIM.S
OWNER NAME (L. F. Ml) Gwx- al Management Corp. '
CONTRACTOR -FIRM NAME '
J.L. Construction
ADDRESS
above
CITYM.OMMUNITY/STATE/ZIP -
PHONE .
SMI Fee
LICNC •
ARC/ENG FIRM NAME
Michael Buccino Assoc.
ADDRESS .
340 S. Farrell Dr. A212
CITYICOMMUNITY/STATE/ZI P
Palm Sbrinas, CA 92262
PHONE •
323-7877
UCNC 0
USE OF PERMIT
Single Family Dwelling
BL
ZON,
105.72 DEP. PAID
FSB
SSB
SSB
'RSB
ggrpeentint
OFC
t Demrtmnt
ZONE ORD I
LOT SZ
END
SIDE
IL
APPUPRMT Onja_N
it
Permit to construct
1247 sq. ft.
of
living area and 433
sq. ft. -of garage
as per approved plans.
mech. Fee
37.00
Plan Check Fee
307.96
Const. Fee
367.00
60.18
SMI Fee
5.46.
Plimbina Fee
85.00
Tnfrastructure *
862.60
105.72 DEP. PAID
756.88
*
ggrpeentint
t Demrtmnt
TOTALOTAL
•
FEE2
60
8 8 UK
i
=• FINONCF VALUATION 77,948.00,