001448 (SFD)44
P.O. BOX 1504
Building 78-105 CALLE ESTADO
,,� '
' Address SUnd n- f't iVe •LA-OUINTA, CALIFORNIA 92253 • . .
Owner a.
No.• 001448
BUILDING: TYPE CONST.
OCC: GRP.
Mailing
Address Y k 3x � 71ft
A.P. Number
_ ....._.
Legal Description
Project Description
rF �,l
ill=s�11i' i,�f:
City
U,
Zip :
Ly
�� 133
Tel.
3.,80 ,,.367.,
Contractor.
I L tXt'�
Address
P.O.. 1.73
city '
Zip
Tel . ...
State Lic.
& Classif. "9822
CityDIG
Lic. # 237
,
Sq. Ft.
Size 433..-
No. No. Dw.
Stories - Units
-Arch., Engr:,.. ..
Designer-
reel .im M
New tt - Add•❑
.>.
Alter❑,:. Repair ❑. ': Demolition ❑'
_
Address
Tel.
340 S, - "$ l
323-78r,
_ -
' City Zip
State
'�iz;;
Lic. #
..... .......
.. ... ... .. ... .-
., LICENSED CONTRACT,OR'$ DECLARATION
I hereby affirm that I am licensed. under provisions of Chapter (commencing with Section
7000) of Division 3 of.the//.B[[usiness and Professions Code, and'my license is in•f"ull force and '
:. effect...
_
-
n
...... .... .
• SIGNATURE " JY / -" a" I i DATE
OWNEWBUILDER DECLARATION . rt; .
I hereby 'affirm that I am exempt from the Contractors 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 lila a signed'statement;that he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) o/-
' Division 3 of tbe'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)...
•_ 0 1, as owner of the property, or m_ y employees with wages as their sole compensation, will
do the work, and 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 -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 improvement is sold within one year of completion, 'the owner -builder will have the'burden-
ro
- of proving that he did not build or improve for the.purpose of sale.)__ •. _ ...
❑ 1, 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 LicenseLaw
does not apply to an owner of propertywhobuilds or improves thereon, and who contracts for.
•• such projects with a contractor(s) licensed pursuant to the Contractor's License Law:)
.....❑Iain exempt undecSec. B. & P.C. for -this reason
Esti fYlated VdlUdtlOn
a
'�
'�j {
'� ` rMoOd
-
'A PERMIT �
-
� � - AMOUNT -
Plan Chk.- Dep.
• - - 105.'72 . •"
Plan Chk. Bal.
02+�. ryAA
- Z A+.6Y§
-
''MeCh.,-
BB
- 9 ♦.
UU
'.Electrical
-
-
Plumbing ".
.. .
S.M.I. •- -
- _
- - •' 5.46.
Grading
_•
Driveway Enc.
Date. - Owner
Infrastructure -
Deftmil : t as a,
with 0=. Dew 10ment
WORKERS' COMPENSATION DECLARATION
• I hereby 'affirm that I have a'cerlificate of consent to'self-insure, dr'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. ..
TOTAL862.60
756@
' CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
REMARKS.
'
(This section, need not be completed it the permit is for one hundred dollars ($100) valuation
.' or less.) .. .. ...
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: •If, after making this Certificate of Exemplion'you should become
' 'subject to"the 'Woikers"'Compensation provisions of "the Labor Code, you must forthwith.
comply with such provisions or this permit shall be deemed revoked. -
,-ZONE:
:Minimum Setback -
- - - -
Front Setback from Center.. Line
:.
_ -
Rear Setback from Rear Prop. Line
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,_ Civil Code.).'. ', -
-
Side Street Setback from Center Line -
Side Setback from Property Line
Lender's Name
Lenders 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.
I agree to comply with-allicity and county -ordinances and state laws relating to.building
construction, and hereby authorize representatives of this city to .enter the above-.
mentioned property for ins f aliowpurposes.
lz1/{ .! tom....,,'.
''
Signature of applicant + Date
Mailing Address ' "'` ¢ t / `
ISSUed'by:
-
'
Validated by;
Validation:
Date Permit .
.• -
City, State, ,Zip `
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. $
UNITS
N
2ND FL. SQ. FT. ®
BONDING
YARD SPKLR SYSTEM
POR. SQ. FT. p
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. I SQ. FT.
GAS (ROUGH)
DRAINAGE PIPING
WALL SQ. 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.COOL HOOD
SIGN
WASH ER(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.
I TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEMIPERM
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
SQ.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 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/INITIALS.
GARDEN WALL FINAL
V
PERMIT APPLICATION
City of La Duinta
Department of Building and Safety
r '
This permit becomes void if work not commenced within 100 days from date o1 Issuance. OR, If work has been suspended or abandoned for a period of 180 days.
CERTIFICATE OF EXEMPTION FROM WORKERSTOMPENSATION INSURANCE: This section need not be completed if
LICENSED CONTRACTORS -DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9
(commencing with Section 7000) of Division 3 o1 the Business and Professions Code, and my license is in full force
and effect.
License Class Lic. Number
Date 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 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 o1 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 of the property, or my employees with wages as Meir 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 o1 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 improvemni 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.).
O 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 o1 property who
builds or improves thereon, and who contracts for such projects with a contractors) licensed pursuant to the
Contractor's License Law.).
O 1 am exempt under Sec. B. d 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 o1 Workers' Compensation Insurance . or a certified copy thereof (Sec. 3800. Lab. C.).
Policy No. Company
D 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 Construction
ADDRESS
P.O. Box 173
CITY/COMMUN I T Y/STATE/ZI P
Nestor; CA 92053
JOB SITE ADDRESS/SPACE -
CITY/COMMUNITY/STATE/ZIP - -
La. to CA 92253
BOIL .
PAG
PRC
C
mech. Fee 37.00
TWN
MIG
SE
S
1990 3
LD%0%
SMI Fee 5.46
MOD
aB
TRACT NAME HORIZON PALMS .
OWNER NAME (L. F. MI( General Management Corp. '
CONTRACTOR -FIRM NAME
J. L. Construction
ADDRESS
above
CITY/COMMUNITY/STATE/ZIP
PHONE a
LICNC .
with chrrminity t Degartmil
ARC/ENG FIRM NAME '
Michael Buccino Assoc.
ADDRESS
340 S. Farrell Dr. A212
CITY1COMMUNITY/STATE/ZIP
Palm Springs, CA 92262
PHONE • LICNC'N
323-7877
USE OF PERMIT -
Sin le Family Dwelling
BL
ZON,
FS8
'SSB
SSB
RSB
OFC
ZONE ORD •
LOT SZ
END
SIDE
the permit Is for one hundred ($IDD) o. 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 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, talsework, or
demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap 3.2. Grp 2. Art 2, Sec 341• Title 8.
C.A.C.)
❑ As owner -builder, I will not employ anyone to do work which would require a permit.from the Division of
Industrial Safety as rioted above• unless such person has a permit'to do such work from that division.
❑ 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. Q.
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 1 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.L ` 4 TE
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
SMI Fee 5.46
Plimbing Fee 85.00 .
Trifrastructure
862.60
105:72 DEP. PAID
.756.88
*neftnrred pa==t as = agreentint
with chrrminity t Degartmil
TOTAL •
'FEE
862.60
A1167 D LS /5688 CK
' FINANCE VALUATION 771948.00"
7j948.00