001406 (SFD)P.O. BOX 1504 No:
Building 44-260 F.. SWI& C 78-105 CALLE ESTADO
Address' LA QUINTA, CALIFORNIA 92253
Owner ..
miaml rmiaamJEog& BUILDING: •TYPE'CONST. OCC: GRP:M'
Mailing
Address 1 Bishop, ft. aAie 2700 r ... A.P;.Number
City Zip Tel.
aqua.. 51.. 95M 17800-367-50M Legal Description
Contractor
Project Description..'.
Address _
!z'.E3.
JLl3
SIGNATURES 1 ! DATE
' OWNER -BUILDER DECLARATION r'
I hereby affirm that 1 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 pursuani'to
City.. _
Zip
Tel.'
the provisions of the Contractor's License. Law, Chapter 9 (commencing with Section '7000)of
-Division' 3 ol'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'.
ChE'
9-n.53
340--55U
- .
Plan .Chk. Bal. .
State Lic.
& Classif. ; . 442322
City
Lic. # 237
Sq. FAV • 1247- No. No. Dw.
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
EleCtrlCdl
Size 't R_ *� Stories Units
Arch:, Engr.,..
'Alter
Designer ' ,�. �x�•���}�
New.1X Add ❑ ❑ •' Repair ❑ Demolition.❑
Address
Tel.
Driveway Enc.
Lender's Name
Date' owner
Infrastructure DM
City PaLlm stwi-VIgs,Zip State
97.262 Lic. #
LICENSED. CONTRACTOR'S. DECLARATION `
I hereby affirm that 1,aAlicensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the#Bustin/ess and Professions. Code, and'my license -is in'full force -and
effect... .. . -rLrs .... l ` ..1A r 3.
r
TOTAL
SIGNATURES 1 ! DATE
' OWNER -BUILDER DECLARATION r'
I hereby affirm that 1 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 pursuani'to
_
Estimated Valuation
PERMIT•;,r
the provisions of the Contractor's License. Law, Chapter 9 (commencing with Section '7000)of
-Division' 3 ol'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'.
• .•n.
Plan' Chk.' Dep. ,
- sub/ectsthe applicant to a civil penalty o/not more than five hundred. dollars. ($500): ° ' '
0 I, as owner of the property, or my employees with wages as their sole_compensation,.wi11
- .
Plan .Chk. Bal. .
COrtSt.
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, o/'property -who,
'Meth.' '
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
EleCtrlCdl
- or improvement is sold .within one year of completion, .the owner -builder will have'the burden
o/ proving that he did not build or improve /or the purpose of sale.) - ..... _ . . .
Plumbing
0 I; as owner of the property, am exclusively contracting with licensed. contractors to con-.
•• - Strutt 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 -.I: .
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) s
' ..0.1 am exempt under Sec. B. 8 P.C. for this reason
. .
Grading
Driveway Enc.
Lender's Name
Date' owner
Infrastructure DM
Lender's Address
This'is'a building permit when properly filled out, signed and validated, and is subject to ;
expiration it work thereunder is suspended for 180 days.
FINAL DATE
INSPECTOR
WORKERS' COMPENSATION DECLARATION
"I hereby affirm that I have a certificate of'cons'ent to'self-insuie, or'a certificate of
.
Worker's Compensation Insurance, or a certified copy thereof.'(Sec: 3800, Labor Code.)
•• '
Policy No. .Company
94
TOTAL
.yv
AMOUNT ..
'REMARKS
105,072
202.24
(This section need not be completed it .the permit is for one hundred , dollars ($100) valuation '
- orless.) .. _ ..... ..
•� I 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 lhe'Workers' Compensation
Laws of California.
7��gge.00 .
' - •s -
.00
- -
' Date Owner
NOTICE TO APPLICANT: If, afterY making this Certificate of Exemption' you. should become'
'subject to the. Workers' Compensation provisions o/:lhe'Labor Code, 'you must forthwith
' comply with such provisions or this permit shall be deemed revoke_ d.
ZONE:' BY:
Minimum Setback Distances: a
-
' w.46_
a
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY. -'
1 hereby affirm that there is's construction lending agency for the performance of.ihe
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 it 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 'relating to building
construction,and hereby authorize representatives -of this city to enter -the above-.
mentioned property for inspection prurposers./t1
Signature of applicant �'r Ir/1! 7f % f ti ... Date�� ^ 3 }?+ y
Mailing Address ° r
0 Copy Is filed with the city. . 0 Certified copy is hereby.furnlshed.
TOTAL
.yv
CERTIFICATE OF EXEMPTION FROM
WORKERS' -COMPENSATION INSURANCE ) '
'REMARKS
(This section need not be completed it .the permit is for one hundred , dollars ($100) valuation '
- orless.) .. _ ..... ..
•� I 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 lhe'Workers' Compensation
Laws of California.
-
' - •s -
-
- -
' Date Owner
NOTICE TO APPLICANT: If, afterY making this Certificate of Exemption' you. should become'
'subject to the. Workers' Compensation provisions o/:lhe'Labor Code, 'you must forthwith
' comply with such provisions or this permit shall be deemed revoke_ d.
ZONE:' BY:
Minimum Setback Distances: a
-
Front Setback. from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY. -'
1 hereby affirm that there is's construction lending agency for the performance of.ihe
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 it 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 'relating to building
construction,and hereby authorize representatives -of this city to enter -the above-.
mentioned property for inspection prurposers./t1
Signature of applicant �'r Ir/1! 7f % f ti ... Date�� ^ 3 }?+ y
Mailing Address ° r
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
SLAB GRADE
2ND FL. SQ. FT.
BONDING
YARD SPKLR SYSTEM
POR. SQ. FT. ®
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.COOL 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.0
I ITEMP 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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1114 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
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
I NSU LATIONISOUN D
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS,
GARDEN WALL FINAL
U
PERMIT APPLICATION
City of La Ouinta
Department of Building and Safety
This permit becomes void it work not commenced within 180 days from date of Issuance. OR, If work has been suspended or abandoned for a period o1 180 days.
CERTIFICATE OF EXEMPTION FROM WORKERSTOMPENSATIONINSURANCE: 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 3of 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) of Division 3 o1 the Business and Professions Cade) 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 (E500.):
0 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. 7004• 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 safe. ll, 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 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 of property who
buitos 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. & 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 Cerlitied 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/COM►NJNITY/STAnal P
Nestor; CA 92053
JOB SITE ADDRESSSPACE
CITY/COI LM4ITY/STATE/ZIP - _ ,
. La. to CA 92253
BOK
PAO
PRC
C
TNM
RND
SE
S
TRACT
LOT
Elect- Fee 60.18
MOD
SB
-PlimbiM Fee 85.00
19903
`JJ 71
862.60
105.72 DEP. PAID
_756.88
T�
TRACT NAME HORIZON PALM .
OWNER NAME (L. F. MI) Caneral Management Co
CONTRACTOR -FIRM NAME
J. L. Construction
ADDRESS
above
CITYICOMAWNITYSTATE/ZIP
PHONE .'
TOTAL
'FEE
LICHC .
862.6f)
ARC/ENO FIRM NAME
Michael Buccino Assoc.
ADDRESS
340 S. Farrell Dr. A212
CITY/COMMUNITY/STATE/ZIP
Palm Sorincts, CA 92262
PHONE . 1 LICNC'.
-
323-7877
USE OF PERMIT
S' le Familv Dwelling
BL
ZON,
FSB
SSB
SSB
RSB
OFC
ZONE ORD s
LOT SZ
ENo
SIDE
A
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 employany person inany manner so asto 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:
0 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, falsework, or
demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap 32. Grp 2. Art 2, Sec 341. Title 8.
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.
0 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-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
Print Applicant/Agent Name ^ 6jZ111
o %
Date
APPL/PRMT 20 DATE
y 5-2-2=85
S.F.D.
Permit to construct 1247 sq. ft.
of
living area and 433 sq. ft. of gaage
as per approved plans.
mech. Fee 37.00
Plm Check Fee 307.96
Const. Fee ..367.00
Elect- Fee 60.18
M Fee 5.46:'
-PlimbiM Fee 85.00
862.60
105.72 DEP. PAID
_756.88
*neferred payment as = agreemilant
with Ccmminity t Department
TOTAL
'FEE
862.6f)
/A 1 1 1 7 J L L / 7 6 8 8 CK
FINANCE VALUATION 77,948:00 .