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001454 (SFD)P.O. BOX 1504 No. 001454 Building 78-105 CALLE ESTADO Address 44-316 W S=d= CreSt Dr. LA QUINTA, CALIFORNIA 92253 OwnerammmiM_ �UMMIML • BUILDING: TYPE CONST. V N OCC: GRP. R 3 Mailing Address IMIc.. Sifte 2700 A.P. Number City Zip Oji J,/ '� Tel. {i�,• 1:$367--5054 Legal Description Contractor Project Description � Wim' JAL cJ^[mtrMUM Address 146 Mdta X 81 IJ�q�1. P.O. BC 173. City Tio - Tel. )30-9"W 92053 State Lic. City 340-5511 & Classif. wjl� Lie. # Sq. Ft. U47 No. No. Dw. Size CSR 433 Stories Units Arch:, Engr., Designer Xtchft3 $WCJM ASWC. New Add ❑ Alter ❑-. Repair ❑ Demolition ❑ Address ����pp�� Tel. g.� yyry.���yy .. 30 . s7. ft�U • • 3 • f 977. _ City Zip State X312 'gor"-wis ' 92 Lic: # _ LICENSED CONTRACTOR'S DECLARATION t I hereby affirm -that I am licensed under provisions of Chapter 9 (commencing with Section + 70 OO) of Division 3 of {{the Business and Professions Code, and my license is in fullforce and. effect. SIGNATURE .4 t t G �r > - 9 DATE OWNER -BUILDER DECLARATION r' . I hereby affirm that I am exempt from the Contractor's License Law for the following Estimated Valuationt? A♦f� RA reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a. S ! i+9411.00 permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also AMOUNT requires the applicant for,such permit to file a signed statement that.he is licensed pursuant to PERMIT - the provisions of the Contractor's License Law, Chapter 9. (commencing ,with Section 7000) of - - Division'3, of the' Busiress 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 Plan Chk. Dep. - 105.72 subjects the applicant to a'civil penalty of not more than five hundred dollars ($500)2- ' Plan Chk. Bal. 4L7�.�2� ❑ I, as 3 owner of the property, or my employees with wages as their sole compensation, will - y A do the work, and the structure is not intended or offered for sale. (Sec. 7044, Bussness and Const. 00 Professions Code: The Contractor's License Law does'not apply,lo an owner of property who builds or improves thereon and who does such work himself or through his own employees, Mech. �p1% provided that such improvements are not intended or offered for sale. If, however, the building 37 .ti 0 or improvement is sold within one year of completion, the owner -builder will have the burden Electrical WAS 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 struct the project. (Sec. 7044, Business and Professions Code: 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.'5.46j ` such projects with a contractor(s) licensed pursuant to the' Contractor's License Law.) Grading ❑ I am.exempt under Sec. 8. t. P.C. for this reason Driveway Enc. DateOwner Infrastructure Mfe=ed 1avi�.as ammemimt . tA3 ! w - T%11 Lr�ay. WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfAnsure, 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. ❑ Certified copy is hereby furnished. 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 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 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. ' CONSTRUCTION LENDING AGENCY. I 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 if 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 laws relating to building construction, and hereby authorize representatives -of this city to enter the 'above-. mentioned property for insp}e)ction purposes. r Signature of applicant / 7 !'!ri 1 a !n Date Mailing Address ✓ r �_ r City, State, Zip HARD COPY TOTAL 862.60 REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line ' Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ 2ND FL. SQ. FT. POR. SQ. FT. ® GAR. SQ. FT. ® CARP. SQ. FT. WALL SQ. FT. SQ FT ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM C 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 WASHER(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, 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: 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 INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS. GARDEN WALL FINAL APPLICANT NAME (L. F. MI) JL Clnnstruction ' ADDRESS P.O. Box 173 CITY/COMMUNITY/STATE/ZI P Nestor; CA 92053 -- JOB SITE ADDRESS/SPACE - CITY/CO NfuNITY/STATE/ZIP La . Quinta, CA 92253 8" PERMIT APPLICATION City of La Oulnta 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. RHO CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section (reed not be completed if 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 7000) of Division 3of the Business and Professions Code, and my license Is in full force issued. I 0all not employany person Inanymannersoesto become subject to the Workers' 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 ofthe Contractor's License Law 01 hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, w ill 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 of 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 Z 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 o1 the property, or my employees with wages as their sole compensation, will do the work, and the O 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 SSB building or improvemnt is sold within one year of completion. theowner-builder will havethe burden of proving that 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 0 1, as owner o1 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. Q. 7044. Business and Professions Code: The Contractor's License Law does not apply to an owner o1 property who Lender's Name builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the END Contractor's License Law.). Lender's Address 0 1 am exempt under Sec. B. & 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-mentioned property for inspection purposes. WORKERS' COMPENSATION DECLARATION: 1 hereby affirm that I have a certificate o1 consent to self -insure, or a certificate of Workers' Compensation Insurance , or a certified copy thereof (Sec. 3800. Lab. C.). Signature o1 Applicant or Agent Date Policy No. Company CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify l have read this application and state that 0 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 *applied upon the property for which 1 have 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/ZI P Nestor; CA 92053 -- JOB SITE ADDRESS/SPACE - CITY/CO NfuNITY/STATE/ZIP La . Quinta, CA 92253 8" PAG PRC I C TWN RHO SE s 199 03 LID Elect- Fee 60.18 MOD I S -Plimbina Fee- 85.00 TRACT NAME HORIZON PALM OWNER NAME (L. F. MI) Gare al Management Co' CONTRACTOR -FIRM NAME ' J.L. Construction ADDRESS above CITY/COMMUNITY/STATE/ZIP PHONE . ' 756.88 LICNC . * ggreentint ARC/ENG FIRM NAME ' Michael Buccino Assoc. ADDRESS 340 S. Farrell Dr. A212 CITY/COMMUNITY/STATE/ZIP Palm sr)rincrs, CA 92262 PHONE a;1 LICNC • 323-7877 TOTAL 7-T FEE USE OF PERMIT single Family Dm1lin BL ZON. FSB SSB SSB -RSS OEC ZONE ORD • LOT SZ END SIDE -Print Applicant/Agent Name 4 Ll S� APPLMRMT 5 - DATE 5-2-2=85 S.T.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 Qmst. Fee 367.00 Elect- Fee 60.18 M Fee 5.46 -Plimbina Fee- 85.00 Tnfrastructure 862.60 105.72 DEP. PAID ' 756.88 * ggreentint with Ccnminit2Z t Department TOTAL 7-T FEE 862.60 A 1 1/ 1 D L 5 % 5& 8 8 CK FINANCE VALUATION '77, 948 .00