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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