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001415 (SFD)rf ; _• 44 Z�I�of��P�V . P.O. BOX 1504 NO. 001415 Building 78-105 CALLE ESTADO Address 44-3.65 �+ � Dr• LA QUINTA, CALIFORNIA 92253 Owner BUILDING: -TYPE CONSTt- �%�$ OCC: GRP.' ;R I . -Mailing. Address IMI Bisbw St. ' te 2704. A.P.,Number. City Zip Tel. Legal Description Contractor. Project Description ' ;iY1 -%M. all B= 173 City .. Zip Tela State Lic. & Classif. .;, '. City. Lic. #..t Sq. Ft. No. No. Dw. Size Q 433 Stories Units Arch., Engr., Designer . .. New•©- Add ❑ Alter ❑ '. .. Repair ❑- Demolition ❑ Address340 Tel. ��ua dg�yyre S'4'7, 323487T City Zip State >'�mZlrxxct 4 �� Lic. # _ y . •. LICENSED CONTRACTOR'S, DEC LA RATION , � hereby affirm that,I.am licensed under provisions of Chapter'9 (commencing With Section 7000) Of Division 3 of t e Business and Professions Code, and my license is in full force and ' effect.. V SIGNATURE ! y r - "��•s "" / `f DATE_- ' OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License.Law for the following!s _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 thal.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• heals'. for the alleged exemption. Any violation o/ Section 7031.5 by any, applicant for: a permit 'subjects the applicant to a civil penalty of not more than'five-hundred dollars'($500). - ' ' '. Jas, owner the property, or my employees -with wages,as their.sole compensation, will •. . ❑ 1, r EStlrtiated Valuation iy ♦�2 �a --�d w9aiicS. i'.0 ' .. - PERMIT- �- - AMOUNT .. - Plan �A Chk. Dep. - - 115.72.. - Plari.Chk. Bal.. 202.24 �f ;* Const. ' - _ - .�6 .';JW'; do the work, and the structure is not•,intended or offered for sale. (Sec. 7044; Buisness andg��q - Professions Code: The Contractor's License Law does not. apply ,to. an owner of. property who builds or improves thereon and who does such work'himsel/ or through his own employees,'Mech'. - - ' provided that such improvements are not intended, or offered for sale. If, however, the building. or improvement,is sold within one year o/ completion, -the owner -builder will have the burden- of proving that he did not, build or improve for. the purpose, of sale.) .. _ - - • �� ' , Electrical -i$ - . ; Plumbing�i ' ' O 1, as owner of the property, am exclusively contracting withlicensed 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.) - ..❑ 1 am exempt under Sec. B. & P.C. for this reason' _ . - �}E S'•M.1. '• s�3(3' Grading Driveway Enc, Date owner. Infrastructure DO exred paimmat,as.aqma=* WORKERS' COMPENSATION DECLARATION hereby affirm that I have.a certificate of consent to self -insure, -or a certificate of. Worker's Compensation Insurance; ora certified copy thereof. (Sec. 3800; Labor Code.) Policy No. Company 0 Copy is filed with the, city. ❑ Certified copy is hereby furnished.... TOTAL 8132.60 756.8- 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. 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 Laws of California. ' _ Date Owner NOTICE TO APPLICANT: I/, ager making this Certificate o%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.' ZO.NE:' BY: Minimum'.Setback Distances:" - ' Front -Setback from Center Line ,.. .. Rear Setback from Rear Prop. Line CONSTRUCTIOWLEN DING AGENCY hereby'affirni that there is a construction lending agency for the performance of the 'workfor which this permit is issued. (Sec. 3097, Civil Code.) Side Street Setback from Cienter Line .. Side Setback from Property, Line Lender's Name Lenders 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. FINAL DATE INSPECTOR ' .. - - I 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 representativesof this city to enter the` above-.--,, mentioned property for inspecctiioon`purposes. , _ flySignature of applicant ! i1��'% Date��Ytf'y r .._. Mailing Address � � i .� � ISSUed by: Date Permit Val idated -by: Validation: ' ; _ City, State, Zip HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SQ. FT. ® $ UNITS SLAB GRADE 2ND FL. SQ. FT. BONDING YARD SPKLR SYSTEM POR. SO. FT. p MOBILEHOME SVC. BAR SINK GAR. SQ, FT, ® POWER OUTLET ROOF DRAINS CARP. SQ. FT. GAS (ROUGH) DRAINAGE PIPING WALL SQ. FT. ® OTHER APP./EQUIP. DRINKING FOUNTAIN SQ FT ® TEMP. POLE URINAL ESTIMATED CONSTRUCTION VALUATION $ GROUT WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SYSTEM WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM 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. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL GAR. FIREWALL SO.FT.GAR ® 3/ac HOUSE SEWER LATHING 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$ _$ 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/IVITIALS GARDEN WALL FINAL APPLICANT NAME (L. F. M1) JL Construction ADDRESS P.O. Box 173 CITY/COMMUNITY/STATE/ZIP ' Nestor, CA 92053 JOB SITE ADDRESS/SPACE ' v CITY/COMMLONITY/STATE/ZIP PERMIT APPLICATION City of Le Duinta Department of Building and Safety This permit becomes void if work not commenced within 180 days from date of issuance, OR, It 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 if LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 the permit is for one hundred (S1OD) o. less. I certify that In the performance of the work for which this permit is (commencing with Section 70110) of Division 3of the Business and Professions Code. and my license is in full force issued, I shall not employany person inanymannersoasto become subject to the Workers'Compensation Laws of and effect. California. License Class Lic. Number Date Applicant Date Contractor NOTICE TO APPLICANT: If, after making this Cert iticate 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 pursuant to the provisions of the Contra.ctor's License Law 01 hereby certify that no excavation live (5) or more feet in depth into whicha person is required to descend. will be *(Chapter 9(commencing with section 7000) of 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, lalsework, 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 32. Grp 2. Art 2. Sec 341, TilleS. subjects the applicant to a civil penalty o1 not more than five hundred dollars (5500.): 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 o1 property who builds, or improves thereon, and who does such work himself or 0 Division of Industrial Safety Permit No. through his own employees. provided that such improvements are not intended or offered for sale. If. however. the PHONE tr LICNC • building or improvemnt is sold within one year of completion: the owner -builder will havethe burden of provingthat 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 0 I, as owner o1 the property, am exculsively comracting with licensed contractors to construct the project (Sec. of the work for which this permit is issued (Sec. 3097, Civ. Q. 7074, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Lender's Name builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the SSe 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 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 hereby authorize representatives 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. C.). Signature of Applicant or Agent Date Policy No. Company CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I 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 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 I have applied for this permit for the purpose of making inspections. Date Applicant APPLICANT NAME (L. F. M1) JL Construction ADDRESS P.O. Box 173 CITY/COMMUNITY/STATE/ZIP ' Nestor, CA 92053 JOB SITE ADDRESS/SPACE ' v CITY/COMMLONITY/STATE/ZIP La. to CA 92253 BOK PAG PRC C TWN - RNG SE S TRACT LOT CM Fee 5.46 MOO M Tnfrastructure 862.60 19903 105.72 DEP. PAID 756.88 *Tlipferrtmd paymwt as pgr agreentint t Departnent TRACT NAME HORIZON PAIMS OWNER NAME (L. F. Mq GanertL al Managmmt Co CONTRACTOR -FIRM NAME J.L. Construction ADDRESS above CITY/'COMMUNITY/STATE/ZIP PHONE tr LICNC e ARC/ENG FIRM NAME Michael Buccino Assoc. ADDRESS 340 S. Farrell.Dr. A212 CITY/COMMUN ITY/STATEalP Palm rings, CA 92262 PHONE tr LICNC • 323-7877 J USE OF PERMIT Single Family Dwelling BL ION.. 'F$B SSe SSB RSB DEC ZONE ORD a LOT SZ END SIDE Signature of Applicant or.Agent ,.......,,.._,.......,_.......... n D 1 H I.`) Date APPL/PRMT s DATE 5-22-85 00 .S'F.D. 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 Elect, Fee 60.18 CM Fee 5.46 plimbing Fee 85.00 Tnfrastructure 862.60 105.72 DEP. PAID 756.88 *Tlipferrtmd paymwt as pgr agreentint t Departnent TOTAL FEE 862.60 H11L6 D LZ /5&88 CK FINANCE VALUATION 77,948.00