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001438 (SFD)Building ' Address Owner P.O. BOX 1504 No.. .001438 78-105 CALLE ESTADO 4.6-241 W_ &MftM nr _ LA QUINTA, CALIFORNIA 92253 Mailing ` Address j City �T lis • ' Contractor Address City " Zip abaft 9205 State Lic. City & Classif. � 7 Lic. # Arch., Engr., .J . _Designer ~' BUILDING: -TYPE CONST. VV OCC: GRP. R-3 A.P. Number !DO--3G?—.W54 Legal Description Project Description Sq. Ff. ;1217 Size- MR -'433 New P Add ❑. - Alter ❑ • Repair ❑ No: No. Dw. Stories, Units Demolition ❑, Address Tel. E . 340 S. �.�. - =77877 . City Zip State �irt..rnris°s 3$ .. Lic. # �,. LICENSED CONTRACTOR'S -DECLARATION herebyy: affirm thatyI am licensed under provisions of Chapter 9 (commencing with Section., 7000) of'Division°3rof3the Business and Professions Code, and'my license is in full force and effect. ', - .. ., •, _', - . SIGNATURE DATE OWNER -BUILDER DECLARATION 1 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 f requires the applicant, for such permit to file a signed statement that he is,licensed-pursuant to. the provislons-of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of " Divlsioh'3'oI the' Business.and'Professions Code, or that. he is exempt therefrom,. and thdaasis.... for the alleged exemption: Any violation of Section 7031.5 by 'any 'applicant for a permit.• '• subjects theapplicant to a"civil penalty of not'more than live hundred dollars (S500). .. ❑ I, as owner of the property; or my employees with wages as theiasole 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'doesnot apply to an owner_of property who bullds' 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 havetheburden' of proving, that he did not build or improve for the purpose of sale.) • - . , - Estimated Valuation .. +�� ' - PERMIT• •' .• AMOUNT - PlanChR.. D-ep.- -. _ Plgn_Chk. Bal. Const. I' 'Mectl. ElectrlCal ' Plumbing O 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 • such projects with a contractor(s) licensed pursuant to. the Contractor's License Law.) .-. .. O I am exempt under Sec: B. & P.C: for this reason - - S.M.I.- Grading Driveway Enc. Date owner Infrastructure Data=ed payaas pEw WORKERS' COMPENSATION DECLARATION " I 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 • O Copy is filed with the. city. O Certified copy is hereby, furnished., TOTAL . ... 756.88 REMARKS CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE - (This section need not be completed if the permit Is for one hundred dollars ($100) valuation or less.) - - - - 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: I/, after making this Certificate of Exemption 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: BY: Minimum Setback Distances: ' 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 ttie 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 Lender's 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. I agree to comply with' all city, and county ordinances and state laws'relatirig to building construction, and hereby authorize representatives sof this city to, enter the ,above, mentioned property for inspec�tion purposes. Signature of applicant AJ f / 1l J`1- Datef �=v -Issued by: Date Permit Validated by: Mailing Address `✓y r i' `.� '" `� Validation: . . City, State, Zip r HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES , 1ST FL. SQ. FT. ® $ UNITS SLAB GRADE 2ND FLSQ. FT. BONDING YARD SPKLR SYSTEM POR. SQ. FT. ® MOBILEHOME SVC. BAR SINK GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS CAR P. SQ. FT. GAS (ROUGH) DRAINAGE PIPING WALL SQ. FT. OTHER APP.IEQUIP. 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 LAUNDRY TRAY 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. 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 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.IEQUIP. 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 SIGNATURESIINITIALS, GARDEN WALL FINAL PERMIT APPLICATION City of La Duinta 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' COMPENSATION 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 7(100) of 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 applicant tot 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 36f 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.): ❑ 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 will have the burden of proving that he did not build or improve for the purpose of 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 builgs 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 sell -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 I APPLICANT NAME (L, F. MI) JL Cxnstruction ADDRESS P.O. Box 173 CITY/COMMUNITY/STATE/ZIP - Nestor., CA 92053 JOB SITE ADDRESS/SPACE CITY/COaMAUNITY/STATE/ZIP La. to CA 92253 BOK PAG PRC C TNN I RNG I SE 1 S 19903 Lo/ Flect. Fee 60.18 Moo se .plimbiM Fee 85.00 TRACT NAME HORIZON P*IM t!*Ranagement OWNER NAME (L. F. MI) Gmeral Co ' 1�11G1 1�•JGLI LCi CONTRACTOWFIRM NAME J.L. Construction ADDRESS aboNire CITY/COMMUNITY/STATE/ZIP PHONE a ' .756.88 LICHC e - ARC/ENG FIRM NAME Michael Bwxino Assoc. 'ADDRESS ' 340 S. Farrell Dr. A212 CITY/COMMUNITY/STATE/ZIP Palm Springs, CA 92262 PHONE a LICNC a 323-7877 TOTAL '• 'FEE USE OF PERMIT ' Single Family Dwelling BL ZON. FSB SSB SSB 'RSB ., OFC . . ZONE ORO a LOT SZ 'END SIDE the permit is for one hundred ($100) o, less. I certify that in the performance o1 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, lalsework, or 'demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap 3.2, Grp Z Art 2, Sec341. Title 8. C.A.C.) ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division o1 Industrial Safety, as noted 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: 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-lnentioned 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 o1 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 • '� 5-22-85 S 'F.D. Permit to construct 1247 sq. ft. of living area and 433 sq. ft. of garcage as per approved plans. Ylech. Fee 37.00. Plan Check Fee 307.96 Const. Fee 367.00 Flect. Fee 60.18 &a Fee 5.46.' .plimbiM Fee 85.00 862.60 105:72 DFP. PAID .756.88 * ggreentint with GcmmmitzZ t De t TOTAL '• 'FEE 862.60 A i i D 6 D LJ /:)N8 S GIS CINANCF VALUATION 77,948.00