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001434 (SFD)•4 ; P.O. BOX 1504 No. 00.434 Building 78-105 CALLE ESTADO Address 44-O W S� Mive ,LA-QUINTA,..CALIFORNIA 92253. • Owner Gmwxal Mmmag3p-amt c Mailing BUILDING: TYPE CONST. OCC; GRP:• . Addressl ,hWSt, SUite, 170(lA.P...Number `'City Zip 96 Tel. Legal Description ` Contractor _ Project Description .']am �3 _ .Address _ .. 146 Mdft jZip State Lic. & Classif. 442822 _ ...Designer M4,t n 1 6aur !ai Tel.. 92053 .30-:55n City Lic. # ... 237 _ Address Tel. 340 -so EhIT11111-11 Mr... 323-7877 CityZip State •�3�� Lic: # " ..... inn _ 'ia '' • y.LICENSED CONTRACTOR'S DECLARATION .: I hereby affirm that I aOlicensed under provisions of Chapter 9'(commencing with�Section 7000) of Division'3 of thvve'�66siness and Professions Code, -and my licennse is in'fullll force and effect..: r ./{7 %:j % �a� 7.: ._ .... : �l j - / 1 , SIGNATURE .f•' }` ,I DATE _ - - OWNER-BUILDEWDECLARATION . Estimated Valuation �q I hereby affirm that I am exempt from the Contractor's License Law for the following - , - 3'e reason: (Sec. 7037.5,Business and Professions Code: Any city or.county, which requires. a 1rt�4 permit to construct, alter, improve, demolish, or repairany structure, prior to its -issuance also - Sq. Ft. IMIG i2Q7 Size G"--433 NewX) : - Add ❑ No. No. Dw. Stories-- Units Alter ❑- ' • Repair ❑ Demolition ❑ - requires.the applicant -for- such permit to file a signed.,statement that he'-is*licensed pursuant to PERMIT "AMOUNT - the -provision s of the Contractor's License Law, .Chapter 9 (commencing with'Section 7000) or - " Division 3 o/ the Business'and'Pro/essions Code, or:that.he is exempt therefrom,. and the basis- for the alleged exemption. Any. violation of Section 7031:5 by any. applicant fora permit • .Plan -Chk. Dep. - -- • - .. f r.. ' subjects the applicant to a'Civil penalty of not more than live hundred dollars (S500). I, the Plan Chk. Bal. - O as owner. of property, or.my.employees with wages.as.their sole:compensaJion, will : do the •viork, and the structure. is not intended or offered for sale. (Sec .,M44, Buisness and Const. „ e� /S#} . Professions Code; The Contractor's License • Law does'not apply to an owner of. property who. / .06 ' builds or improves thereon and . who does such work' himself or through his own employees, - that improvements intended 'offered for ' Mech.' ' provided such are not or, sale. If,. however, the building. - • orimprovement 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�f�& struct the project: (Sec. 7044, Business and -Professions Code: The Contractor's License Law does not apply to an owner or property who builds.or improves thereon, and who' contracts for S•M.L- - 5.46 - • such•projects with a contractor(s)• licensed pursuant to the Contractor's License Law.) Grading ❑ 1 a exempt -under Sec. B. & P.C. for•this reason. Driveway Enc. Date owner Infrastructure ftfaamd PWIMM.. as PX cR:t9t WORKERS' COMPENSATION DECLARATION hereby affirm that I have'a"cefiificate of consent to'self-.insure, or-a'certificate of Worker's Compensation Insurance, or.a certified copy thereof. (Sec. 3800, Labor Code.)' ' PolicyNo.... Company . _ ❑ Copy is filed with.the city. ,O Certified copy is hereby furnished.. .. .. TOTAL i 7.Rf _ CERTIFICATE OF EXEMPTION FROM REMARKS. WORKERS'. COMPENSATION INSURANCE (This section need not be completed i/ the permit. is for one hundred dollars •($900) 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 ,a. Laws of California. Date Owner ' NOTICE TO APPLICANT: If, after making this' Certificate o/ Exemption you* should become 'subject ZONE: BY: ' 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 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. 'county Issued by: Date Permit agree to comply' with all city •and ordinances and state laws gelating to building construction, and hereby authorize representatives -of this city to enter 'the above- mentioned property for inspectiori3purposes. jar t/ r !. y� Signature'of applicant ! 1. l �!. /'i.. Date— Validated by: Mailing Address dr. / Validation: City, State, Zip ' HARD COPY I CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES .. 1ST FL. SO. FT. ® $ 2ND FL ` SO. FT. POR. SO. FT. ® GAR. SO. FT. p CARP. S0. FT. WALL SO. 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 WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APP./EOUIP. LAUNDRYTRAY 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 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: 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 INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESJNITIALS GARDEN WALL FINAL ,e; LICENSED CONTRACTORS DECLARATI -(commencing with Section 7000) of Divi and effect. License Class Lic. Number Dale Contractor OWNER -BUILDER DECLARATION: 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5. Business and Professions Code: Any cityor county which requires a permit to construct. after, 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 the provisions of the Contractor's License Law (Chapter 9(commencing with section 7000) of Division Sof 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 I. as owner of 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 wil (have the burden of proving that he did not build or improve for the purpose of sale.). 0 I, 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 not apply to an owner of property who builQs 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. (Attached Certificate). Dale Owner 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. Q. 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 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'COMPENSATIONINSURANCE: This section need not becompleted 'if ON: I hereby affirm that I am licensed under provisions of Chapter 9 the permit is for one hundred (5100) o. less. l certify that in the performance of the work for which this permit is s ion 3ofthe Business and Professions Code, and mylicense isinfull force issued, I shall not employ any person in any manner so as to become subject to the Wotkers'Compensation Laws of California. APPLICANT NAME (L. F. MI) �T AJ iJ Construction ADDRESS P.O. Box 173 CITY/COMMUNITY/STATE/ZIP Nestor, CA 92053 JOB SITE ADDRES$/SPACE CITY/COIiIUNITY/STATE/ZIP La. to CA 92253 BOK PAD PRC C Mech. Fee 37.00 TWA- RNG SE S TRACT 19903 LOTS SMI Fee 5.46:' MOD. SB TRACT NAME HORIZON PAl.A• S ' OWNER NAME (L. i; -MO ieal na�1� gement Corp. CONTRACTOR -FIRM NAME J.L. Constniction ADDRESS .. above CITY/COMMUNITY/STATE/ZIP PHONE / - LICNC I with CcYrTrainity t De ARC/ENG FIRM NAME - Michael Buccino Assoc. ADDRESS 340 S. Farrell Dr. A212 CRY/COMMUN ITY/STATE/ZI P Palm rin s CA 92262 PHONE I f LICNC I 323-7877 USE OF PERMIT Single FamilyDwelling BL ZON, -. FSB 'SSB SSS RSB ; DEC ZONE ORD I LOT SZ END SIDE Dale Applicant NOTICE TO APPLICANT: If. after making this Certiticate of Exemption. you should bacon* 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: 0 I 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) feel high. (Chap 3.2, Grp 2 Art 2. Sec 341, Title B, 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. 0 Division of Industrial Safety Permit No. Date Applicant 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, Civ. C.). Lender's Name •lender's Add ress I certify that 1 have read Misapplication and stale that the above information is correct. l agree to comply with all city and county ordinances and state laws relating to building construction, and herebyauthorize representatives of this county to enter upon the above•inentioned 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 APPL/PRMT GATE ?A 85 S.T.D. Permit to construct 1247 sq. ft. of livingarea and 433 . ft. of age as r a roved plans. Mech. Fee 37.00 Plan Check Fee 307.96 . Const. Fee 367.00 60.18 SMI Fee 5.46:' Plurrbing Fee 85.00 Tnfrastructure 862.60 105.72 DEP. PAID .756.88 * a eemtnt with CcYrTrainity t De t TOTAL FEE 2 6U H117L. 7 LS 756,88 CK FINANCE VALUATION 77, 948.00 .