001447 (SFD)C
P.O. BOX 1504 No. ' 001447
Building78-105 CALLE ESTADO
Address 44--3.76 W � �cL , LA:.QUINTA, CALIFORNIA -92253...
Owner ,
Mailing `. ' ' � BUILDING: TYPE CONST. • V N' :• OCC: GRP. - $? I' -
Address 1001 UshOP St— Suite 4-700A.P. Number
City Zip�Tel. h
ulu* Legal Description
Contractor-
�.�. Project Description1�$''�'SM'11Yi
..Address.
_ . City. Zip ... Tel..
92053 340-Wl . '.
State Lic. City
& Classif. Lic. #
Arch.; Engr.,
Designer .�
Address 4 Tel.
.. _, .. -3 '' m ;t:�h .
121_7A"n�
'DWVAT
Sq. Ft, No.
Size- - Stories
New :MAdd ❑ Alter ❑' Repair ❑ .:
No. Dw.
•' • � - Units -
Demolition ❑
City
Zip
State
Palm S!l��9
Lic. #-
" LICENSED CONTRACTOR'S. DECLARATION,
I hereby affirm that I„am licensed under provisions of Chapter -9 (commencing with Section
7000) of Division 3 ofithe /Business and Professions Code, and my license is -in full forceiand '
effect....
/
SIGNATURE .-.-/- .+ /'•/' -/ DATE
- . OWNER•BUILDER,DECLARATION
I hereby affirm that I am exempt from the Contractor's. License Law for the -following
°
EStlmated Valuation p�
.• reason: (Sec. 7031.S,Business and Professions Coder 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.
the provisions of the Contractor's License. Law, Chapter:9 (commencing- with'Section :7000) of
- 'Division 3 o the. Business and Professions 'Code;'orthat: he -Is ' exempt therefrom, and the basis.
for the alleged exemption. Any violation of Section '7031:5 by 'any applicant fora. permit -
,
•' s: e a -
.- PERMIT 't -AMOUNT
' ' -
'
.Plan' Chk. Dep.- ' • •� .. '” 315.72
" subjects the applicant to a'civil penally'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
Plan .Chk.,Bal. .
Const.. 3 a
do.the work, avid the structure is not intended or offered for sale. (Sec. 7044; Buisness'and
Professions Code: The Contractor's License Law does not apply to an owner or property who .
.Mach:
'
builds of 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
Electrical' 60.18
• ,or improvement is sold -within one year of completion, the - owner -builder will have the burden
oI 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's License Law.
does not apply to an owner or property who builds or'improves thereon; and who contracts for
$. M'a. "..•' - �a
• such projects with a contractor(s) licensed pursuant to the Contractor's License taw.)
❑ I am exempt :under Sec.. B,.& P.C: for this reason
Grading
Driveway Enc.
Date owner
Infrastructure iti iit as t
_ �TactiXG
Wil .. VM AC=Mt
WORKERS' COMPENSATION DECLARATION
hereby affirm that 1 have a'certificate of consent'to self=insurd; 'or 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. ...
..
TOTAL P.62.SO: MAR
CERTIFICATE OF EXEMPTION FROM
.,WORKERS',COMPENSATIONINSURANCE.
REMARK'S
- -
(This. section need not be completed if the permit is for one'hundred dollars ($100) -valuation
or less:] ._. _
certify that in -the performance of tho work for which this permit is issued, I shall not
' - - employ any -person in any -manner so as to become. subiect_to*the Workers' Compensation"
Laws of California.
- - - -
. 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:
ZONE: - BY: --
Minimum Setback Distances: ' - '
F tS tb kf C
CONSTRUCTION LENDING AGENCY
hereby, affirmVidt there is'a,construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civii.Code.) ..
Lender's - Name
Lender's Address
This is's 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.
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 inspectioon purposes.
Signature of applicant -_1:&i• i/ ! �, lrr t • Date) i
Mailing Address
City, State, Zip
ron a ac .rom enter Llne
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:
HARD COPY I ..
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. @ $
UNITS
SLAB GRADE
2ND FL.SO. FT. @
BONDING
YARD SPKLR SYSTEM
POR. SO. FT. @
MOBILEHOME SVC.
BAR SINK
GAR. SO, FT, @
POWER OUTLET
ROOF DRAINS
CARP. SO. FT.
GAS (ROUGH)
DRAINAGE PIPING
WALL SO. FT.
OTHER APP./EQUIP.
DRINKING FOUNTAIN
SO 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, 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
GAR. FIREWALL
SO.FT.GAR @ 3/ac
HOUSE SEWER
LATHING
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 —ANK
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 SIGNATURESIINITIALS.
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 o1 issuance. OR, if work has been suspended or abandoned for a period of 160 days.
CERTIFICATE OF EXEMPTION FROM WORKERSTOMPENSATION 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) o1 Division 3ot the Business and Professions Code, and my license is in full force
and effect.
License Class Lic. 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 file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law
(Chapter 9 (commencing with section 7000) o1 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 o1 not more than five hundred dollars
0 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. IL 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 of sale.).
0 1, as owner of the property, am exculsively contracting with licensed contractors to construct the project (Sec.
7041, Business and Professions Code: The Contractor's License Law does not apply to an owner o1 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. 8 P.C. (Attached Certificate).
Date Owner
WORKERS' COMPENSATION DECLARATION: 1 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.).
Policy No. 'Company
0 Certified copy is hereby furnished.
0 Certified copy is filed with the City Building Inspection Department or City Department.
Date Applicant
APPLICANT NAME (l, F. M11 JL Cms l.L LLction -
ADDRESS P.O. Box 173
CITY/COMMUN I TY/STAT MI P
Nestor; CA 92053
JOB SITE ADDRESS/SPACE
V
CITY/COMMLONITY/STATE/ZIP '
La to CA 92253
80K
PAG
PRC I
C I
TNN
RNO
SE
S
19903
LD%0
SW Fee 5.46
-10
se
TRACT NAME
HORIZON PAIMS
OWNER NAME lL. F. MII Ganeral Management Corp. '
CONTRACTOR -FIRM NAME
J.L. Construction
ADDRESS
abcme
CITYPCOMM UNITY/STATE/ZIP
PHONE I
LICHC •
with rerminity t Department
ARC/ENG FIRM NAME ...
Michael Buccino Assoc.
ADDRESS
340 S. Farrell Dr. A212
CiTY/COMMUNITY/STATMI P
Palm rin s CA 92262
PHONE I
LICNC'I
323-7877
USE OF PERMIT
Sin le FaTdlv Dmllin
BL
ZON,
FSB
SSB
SSB
RSB.OFC
I.—
ZONE ORD I
LOT Sz
END
SIDE
the permit is for one hundred ($100) o. less. I certify that in the performance of the work for which this permit is
issued, l shall not employ any person in any manner so as to become subject to the Workers' Compensation laws o1
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:
0 1 hereby certify that no excavation five (5) or more feel 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, Sec341, Title 8.
C.A.C.)
0 As owner -builder, I will not employ anyone to do work which would require a permit from the Division o1
Industrial Safety, as rioted above, unless such person has a permit to do such work from that division.
0 Division o1 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 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
APPUPRMT .s GATE
, :, 5-22=85
S T.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
Fee 60.18
SW Fee 5.46
.21uribing Fee 85.00
Tnfrastructure
862.60
105.72 DEP. PAID
756.88
* 4greentint
with rerminity t Department
TOTAL •.
OTE
2 60
n 1 1 04)I, c-) / D 6. 8 8 R
' i i i.�i ia`t
FINONCE 41 VALUATION 77, 948 .00