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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