001453 (SFD)P.O. BOX 1504 .0 4 5 3
Building 78-105 CALLE ESTADO
Address 44-295 W. ftaftffj CMSt Di. LA OUINTA, CALIFORNIA 92253
Owner ... ,. .. . -. .. _ .
Og
Corp.
Mailing : s BUILDING: TYPE CONST: OCC -.'GRP.:. -
Address 1M Rishm St. 'Mite 2700 A.P. Number
City ZiP l7 Tel.
iulm..HaqaU . 320% .. � � Legal Description
Contractor Project Description riw;pa -palm A
Address.... _ 145 IIats ial ..
.. ... .. _ . -::. ... ' • _. .. i'
P.O. BINK 173
City .. Zip _ Tela "
mtw 92053340 --SSU
State Lic. City 3 .
& Classif. Lic. # Sq. Ft. No. No. Dw.
"2422. .._
size 433 Stories Units
Arch., Engr:, ..
' Desigrier 2kS=,, New.ist Add ❑ : Alter ❑• 'Repair ❑.. Demolition ❑
Address Tel.
34 3. 4 .. FAXT213 123,r7877.. ,
City Zip State
4 Lic: #...:....
_ LICENSED CONTRACTOR'S DECLARATION
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
f
• ' effect.
SIGNATURE i DATE .. .. .. .. :,
OWNER -BUILDER DECLARATION '
I hereby affirm that I am exempt from the Contractor's License Law for the following Es1lmated V81U3tlOn-4-77i949400
�j� p� g� p�
reason: (Sec, 7031.5, Business and Professions Code: Any city or: county which requires 'a.; lr..!'�7��aF�tJ -
-permit to construct, alter, improve, demolish, or repair• any.structure, 'prior to- its issuance also
requires the applicant,lor such permit to file -a signed• statement that *he is'licensed pursuant to' PERMIT - - AMO
provisions of the Contractor's License Law, Chapter 9, -(commencing with Section 7000) of . _nom
Division 3 of the Business and Professions Code, or that. he - is exempt therefrom; and'the• basis-' - � � - - YL� •-y
for the. alleged exemption. Any violation of Section 7031-.5 by 'any applicant for a permit Plan.Chk. Dep" - 105 ,
subjects the applicant to a civil penalty of not more than five: hundred dollars'($500).
❑ I; as owner of the property, or my employees with wages as their.sole Plan. Chk. Bal.
ole cgmpensation, will ' 20C�2l.24,
• - do .the work, and the structure is not intended or offered for sale. (Sec. 7044; Buisness and COftSt. ��i 6 .'
Professions Code: The Contractor's License Law does not,apply:to an 'owner of property who y F7s1
builds or improves thereon and who does such work himself or through his .own employees, 'MeCh., 3740
provided that•such_improvements are not intended or. offered for sale. If, however, -the'building.•
or improvement is sold within one year of completion, the owner -builder .will:have the burden • _Electrical �s
of proving that he did not- build or improve for the purpose of sale.) .-
❑ I, as owner of the property, am exclusively contracting with licensed contractors to'con• Plumbing '
Strutt the project. (Sec. 7044, -Business -and Professions Code:' The. Contractor's License'Law - �r
does not apply to an owner of property who builds or improves thereon, and who contracts for •$,M.I. 5.46
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) - -
0.1 am exempt under Sec. B. & P.P.C.-Grading for this reason- -
Driveway Enc.
Date owner Infrastructure De fe=ed POJAUMts agmenwit
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I' 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 ... .. ..
_ O Copy is filed with the city. ❑ Certified copy is :hereby. furnished.'
TOTAL�i.�i
• CERTIFICATE OF EXEMPTION FROM REMARKS
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.thg work for which this permit is issued, l 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 Hie Labor Code, you mist forthwith Minimum Setback Distances:
comply with such provisions or this permit shall be deemed revoked. - '
Front Setback from Center Line
Rear Setback from Rear. Prop. Line
CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line'. _.
hereby affirm,that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil code,) 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 FINAL DATE INSPECTOR
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
agree to comply with all 'city and county ordinances and state laws relating to building Y
construction, and hereby authorize representatives ,of this city to enter the 'above•:
mentioned property for inspection purposes. r tf Validated by:
Signature of applicant""'V111", i' .%i ; - Date
Mailing Address } / Validation:
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
SLAB GRADE
2ND FL. "' SQ. FT.
BONDING
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT.
GAS (ROUGH)
DRAINAGE PIPING
WALL SO. 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
WASH ER(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.
SO. 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 SIGNATURES11NITIALS.
GARDEN WALL FINAL
PERMIT APPLICATION A r
City of U Ouinta
Department of Building and Safety
This permit becomes void if work not commenced within 180 days from date of issuance. OR, If work ties been suspended or abandoned for a period of 180 days
APPLICANT NAME (L. F, MI)
JL Construction
CERTIFICATE OF EXEMPTION FROMWORKERS'COMPENSATIONINSURANCE: This section need not be completed if
LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9
the permit is for one hundred ($100) o. less. I certify that in the performance o1 the work for which this permit is
(commencing with Section 7000) of Division 3 o1 the Business and Professions Code, and my license is in full force
Issued, I shall not employ any person in any manner soasto become subject to the Workers'CompensationLaws of
and effect.
California.
License Class Lic.' Number
Date Applicant
Date Contractor
NOTICE TO APPLICANT: If, atter making this Certificate of Exemption, you should become subject to the Workers'
OWNER -BUILDER DECLARATION: I 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 tile a signed statement that he is licensed pursuant to the provisions of the Contra ' ctor'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 of the Business and Professions Code) or that he is exempt
made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, 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, Art 2, Sec 341, Title 8.
subjects the applicant to a civil penalty of not more than five hundred dollars ($500.):
C.A.C.)
O I, as owner of the property, or my employees with wages as Meir sole compensation, will do the work, and the
0 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
❑Division of Industrial Salary Permit No.
through his own employees, provided that such improvements are not intended or offered for sale. 11, however, the
ADDRESS
340 S. Farrell Dr. A212
building orimprovemntissold within one year ofcompletion, the owner -builder will havethe burden of provingthat
Date Applicant
he did not build or improve for the purpose of sale.).
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance
O I, as owner of the property, am exculsively contracting with licensed contractors to construct the project (Sec:
o1 the work for which this permit is issued (Sec. 3097, Civ. C.).
7004. Business and Professions Code: The Contractor's License Law does riot apply to an owner o1 property who
Lender's Name
builgs or improves thereon, and who contracts for such projects with a contractors) licensed pursuant to the
SSB
Contractor's License Law.).
Lender's Address
0 1 am exempt under Sec. B. 8 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 herebyauthorize representatives
Date
of this county to enter upon the above-fientioned property for inspection purposes.
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate o1 consent to sell -insure, or a '
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 I have read this application and state that
O Certified copy is hereby furnished.
the information given is correct. I agree to comply with all state laws and county ordinances relating to buidling
0 Certified COPY is filed with the City Building Inspection Department or City Department.
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.
Date Applicant
Signature of Applicant or Agent Date
APPLICANT NAME (L. F, MI)
JL Construction
ADDRESS
P.O.-Box 173
CITYXOMMUNITY/STATE/ZI P
Nestor,.CA 92053
-
JOB SITE ADDRECSBPACE
CITY/COMMUNITY/STATE/ZIP
La. to CA 92253
Bole
PAD
PRC
C
as per approved plans.
T"
RND
SE
s
19903
L�%D
Plan Check Fee
MOD
I sa
Const. Fee
TRACT NAME i1lJRIZCN PAU4S
L1amrtJ. Va11Y
��1 igemutt Corp. '
OWNER NAME (L. F. MI)
CONTRACTOR -FIRM NAME
J.L. Construction
ADDRESS
alxnm
CITY/COMMUNITY/STATE/ZIP
PNONE •
5.46.
LI.NC
.Plumbing Fee
ARC/ENO FIRM NAME '
Michael.Buccino Assoc.
ADDRESS
340 S. Farrell Dr. A212
CITY/COMMUN M/STATE/ZIP
Palm in s CA 92262
PHONE LICNC"•
323-7877
USE OF PERMIT '
Single Family M11in
BL
ZON,
(105.72)DEP. PAID
FSB
SSB
SSB
'RFC
SB
as = 4greembnt
O
t Department
ZONE ORD 0
LOT SZ -
'END
SIDE
Print Applicant/Agent Name ^ ^/i /�n
�; ' "'
APPL/PRMT004 IL
5 2-2=85
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
SM
5.46.
.Plumbing Fee
85.00
*
TnfragctrlactUM
862.60
(105.72)DEP. PAID
.756.88
*Deferred pa=ant
as = 4greembnt
t Department
TOTAL •
'FEE -T862.6
Hit/U D LS 75&88 CK
FINANCE VALUATION F77,948.00