001452 (SFD)Yf
P.O. BOX 1504 No.. 00152
Building 78-105 CALLE ESTADO
Address 44--276 Wo S€ yXk%311CleSt D'. %>. . LA QUINTA, CALIFORNIA 92253 ^
Owner
Gmeral Mrawmmt Omp. BUILDING: TYPE CONST. -V-W- OCC:.GRP:F- -14
Mailing-,
Address Infil 1X4p sevn %-_ Alrfft_t '7705 A.P. Number
CityZip Tel.
00
4� .�7f,; —367-� 5 Legal Description
Contractor
T 3T Project Description''?s5>^��LSTi F�Yta '•:
.> �.
` Address . ...
P.Q3 D= 173
City .. Zip Tel.. ..
920 340-551-1
State Lic. City
& Classif. 442822 Lic. # 23
Arch.; Engr., ..- .
Designer miebaei Bucaj* mow.
Address Tel.
3�4 S; �113�3 777:
CityZip State
Ual�n - Q2d Lic. # .
` LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencingfwilh.Sectiori
7000) of Division 3'of`the Business and Professions Code, and my license is in'full force and
effect. i /.ii. rF Id --a �� J — —
It -
Sq. Ft W 1247,
Size• -,%ri, • •A -VA
New Rl, Add ❑
No. No. Dw.
Stories Units
Alter ❑- Repair ❑
Demolition ❑
........
'
SIGNATURE `�-+•� Y - f DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the. Contractor's License Law for the.following
Estimated Valuation
reason:•(Sec. 7031.5,Business and.Professions Code:..Any city or. county. which requires a,��1-
permit to construct, after, improve, demolish, or repair any structure, pdor to its issuance also ..:
requires the applicant for such permit to fife a signed statement that he is licensed pursuant to
-�. -•
PERMIT"
- --
- AMOUNT -
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 of Section 7031.5 by 'any applicant for a. permit
-'
t•- _
: Plan.Chk..Dep...
-
-105.72 .
' subjects the applicant to a civil penalty or not more than five hundred dollars ($500):"
� I, as owner of the ro ert or m employees wilh.wa es as their.sole.com compensation, will.
p p y y 9 p
'is
Plan Chk. bal. .
i��_ �.
"
- -467 -
do the work, and the structure not intended or offered, for sale. (Sec. 7044, Buisness>andCOrISt.'
Professions Code: The Contractor's, License Law does- not apply to an owner. of property who,..
' MecK:
.�+�g n '
3 7.0+��0
n.
. 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
60.12 '
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
,
"
O 1, as owner of the property, am exclusively. contracting with licensed contractors to con-.. '
• strucl the project. (Sec.. 7044, Business -and Professions Coder 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.
_
.. 5446
•such,projects with a contractor(s) licensed. pursuant to the Contractor's License Law.) ,
O 1 am exempt under Sec.. B. & P.C. for this -reason
Grading
• -
Driveway Enc.
- Date owner
Infrastructure
��,,,,��cc
aa. t• .t t .
,..
WORKERS' COMPENSATION DECLARATION
I hereby affirm 'that I have a certificate of consent 10 self -insure, or 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.
REMARKS
_ .TOTAL
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.) .._ .. .. ..
. I certify that in the performance of tho 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.
- ' k, -
Date' ' " Owner _..._.
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.
ZONE: BY:
.Minimum Setback Distances: " --
Front Setback from. -Center Line
.
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY r'
Side Street Setback from Center Line
' I hereby affirm that there is a construction lending.agency'for'the perfoimance of the.
work forwhich this permit is issued.•(Sec. 3097, CivilCoda.)' •
'
Side Setback from Property Line "
Lender's Name
Lender's 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.l .have read this application and state that the above information is correct.Issued
I agree to comply with' all city and county ordinances and sfafi laws' relating Co building
construction, and- hereby 'authorize representatives' ,of this city• to enter the above-.'
mentioned property for inspection purposes..
Signature of applicant) /J' : b'!7" Dates %
Mailing Address %� �✓.
by:
Validated by:
.Validation.:
Date - Permit
-
i
_
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEILS
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SQ, FT. ®
CAR P. SQ. FT.
WALL SQ. FT. ®
SO. 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
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP.IEQUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
IKITCHEN 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
SQ.FT.GAR ® 3/ac
HOUSE SEWER
REMARKS:
VENTILATION.
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 Oufnta
Department of Building and Safety
This permit becomes void if work not commenced within 160 days from date of Issuance, OR. If work has been suspended or abandoned for a period o1 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 7000) 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 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 of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty o1 not more than five hundred dollars (5500.):
0 I. 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 sate (Sec. 7044. Business and Professions Code: The Contractors 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 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.).
0 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 rat 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.).
0 1 am exempt under Sec. B. & P.C. (Attached Certificate).
Date Owner
WORKERS' COMPENSATION DECLARATION: I hereby affirm that 1 have a certificate o1 consent to sell -insure, or a
certificate of Workers' Compensation Insurance , or a certified copy thereof (Sec. 3800. Lab. C.).
Policy No. Company
0 Certified copy is hereby furnished.
0 Certified copy is filed with the City Building Inspection Department or City Department.
Date Applicant
APPLICANT NAME (L. F. MI)
JL (]instruction
ADDRESS
P.O. Box 173
CITY/COMMUNITY/STATE21P
Nestor; CA -92053,
JOB SITE ADDRESS/SPACE
CITY/COMMUNITY/STATE/ZIP - - -
Ia.Quinta, CA 92253
BOIL '
PAG
PRC
Mech. Fee
37.00
TWN
RNG
SE
s
:1-9103
L%�
Wr POP
5.46
MoD
sa
*
Trifrastructure
TRACT NAME HORIZON PALMS
OWNER NAME (L. F. MI) Ganeral Management Corp • '
CONTRACTOR -FIRM NAME
J. L. 'Construction
ADDRESS
above
CITY/COMMUNITY/STATE/ZIP
ab
PHONE •
756.88
LICNC
ggreernhnt
ARC/ENO FIRM NAME
Michael Buccino Assoc.
ADDRESS
340 S. Farrell Dr. A212
CITYMOMMUNITY/STATMIP
Palm Springs, CA 92262
PHONE a LICNC
862.60
323-7877
USE OF PERMIT - -
Single Family Dtaellin
BL
ZOIC.
-FSB
" Sea
.SSB
'RSB
k
OFC -
ZONE ORD a
LOT SZ
END
SIDE
the,permit is for one hundred ($100) It. less. I certify that In the performance of the work for which this permit is
issued. 1 shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws o1
California.
Date Applicant
NOTICE TO APPLICANT: It. 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 feel 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 Z 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 o1
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: 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. 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 Ihave 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 Duinta 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 o1 Applicant or Agent . 'Date
Print Applicant/Agent Name O /)/!�4�z
APPL/PNMT n 40?moi' s
52.2 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
Wr POP
5.46
..Plurrbina Fee
85.00
*
Trifrastructure
862.60
105.72 DEP. PAID
756.88
*
ggreernhnt
With cn=mity
t De t
TOTAL •
FEE
862.60
h 1 1 0 7 J L
CIMAIMrPe VALUATION 77,948.007