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001408 (SFD)a Zip ... .L t •� ' Building Address•-' . Uor,5511 Owner State Lic. City Mailing .Issued:by: Address Lic. #' City No. Dw. TA h1f 44 P.O. BOX 1504 No. 78-105 CALLE ESTADO r1r. LA QUINTA, CALIFORNIA 92253 Zip Tel. 36813111.1-800-3 Contractor Address . :. P.O.' BUILDING: TYPE CONST. VX ::OCC: GRP. R I A.P. Number Legal Description Project Description kMM:- City Zip ... Tel.' . 92053 . Uor,5511 Side Street Setback from Centerline State Lic. City INSPECTOR .Issued:by: & Classif.-1247 � Lic. #' Sq. Ft. No. No. Dw. Validation: Size KRA Win Stories - -Units - Arch.iEngr:,--Add .DesDesigner New ❑ Alter ❑ . Repair ❑• Demolition ❑- p Address Tel. q 171-7977 City Zip State . . _. Tal* i> 92262Lic. #... LICENSED CONTRACTOR'S DECLARATION �I — hereby affirm that l am licensed under provisions of Chapter 9'(commencing with Section' 7000) of Divisiojn'36frtyghee Busttiness and Professions Code, -and my license is in fullforceYalnd i effect. J/t J i S / .Tf.`• : / 1_3 •707 J DATE. .. _ .. .. .... .- ... _ oWNER•BUILDER DECLARATION'. Estimated Valuation I hereby affirm that I am exempt from the Contractor's License Law for the following Any �w.'Qj q �qA 94 ' reason:,.(Sec. 7031;5,Business and Professions. Code: 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 i9 ,1 X00 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. exempl'theiefrom,' and the basis. -- for the Any Section 7031.5 by 'any. for Plan. Chk. Ddp.'. - - -• 195.72. alleged' exemption. violation of applicant.. a permit: subjects the applicant to a civil penalty of not more than'five'hundred:dollars ($500). '•- 'O ' Plan Chk. Bal.. . , 2024, 24 I, as owner,of the property, or my employees with wages;as their sole -compensation, will . . - do the work, and th6.str66ture is not intended oroffered for sale. (Sec. 7044,'Buisness and '• ConM*.'_ 3'7�0� • .Professions Code: The Contractor's License Law does not. apply,to•an owner.of, property who. , builds or improves thereon and who does such work:.himself- or through 'his own employees, ' Mebh. R 3 . ,provided: that such improvements -are_ not intended or offered, for sale. If, however; the. building j .•00 . or improvement is sold within one year of completion,- the. -owner -builder will have the. burden Electrical-.� • of proving. that he.did not build or improve,for.the purpose of sale.) ._ - - , .O I, as owner of the property, am exclusively contracting with licensed• contractors to con- Plumbing ' 85.00 " struct the project. (Sec. -7044, Business and -Professions Code: The Contractor's 'License Law does not to *an who builds improves thereon, for S.M.I.' - • apply owner of property or and who contracts - suchprojects with a contractors) licensed pursuant to the Contractor's License Law.) • - 5..56 - Grading . ❑ I am exempt under Sec. B. 8 P.C. for this reason Driveway Enc. Date owner Infrastructure 19fa t a$•i WORKERS' COMPENSATION DECLARATION I hereby affirm that -1 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 00 Company ' ld Copy is filed with the city., ,O,Certified copy is hereby.furnished. CERTIFICATE OF EXEMPTION FROM }{ WORKERS' COMPENSATION INSURANCE (This lseclion need not be completed it the permit is -for one Ihundred'dollars ($100) valuation .. or less.) .. 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 the-Workers"Compensation Laws of California. Date_' Owner NOTICE TO APPLICANT: If, after making this. Certificate or 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. ' CONSTRUCTION LENDING AGENCY" . (.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.)', 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. 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.faws relating to'building' construction, and hereby authorize representatives: -of this city to enter the' above mentioned property for inspection:purposes. }#' Signature of applicant Y 11 _ r` !i : r - :' Dat -Q k d Iy_ Mailing Address -- City, State, Zip r HARD COPY ` .. �1� �'leissnreais$4csi?xagt t►1SM+sraf Tit�'t1'9�' TOTAL -5-REMARKS ZONE: BY: Minimum Setback Distances: Front Setback -from Center.Line Rear Setback from Rear.Prop. Line Side Street Setback from Centerline Side Setback from.Property.Line .FINAL DATE_ INSPECTOR .Issued:by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEE'S IST FL. SQ. FT. ® $ 2ND FL. SQ. FT. POR. SO. FT. ® GAR. SO. 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.000L HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APP.IEOUIP. LAUNDRY TRAY AIR HANDLING UNIT CFM TEMP. POLE 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. SO. FT. ® c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL SO.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.IEOUIP. 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 CNSPECTOR'S SIGNATURES/INITIALS. GARDEN WALL FINAL PERMIT APPLICATION City of La Ouinta 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 it LICENSED CONTRACTORS DECLARATION: I hereby affirm that 1 am licensed under provisions of Chapter 9 the permit Is for one hundred ($100) o, less. l certify that in the performance of the work for which this permit is (commencing with Section MOO) of Division 3of the Business and Professions Code, and my license Is in full force - issued, I shall not employ any person In any manner so as to become subject to theWorkers'Compensation 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: 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 file a signed statement that he is licensed pursuant to the provisions oftheContra ctor'slicenseCaw 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 70DO) o1 Division 3 o 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 their sole compensation, will do the work, and the O As owner -builder, I 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 o1 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 ADORESS 340 S. Farrell Dr. A212 building or improverrint is sold within one year of completion. the owner -builder will have the burden of proving that Date Applicant he did not build or improve for the purpose of sate.). CONSTRUCTION LENDING AGENCY: I hereby affirm that there 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.). 7004. Business and Professions Code: The Contractor's License Law does not apply to an owner of 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 O 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 'city and county ordinances and state laws relating to building construction, and hereby authorize representatives Date Owner of this county to enter upon the above-blentioned 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 l 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 O 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 APPLICANT NAME (L. F. MI) JL Clnnstruction ADDRESS P.O. Box 173 CITY/COMMUNITY/STATE/ZIP Nestor, CA 92053 JOB SITE AODRESSiSPACE - CITY/C06111AUNITY/STATE/ZIP - - -- - - La. to CA 92253 BOK PAG PRC J C I I TWN I AND J SE s TRACT 19903 LOT Elect- Fee 60.18 MOD Ste .21urrbing Fee 85.00 TRACT NAME _ ON HORIZPALMS HORIZON OWNER NAME (L, F, MI) Maamigement Corp.' COIRRACTOR-FIRM NAME J.L. Construction ADDRESS ahimm CITY/COMMUNITY/STATE/ZIP PHONE a 756.88 LICNC I * ggreenitint ARC/ENG FIRM NAME Michael Buccino Assoc. ADORESS 340 S. Farrell Dr. A212 CITY/C01101MUNITY/STATE21P Palmrin s CA 92262 PHONE frLICNC 323-7877 8 2.6Q USE OF PERMIT ' Sin le Family Dwelling BL ZON, •FSB SSB SSB RSB DEC' - ZONE ORD • LOT SZ 'END SIDE Signature of Applicant or Agent Date Print Applicant/Agent Name eq 1 1 APPIMT�5 2-2=85 S.F.D. Permit to construct 1247 sq. ft. of livinq area and 433 sq. ft. of age as Per approved Plans. Mech. Fee 37.00 Plan Check Fee 307.96 Ctinst. Fee 367.00 Elect- Fee 60.18 SME Fee 5.46 .21urrbing Fee 85.00 Tnfrastructure 862.60 (105.72)DEP. PAID 756.88 * ggreenitint with Oo=mity t De t TOTAL FEE 1 8 2.6Q A l l L 1 7 L L / 7 61 6 115 U /. GIAI A AIP& VALUATION 77,948.00 '