001418 (SFD)v P.O. BOX 1504
No. 001418
Building
'Address. 4— IL S�D. LA QUINTA CAL CALIFORNIAFORNIIA 92253
-
Owner '
Gamma BUILDING: TYPE CONST. " OCC: GRP.•P i
Mailing _ ..
Address
3001. PL4po Sti. 9saite 2720 A; P. Number ,. _..
City Zip- Tel.
Legal Description
Contractor Project. Description Hi7m'
JL. 0MISUCC611M
.
....Address. __. .... "
F.O.: c 1.73 x.:. .
City- _ . _ . .� ZIP'
Tela
920340—SSU:
State Lic. City
& Classif. //4 Lic. # g''��No. Dw.
Size. Mme•" A",— • - Stories Units
.Arch:, Engr:;.
• •' DesignerNewil7 Add ❑ Alter ❑ ' Repair ❑ Demolition ❑
Address Tel.
_.. 340 S, r' 1.. Dffr. 323-7877-;
City Zip State
incm 9262 Lie. #
. , LICENSED CONTRACTOR'S DECLARATION,
I hereby affirm that.i am licensed under provisions of.Chapter 9'(commencing 'mhth Section -
7000) of Division 3 of,tttid;Bus✓iness and Professions Code, and my license is in full force and
effect... J1 .a �r.�./.,,J
SIGNATURE +'- !' - DATE
OWNER -BUILDER DECLARATION ' . Estimated Valuation
hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Business and Pro./essions Code: Any' city or;county which • requires: a. `
permit to construct, alter, improve,-c.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 PERMIT
the provisions of the Contractor's License Law, Chapter 9 (commencing with .Section .7000) o/
Division.3 o/ the Business'a'nd Professions Code; or that..he is exernpi:`therefrom, and the basis .
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).
O I,, as owner of the property,,or my employees with wages as their. sole •compensation, will Plan. Chk..Bal.
do the work, and the structure is not intended or offered for sale. (Sec. 704.4, Buisness and
Code: The Contractor's License Law does'not apply to an.owner'of property who '
Const.
Mech: '
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
Electrical '
or improvement 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.)
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 of property who builds or improves thereon, and who contracts for
S. M.1.
• such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
. ❑.I am -exempt under Seca B. & P.C. for this reason
Grading
Driveway Enc.
Date Owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
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
❑ Copy is filed.with the city. , ❑ Certified copy is,hereby furnished.
'TOTAL
CERTIFICATE OF EXEMPTION FROM
AMOUNT -
e�2���t
�+r� agq%a '
*24
WORKERS' COMPENSATION INSURANCE
REMARKJ..
(This section need not be completed it the permit is for one hundred dollars ($900) valuation
-
or less.) �, .. ..... .. . ,. ..
1 certify that in the performance of thg work for which this permit -is issued, I shall not
^
employ any -person in any manner so-as'to become subject to the Workers' Compensation
Laws of California.
Date • "' Owner
NOTICE TO APPLICANT., If, after making this Certificate oV Exemption you should become
BY:
subject to' the' Workers' Compensation provisions of 'the ' Labor' Code, you must forthwith'
-comply with such provisions or this permit shall be deemed'revoked. -
•ZONE:
Unimuin Setback Distances: -
Front Setback.from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY ..
Side Street Setback from Center Line
I hereby affirm that there is a construction lending agency for the performance of the
• work for which this permit is issued. (Sec: 3097, Civil Code.)
Side Setback from,Property Line
Lender's Name
Lender's Address
INSPECTOR.'
This is a'building permit when properly filled out, signed and validated,'and is subject to
.,FINAL.DATE
expiration it work thereunder is suspended for 180 days.
.I certify.that I have read this application and state that the above information is correct.
Issued -by:
Date Permit
I`agree to comply with all city and county ordinances -and state laws relating to building
construction, and hereby authorize. representatives of this city to enter, the abovei
mentioned property for inspection,purposes.
Validated.by:
Signature of applicant J t f �1 'r i* • Dates r e 2 r.?
Mailing Address r ' �� l'
Validation:
•
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEE$
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT.
FOR. SO. FT. ®
GAR. SO. FT. ®
CAR P. SQ. FT.
WALL SQ. FT. ®
SQ. 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.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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.
SO. FT. RESID ® 1 Vi c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
REMARKS:
GAS G
PERMIT FEE
PERMIT FEE
PERE
E
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 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
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIIVITIALS,
GARDEN WALL FINAL
PERMIT APPLICATION
City of La Duinta
Department of Building and Safety
This permit becomes void if work not commenced within.ISO days from date of 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 it
LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9
(commencing with Section 7000) o1 Division 3 of 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 applicari 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 of the Business and Professions Code) or that he is exempt
therefrom and the basis for the alleged exemption. Any violation o1 Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty o1 not more than five hundred dollars
O I. 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 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 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 o1 sale.).
O 1, 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
builps or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the
Contractor's license Law.).
O 1 am exempt under Sec. B. 8 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 of Workers' Compensation Insurance , or a certified copy thereof (Sec. 3800. Lab. C.)•
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
APPLICANT NAME (L. F. MI) JL Construction
ADDRESS
P.O. Box 173
CITY/COMMUNITY/STATE/ZIP
Nestor; CA 92053
JOB SITE ADORECS/SPACE
CiTYICOhM4UNITY/STATE/ZIP .
La. Quinta, CA 92253
BDII 1
PAG
PRC
I c
TWN
RNG
SE
s
TRACT
19903
I LOTV4A
Elect- Fee 60.18
MOD
I SB
TRACT NAME '
HORIZON PALMS
OWNER NAME (L. F. Ml) Gmer'al Manag imt Co
CONTRACTOR -FIRM NAME
J.L. Construction
ADDRESS
ablove
CITY/COMMUNITY/STATE/ZIP
PHONE •
n
LICHC e
ARC/ENG FIRM NAME
Michael Buccino Assoc.
ADDRESS
340 S. Farrell Dr. A212
CITY/COMMUNITY/STATE/ZIP
Palm scorincrs, CA 92262
PHONE • I LICHC e
323-7877
USE OF PERMIT '
Single Fami1v Dwelling
BL
862.60
ZON,
FSB
SSB
SSB
RSB
I
OFC
.—
ZONE ORD •
LOT SZ
END
SIDE
I
the permit is for one hundred ($100) 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 [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) feet high. (Chap 3.2, Grp 2 Art 2, Sec341, 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.
O 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 Address
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 representatives .
of this county to enter upon the above4mentioned 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 1 have applied for this permit for the purpose of making inspections.
Signature of Applicant or Agent Date
Print Applicant/Agent Name o O I IA-
APPL/PRMT DATE
5-2-2=85
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
SM Fee 5.46.
Thm-bing Fee 85.00
Tnfrastructure
862.60
105.72 DEP. PAID
_..756.88
* ggreentint
with Crimmity t Department
TOTAL
'FEE
862.60
n11JU Z 756,88 CK
�. CxAI A Arf.G VALUATION 77,948.00