001407 (SFD)".
414.
:` P.O. BOX 1504 No.
Building78-105 CALLE ESTADO
Address 44-28()�» SUndaM 'CVWt Dr. LA QUINTA, CALIFORNIA 92253
Owner _... ti
Mailing - •- _ • .. .. . --
BUILDING`. TYPE-CQNST. VN - • OCC. GRP.,
Address St. ftite =0 A.P. Number
el.
City Zip T
A -�3G_ 7 -ext$ Legal Description
Contractor
Project Description
Address ■,►'
. ..... .. .. ..r.. «� . ..- .
City Zip Tela
92063 140 -SSS.
State Lic. City
& Classif. "22 Lic. # 237. ' Sq. Ft: 1247 No. No. Dw.
Size dM, 433- Stories • Units .
-Arch., Engr:
Designer New Add Add ❑ Alter ❑`• Repair ❑' Demolition ❑ '
yxxi ,�an.Oyndm emir_
Address �q.,. Tel. �tyg .fig
.. ....40 Se, B;fbF� iii♦ 3..3""Q877 " -
City Zip State
.9322&2. _.. Lic: # -
„ LICENSED CONTRACTOR'S DECLARATION-, herebyaffirm that I;am licensed under provisions of Chapter 9 (commencing with Section
�r
70 '00) of Division 3°ofAWBttussi/inessfand Professions Code,'and=my license Win full force and'
effect..! fd..+%f I) JjY.rt j•,;
Ott !
SIGNATURE u ! - If / DATE .. ... .. .. . , .. ..
OWNER -BUILDER DECLARATION ` '
A hereby affirm that I am .exempt. from the Contractor's License Law 'for.the. following . Estimated Valuation -
reason: (Sec. 7031.5, Business and Professions Coder Any cty,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 rile a signed -statement that he is licensed *pursuant ;to - PERMIT AMOUNT
the provisions or the Contractor's License Law, Chapter. 9 (commencing ,with Section 7000) of. x.^
Division 3':6f the Business and. Professions' Code; of -that. be is' exeinpt therefrom, and the.basis-
for the• alleged exemption. Any violation or Section 7031.5' by 'any applicant for •a. permit Plan•.Chk.'Dep.•. 105..72
subjects the applicant'to a civil penalty of not'more than five -hundred dollars (3500). .. -
., as owner of_the, ro ert or rn Plan Chk. Bal.
❑ 1
p p y, _ y employees'with wages as their sole compensation, will . 202.24
do the work, and the structure is not intended or offered •for sale. (Sec. '7044, Buisness and Con St..367.00 +'
... _Professions Code: *The Contractor's License Law does not- apply to ari'owner. of .property who '
builds or improves thereon and,who does such work himself or through his own employees, Mach: ''7" ;8�, ,
.provided that m
such improveents are not intended or,offered for sale. If, however, the building. •
or improvement is sold within one year of completion, ;the 'owner -builder will have the. burden "Electrical � -
of.proving that he did not build or improveJor the purpose of sale.). - 60.1q8�
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing std
struct the, project. (Sec. 7044, Business and Professions Code: The Contractor's License Law -
does not apply to an owner or property who builds or improves thereon, and who contracts for S.W.' : 5.46
such projects with a contractor(s) licensed pursuant to the Contractor's -License Law.), .,
❑ Lam exempt under Sec. B. & P.C. Grading for this reason • ,
Driveway Enc.
Date owner Infrastructure Deft xed PwAwt. as. 1 irp
'With - ireatm.
WORKERS' COMPENSATION DECLARATION
1 -hereby affirmthatI 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. O Certified copy. is hereby furnished. • . ,.
TOTAL 862.60 756.88
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION. INSURANCE
(This section need not be completed if the permit is for one hundred dollars (3100) valuation - - -
orless.).... • . _
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 "'Owner '
NOTICE TO APPLICANT: If, after making this Certificate of Exemption' you- should become' ZONE: BY:
subject to the Workers' Compensation provisions _'of the Labor Code,- you- must rodhwith - Minimum Setback Distances: '
comply with such provisions of this permit shall be deemed revoked. -
Front Setback from Cen.ter,Line
Rear. Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY Side Street Setback from Center. Line
heretiy affirm that there'is a construction lending agency forthe performance of the'
-work for which this permit is issued. (Sec. 3097, Civil Code.)% Side Setback- from Property Line,
Lender's Name
Lenders Address -
FINAL DATE INSPECTOR
This is a building permit.wh'en properly filled out, signed: and validated; and is subject to
expiration if 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 above..
mentioned property for inspection, purposes. % Validated,by:
Signature of applicant Date + 'l
Mailing Address 1 / 1 Validation:
City, .State, Zip i
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
SLAB GRADE
2ND FL. SO. FT. ®
BONDING
YARD SPKLR SYSTEM
POR. SQ. FT. p
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
SO. 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
LAUNDRYTRAY
AIR HANDLING UNIT CFM
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.
SQ. FT. RESID ® 11/4 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
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./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
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/lt,'ITIALS
GARDEN WALL FINAL
Rev. •
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
APPLICANT NAME (L. F. MI)
JL Clnnstruction
CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATION INSURANCE: This section need not be completed if
LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions o1 Chapter 9
the permit is for one hundred (5100) o, less. I certify that in the performance o1 the work for which this permit is
(commencing with Section]000) of Division 3ol the Business and Professions Code, and my license Is in full force
Issued, I shall not employ any person inanymannersoasto become subject to the Workers'Compenplion Laws of
and effect.
California.
License Class Lic. Number
Date Applicant
Date Contractor
NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to the Workers'
OWNER BUILDER DECLARATION: 1 hereby affirm that I am exempt from the Contractor's License Law for the
Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall
be deemed revoked.
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
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
such permit to file a signed statement that he is licensed pursuant to the provisions ofthe Contractor's License Law
01 hereby certify that no excavation live (5) or more feet in depth into which a person is required to descend, will be
(Chapter 9(commencing with section 7000) of Division 3 o1 the Business and Professions Code) orthat he is exempt
made in connection with work authorized by this permit,andthat no building structure, scaffolding, lalsework, or
therefrom and the basis for the alleged exemption. Any violation o1 Section 7031.5 by any applicant for a permit
demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap 3.2, Grp 2 An 2, Sec 341, Title 8,
subjects the applicant to a civil penalty o1 not more than five hundred dollars (5500.):
C.A.C.)
❑ I. as owner of the property, or my employees with wages as their sole compensation, will do the work, and the
❑ As owner -builder, 1 will not employ anyone to do work which would require a permit from the Division of
structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's license
Industrial Safety, as noted above, unless such person has a permit to do such work from that division.
Law does not apply to an owner of property who builds, or improves thereon, and who does such work himself or
O Division of Industrial Safety Permit No.
through his own employees• provided that such improvements are not intended or offered for sale. If, however, the
PHONE . LICNC'.
323-7877
building orimprovemntissold within one year ofcompletion. the owner -builder will have the burden of proving that
Date '. Applicant
he did not build or improve for the purpose of sale.).
CONSTRUCTION LENDING AGENCY: I hereby affirm that where is a construction lending agency for the performance
O 1, as owner of the property, am exculsively contracting with licensed contractors to construct the project (Sec.
of the work for which this permit is issued (Sec. 3097, Civ. C.).
7044. Business and Professions Code: The Contractor's License Law does not apply to an owner of property who
Lender's Name
builQs or Improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the
RSB
Contractor's License Law.).
Lender's Address
O 1 am exempt under Sec. B. 6 P.C. (Attached Certificate).
I certify that I have read this application and state that the above information is correct. I agree to comply with all
Owner
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
Date
of this county to enter upon the above-mentioned property for inspection purposes.
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate o1 consent to sell -insure• or a '
-SIDE
certificate of Workers' Compensation Insurance . or a certified copy thereof (Sec. 3800. Lab. C.).
Signature of Applicant or Agent Date
Policy No. :Company
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify l have read this application and state that
❑ Certified copy is hereby furnished.
the information given is correct. l agree to comply with all state laws and county ordinances relating to buldling .
O Certified copy is filed with the City Building Inspection Department or City Department.
•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.
Date Applicant
Signature of Applicant or Agent Date
APPLICANT NAME (L. F. MI)
JL Clnnstruction
ADDRESS
P.O. Box 173
CITY/COMMUNITY/STATE/ZIP
Nestor; CA 92053
JOB SITE ADDRESSISPACE
CITY/COWUNITY/STATE/ZIP .._.. ... _ .
La. Quinta, CA 92253
BOIc
PAW
PRC
I C
TWN
I ANG
SE
s
TRACTlOT
19903
Elect, Fee 60.18
MOD
SB
.21mbing Fee.-. 85.00
7�T 1��+
TRACT NAME HORIZON PALMS
OWNER NAME (L. F. MI) Gw eral Management Corp. '
CONTRACTOR -FIRM NAME
J.L. Construction
ADDRESS
above
CITY/COMMuwITY/sTATE/ZIP
PHONE .
756.88
LICNC .
*nefp=ad pa==t as = ggreentint
ARC/ENG FIRM NAME
Michael Buccino Assoc.
ADDRESS
340 S. Farrell Dr. A212
CITYOCOMMUNITY/STATEmP
Palm SDrin s CA 92262
PHONE . LICNC'.
323-7877
TOTAL •
FEE
USE OF PERMIT '
Single Farni1v Dwellin
Bl
ZON,
FSB
SSO
SSB
RSB
OFC
ZONE ORD a
LOT SZ
END
-SIDE
Print Applicant/Agent Name ^ 6 / Vl)
APPL/PRMT 3 ' DATE -
5-22=85 ]
S.F.D.
Permit to construct 1247 sq. ft.
of
living area and 433 sq. ft. of garage
as approved,plans.
mech. Fee 37.00
Plan Check Fee 307.96
Con9t. Fee 367.00
Elect, Fee 60.18
SE Fee 5.46.
.21mbing Fee.-. 85.00
cit
Infrastructure
862.60
105.72 DEP. PAID
756.88
*nefp=ad pa==t as = ggreentint
t Departnient
TOTAL •
FEE
862.60
M 1 L L U. J L L / 7 (a 8 UK
ClluaNf_F VALUATION 77,948.00