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001423 (SFD)Building Address—S2S Owner Mailing Address t _ City Zip- . Contractor J.L. Address _.. P.O. B= 173 City ... - - Zip- .. _ 92053 U MOM P.O. BOX 1504 No, 001423 78-105 CALLE ESTADO .._ LA QUINTA, CALIFORNIA 92253 BUILDING: TYPE CONST. V m- OCC.,GRP. R.3 A 77M A.P. Number el. Legal Description Project Description Abiiizbi2 �t J., 146 'tier `'Tesideftial Dom. Tel. 340- wVJ State Lic. City & Classif. .: 822 Lic. # 23Sq: Ft: . ' 7 No. No. Dw. ``� Size M� �: Stories Units Arch., Engr. _ - DesignerA2800."` NewXl Add ❑' Alter'❑. ' Repair ❑ ` Address Tel. M--7077 City Zip State ,. ' 92,262 Lic. # LICENSED.CONTRACTOR'S DECLARATION... � I hereby affirm that -I arr'JIcensed under provisions of Chapter 9.(commencing with Section 7000) of Division 3 of, Ir Business and Professions' Code; and1my license is in full'force and effect. .. 7 . " � I v'_ `I :, ✓t) !4,Z 1' Demolition 0 - OWNER -BUILDER DECLARATION " I hereby affirm that 1 am exempt from the Contractor's* License Law for the. following - Estimated Valuation. tArttf� p -79 3 f3�t1 . • _ reason: (Sec. 7031, 5, Business and Professions Code:. Any city or county which requires'. a - r - •„ 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. - .. PERMIT"- - .S AMOUNT • the provisions of. the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 oftheBusiness and Professions Code, of that: he is .exerriot therefrom, and the basis. for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for 'a. permit' Plan•Chk. Dep.- - - - �� 2. ' 'subjects'the'applicant to a'civil penalty of not more than five hundred dollars ($500): ' '> " ••'- Rlan.Chk. Bal. 2e�rta:�2p 2�4A "'- O I, as owner of the property, or my.employees,with wages as their sole compensation, will Baarss•6St ,- do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and' Const.' .���g �$j . 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,.,' 'however; Mech. :30.00 •00 , -� - . provided that such improvements are not intended or offered for sale. If, the building .. or.improvement is sold,withln one year of completion, the owner -builder will have -the burden Electrical' • , of proving that he did not build or improve for the purpose ofsale.)' • • O I, as owner of the property, am exclusively contracting with licensed' contractors to con- Plumbing ,6il•2� 85.01D - slruct the project. (Sec. 7044; Business and Professions. Code: The Contractor's. License Law does not apply to, an owner of properly who builds or improves thereon, and who contracts for S.M.I.' g - 5.46 such projects with a contractor(s) licensed pursuant to the Contractor'sLicense Law.) " • Grading _ - ❑ 1 am exempt under Sec. B. & P.C: for -this reason Driveway Enc. Date owner Infrastructure Deferred: fwmm rt. as WORKERS' COMPENSATION DECLARATION a r ' I hereby affirm 'that I have a'certificate of consent to self -insure, oe 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., O Certified copy. is hereby furnished. TOTAL fs 62.60 756.88 -CERTIFICATE OF EXEMPTION FROM REMARKS ' WORKERS; COMPENSATION. INSURANCE . . (This section need not be completed if the permit is for one hundred dollars ($.100) valuation ' or less.). _ .. I certify that in the performance of thip 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 ZONE: BY: - ' subject' to. the Workers' Compensation '.provisions'of the Labor Code, -you must forthwith '- comply with such provisions or this permit shall be deemed revoked.. - Minimum Setback Distances:. Front.Setback.from Center.Line Rear Setback from Rear. Prop. Line colusraucnoN LENDING AGENCY Side Street -Setback from Center Line Ihereby affirm that.there is a construction lending agency for the Performance 'of the " work for which this permit is issued. (Sec. 3097, Civi6Code.), Side Setback from. Property Line Lender's Name Lender's Address ' FINAL DATE INSPECTOR 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_Ahat the above information is.correct.- - 'Issued by: Date Permit ' I agree to comply with all city and,county ordinance's and state laws relating to building • construction, and .herebyauthorize representatives -of this city to enter the above-: u , , mentioned property for,inspection purposes. �( Validated by: Signature of applicant • fl �r if r+ fL Date's Mailing Address" : Validation: City, State, Zip HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ 2ND FL. S0. FT. POR. SO. FT. ® GAR. SO. FT. ® CARP. SO. FT. WALL SO. 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.COOL 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, 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 ® 3Ac 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 INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATUREESIINITIALS. GARDEN WALL FINAL �- .w.l-4uy ��w-y.M..r; ✓... r,..•......r..-+warn .. .v«. -u.. .f .r-......r..-...���.�.. ;.-__. _., _ , - ' - Y -, t .... 1� � PERMIT APPLICATION City o1 La Ouinta Department of Building and Safety This permit becomes void it work not commenced within 180 days from date of Issuance. OR, If work has been suspended or abandoned for a period o1 180 days. CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATIONINSURANCE: This section need not be completedif 'LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 o the Business and Professions Code, and my license is in full force and effect. License Class Lic. Number Date Contractor .OWNER -BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractor's License Law for the '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 such permit to file a signed statement that he is licensed pursuant to 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 exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500.): 0 I, as owner of the property. or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (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 does such work himself or through his own employees• provided that such improvements are not intended or offered for safe. If, however, the building or improvemni is sold within one year of completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale.). 0 I, as owner o1 the property, am exculsively contracting with licensed contractors to construct the project (Sec. 7044. Business and Professions Code: The Contractor's License Law does riot apply to an owner of property who builps or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.). 0 1 am exempt under Sec. B. 8 P.C. (Attached Certificate). Date Owner WORKERS' COMPENSATION DECLARATION: I hereby affirm that 1 have a certificate of consent to self -insure, or a certificate of Workers' Compensation Insurance , or a certified copy thereof (Sec. 3800. Lab. Q. Policy No. Company 0 Certified copy is hereby furnished. 0 Certified copy is filed with the City Building Inspection Department or City Department. Date Applicant APPLICANT NAME (L. F. MI) JL Construction ADDRESS P.O. Box 173 CITY/COMMM ITY/STATE/ZIP Nestor; CA 92053 JOB SITE ADORESS/SPACE ` living area and 433 sq. ft. of garage CITYICOMMUNITY/STATE/ZIP La. to CA 92253 BOK PAG PRC I C TYWN ANG SE S TRACT LO 1 M Fee 5.46. MOO Sa 19903 I 862.60 105:72 DEP. PAID 1 TRACT NAME HORIZON PAIMB. OWNER ►NME (L. F. MI) (neral Management Co ' COWRACTOR-FIRM NAME J. L. Construction ADDRESS wbove CITY/COMMIINITY/STATE/ZIP . PHONE a LICNC ARC/ENG FIRM NAME - Michael Buccino Assoc. ADDRESS 340 S. Farrell.Dr. A212 CITY/COMMUNITY/STATE/ZIP Palm cin s CA 92262 PHONE a LICNC 0 323-7877 I USE OF PERMIT Sin le Family Dm1lin BL ZON. FSS SSB SSB RSB OFC ZONE ORD a - LOT SZ END SIDE the permit is for one hundred ($100) o. less. I 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 Applicant 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. DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: 0 I hereby certify that no excavation live (5) or more feel in depth into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, fafsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap 3.2. Grp 2 Art 2, Sec341, TitleB, C.A.C.) 0 As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from that division. 0 Division o1 Industrial Safety Permit No. Date Applicant 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, Civ. Q. Lender's Name Lender's Address 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 county to enter upon the aboveanentioned property for inspection purposes. Signature of Applicant or Agent Date CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have read this application and state that the information given is correct. I agree to comply with all state laws and county ordinances relating to buidling . 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. Signature of Applicant or Agent Date' Print Applicant/Agent Name 061/ "I 'APPL/PRMT DATE 5-2.2 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 M Fee 5.46. ..Pluffbinq Fee 85.00 * Trifrastructure 862.60 105:72 DEP. PAID 756.88 *Deferred pa=mt as = agreentnt With chirmMity t Department TOTAL FEE 862 .60 H 1 1 4 1 .'< FIrdamrp L / )IN88 CK VALUATION 77,948.00