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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 .