001424 (SFD)P.O. BOX 1504 No;
Building, 78-105 CALLE ESTADO.001424
Address 44-34S E. SMl=' CCWt Mr. LA QUINTA, CALIFORNIA 92253
Owner _
TINTY
Mailing
Address
City
Zip
Contractor
Address
-City _ . Zil
2700'
Tel. I r
Tel.
BUILDING: 'TYPE CONST. OCC: GRP.: :&t
A.P. Number
Legal Description
Project Description .M y ylq�PyO=
.. a. 146 ii ra:..Ta'Ie.L'N 'iiY IACSVPRw .. ...
. J.i.
State Lic.
City
1247
& Classif..
Lic. #�"
*UM
Sq. Ft.•�
Size
No. No. Dw.
Stories' Units
,.. Arch":,-Engr.;
.Designer Aebtlibl a=i=t 'moo
Newt . Add ❑
Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
qq ,��
.. s. Puzen ft.. ....
gy��,����++��e�o�
.' dTT � L'� � 7 _
• City
Zip
State
- MIA
92262-
Lic. # _..
LICENSED. CONTRACTOR'S DECLARATION
n: -
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
effect. yi J / ✓
,1,0711 a
_. .. ..
.. .. _ .. .. .. ..
SIGNATURE - '� -. 1 r DATE
OWNER -BUILDER DECLARATION
I hereby affirm thal.l ani exempt from the Contractor's License Law for the following'�9'AZi
reason: (Sec. 7031.5,Business and Professions Code... Any -city or- county . which requires a'
peimit,to construct; alter, improve, demolish, or repair -any structure, prior to. its issuance also •
the 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, of that. he is exempt theiefrom, -and the basis
• for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a' permit
' 'subjects the'applicanf to'a civil penalty'of not 'more 'than five'hundred.dollars•($500):
0 I, as owner of the property,, or my employees with wages as their sole compensation, will
a . do the work, and the structure is not intended or offered. for sale. (Sec.7044, Buisness 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 sale. If, however, the building
Estimated VaiUatlOn
/��p /�p�
i:dt0
-
-
• PERMIT.
,
.. -
AMOUNT
Plan•Chk. Dep.
-10So12
-
Plan Chk. Bal..
,202.24
'Const• ,
�'7 60
r
' Mech. - • -
-
- '�. - .
Electrical•
or improvement 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.) -
Plumbing.-
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
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
- such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
O 1 am exempt -under Sec. B: & P.C. for this reason
S.M:I:''•
��
Grading
"
Driveway Enc.
,
Date owner
Infrastructure
• �t-t
WORKERS' COMPENSATION DECLARATION
+affirm
I hereby that"I'have a -certificate of consent to self -insure, or acertificate 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_t.
CERTIFICATE OF EXEMPTION FROMREMARKS.
WORKERS' COMPENSATION INSURANCE 4. . - I . - ...
. (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 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 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.
ZONE: BY:
Minimum Setback Distances' '
Front Setback from Center Line
_
Rear Setback from. Rear. Prop. Line
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: 309.7, -Civil Code.) ', - -- - ..
Side Street Setback from Center Line' '
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,'an8.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:correbL-
agree to comply with all city and county ordinances and stale laws relatingao building
" construction, and hereby -authorize representatives of. this city to enter the above-
mentioned property for inspection`purposes.
Signature of app-.--..— / /r. .r7 )/117Date's
Mailing Address. _ ' ✓
'-Issued by:
Validated by:
Validation:,
- Date -Permit -
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. SO. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. S0. FT.
WALL SO. FT.
SO FT ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
t4
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 APPJEOUIP.
LAUNDRYTRAY
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.
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/ec
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 APPJEOUIP.
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 SIGNATURESANITIALS
GARDEN WALL FINAL
PERMIT APPLICATION
City of La Duinta
Department of Building and Safety
This permit becomes void if work not commenced within 180 days from date o1 issuance. OR, If work has been suspended or abandoned for a period of 180 days.
CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATION INSURANCE: This section need not be completed if
LICENSED CONTRACTORS DECLARATION: I 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 effect.
License Class Lic.' Number
Date Contractor
OWNER -BUILDER DECLARATION: 1 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 o11he 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 o1 Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than live hundred dollars ($500.):
O 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 sale. If, however, the
building or improvemnt 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.).
O 1, as owner of the property, am exculsively contracting with licensed contractors to construct the project (Sec.
7004, Business and Professions Code: The Contractor's License Law does not apply to an owner o1 property who
buil(ts or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the
Contractor's License Law.).
O 1 am exempt under Sec. B. 8 P.C. (Attached Certificate).
Date Owner
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure, or a
certificate of Workers' Compensation Insurance , or a certified copy thereof (Sec. 3800. Lab. C.).
Policy No. 'Company
O Certified copy is hereby furnished.
O Certified copy is filed with the City Building Inspection Department or City Department.
Date 'Applicant
APPLICANT NAME (L. F. Will
JL Construction
ADDRESS
P.O. Box 173
CITY/COMMUNITY/STATE/ZIP
Nestor; CA 92053
JOB SITE ADDRESS/SPACE
_ —
CITY/COMMLMITY/STATE/ZIP
lia-Quinta, CA 92253
BOK
PAG
PRC
c
TwN
RNo
SE
s
19903
LOT
C
MoD
sa
P1 imbing Fee 85.00
TRACT NAME HORIZON PALMS
OWNER NAME (L. F. MI) General Management Corp. '
CONTRACTOR -FIRM NAME
J.L. Constriction
ADDRESS
above
CITY/COMMUNITY/STATE/ZIP
PHONE .
756.88
LICNC e
* agreembnt
ARC/ENG FIRM NAME
Michael Buccino Assoc.
ADDRESS
340 S. Farrell Dr. A212
CITY/COMMUNITYSTATE21P
Palm Sprinas, CA 92262
PHONE I LICNC e
323-7877
TOTAL .
'FEE
USE OF PERMIT
S' le Family Dwelling
BL
ZON.
•FSB
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, l 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:
O 1 hereby certify that no excavation five (5) or more feel in depth into which aperson is required to descend, will be
made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or
demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap 3.2. Grp Z Art 2, Sec 341, Title 8,
C.A.C.)
O 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.
O Division of Industrial Safety Permit No.
Date Applicant
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance
o1 the work for which this permit is issued (Sec. 3097, Civ. C.).
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 above4nentioned property for inspection purposes.
Signature of Applicant or Agent Date
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify Ihave 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
AooUPRMT0153-R-1� 5 2�=85
S.F.D.
Permit to construct 1247 sq. ft.
of
livinq 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
RMT Fee 5.46:
P1 imbing Fee 85.00
*
862.60
105:72 DEP. PAID
756.88
* agreembnt
with Chminity t Departnent
TOTAL .
'FEE
862-60
A 1 1 4 2 5 23 • 75
FINANCE VALUATION 7'7'948.00