001425 (SFD)i� •
44
P.O. BOX 1504 No. .00425
Building 78-105 CALLE ESTADO
Address A4_365 E. SWX--bM Er. LA QUINTA, CALIFORNIA 92253
Owner
Mailing.
a�$ _ Vs
BUILDING TYPE CONST. • OCC: GRP..- R. 3"
Address .1001 Bid's Ste Mit& 270 , .:. ..
A. P: Number, • '
City Zip s�l Tel.
_ t't1Rr. @ma Legal Description
Contractor
Project Description -
F astr wt3
Address .......... - ... r .... -.. . - .
146 € nits -Fieslfimtlal.
�.�3., ice►' �
City. Zip . .-- , _, Tel...
92053 340--5511
State Lic. City
&.Classif., 442822'' Lic. # 237 ' Sq. Ft"VMM47 No. No. Dw.
• Arch., Engr., .. ..
Size..-,. 4-1'•3• Stories-., .... Units
Designer New C+� Add ❑ Alter ❑ Repair ❑ Demolition' ❑
Address Tel.
CityZip, State
-z Lic: #.
CENSED CONTRACTOR'S DECLARATION
hereby affirm that I am,licensed under provisions of Chapter 9 (commencing with SectionE
7000) of Division 3 of th,}eiBu!siness and Professions Code, and my license isin full force and, i
.effect.?/.Je�Y'r�_.f Ytl s�.J
SIGNATURE t O - .DATE- _ -
'
OWNER -BUILDER DECLARATIONE$tlmated Valuation
hereby affirm that I am exempt from the Contractor's' License Law for the following
reason: (Sec, 703.1_5,93usiness and Professions.Code: Any city or. county which requires ,a ��'•
- permit ' to construct, alter, improve, -demolish, or. epair any, structure, prior to its issuance also - - •< 1
requires the applicant for such permit to file a signed statement that.he is licensed pursuant to, • PERMIT . • - - AMOUNT ,
the provisions o/ 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 - -. Plan Chk. bep... }��`� -
subjects the applicant to a civil penalty of not more than -five hundred' dollars:($500). - 105,
❑ I, as owner of the. property, or my employees with wages as their sole compensation, will Plan. Chk:. Bal: �202.24
do the work, and -the structure is not intended,or offered for sale. (Sec: 7044, Buisness.end COr1St. , 67.
Professions Code: The ,Contractor's .License Law does not apply-to,arr owner of property -who.:,
builds•or improves.thereon and who does such work -himself or through°his ownemployees,' Mech. - heg e�/y
provided. that such improvements are not intended or; offered for, sale. If, however,- the building. - .37 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 /or the purpose o%sale.) . • ,. . _ .
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 85.00
struct the. project. (Sec. 7044, Business and Professions Coder The Contractor's- License Law
does not apply to an owner o/ property who builds or improves thereon, and who contracts for .. S.M. I.
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)•� - .. -
Grading '
❑ I.am exempt under Sec. • B. & P.C. for this reason
Driveway Enc.
Date owner Infrastructure mvmw&-as.' aZ afmmi
WORKERS' COMPENSATION DECLARATION
:l hereby affirm that I'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 No. j Company
❑ Copy, is filed.with the city. , ❑.Certified copy is hereby furnished. _
TOTAL ;� � # 1756»
CERTIFICATE OF EXEMPTION FROM REMARKS..
WORKERS'.COMPENSATION.INSURANCE -
(This section need not be completed i/ the permit is for one hundred dollars ($100) valuation - _ - - `• '
or less.)- . .w _ -... .. .. - ..
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: 1f,after making this Certificate of Exemption you should become ZONE: BY: -
subject to' the Workers'. Compensation provisions o/ the Labor Code, you must .forthwith
comply with such provisions or this permit shall be deemed'revoked.minimum $ct bac k' D l sta n CC S:
Front Setback. from. Center Line
e Rear Setback from,Rear Prop.. Line
CONSTRUCTION LENDING AGENCY. - • Side Street .Setback from Center Line' '
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:) . ; - Side Setback from,Properfy Line ,
Lender's Name
Lender's Address
This is -a building permit'when-properly filled out, signed and validated, and is subject to FINAL.DATE INSPECTOR' ;
I' 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. aJssued by: Date' Permit
agree to comply with 'all city and county ordinances and state laws relating to building. r:
construction, and hereby authorize representatives of this city to enter the/above-,
mentioned property for inspection purposes. Validated by:
Signature of applicant � Al f � /i Date-)/,-' � r.:
i Mailing Address _ v ` / Validation:
i'• City, State, Zip
HARD COPY _
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES',
1ST FL. SQ. FT_ ® $
2ND FLSQ. FT.
POR. SO. FT. ®
GAR. SQ, FT. ®
CARP. SQ. FT.
WALL SQ. FT. ®
SQ FT ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM 4
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.
LAUNDRYTRAY
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.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
REMARKS:
VENTILATION
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PLCK.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
INSPECTOR'S SIGNATURESIIYITIALS
GARDEN WALL FINAL
PERMIT APPLICATION
City of 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 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 o1 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 Contractors License Law
(Chapter 9 (commencing with section 7000) o1 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 7031.5by 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 sale. If, however, the
building or improvemnt is sold within one year of completion. Me owner -builder will have the burden of proving that
he did not build or improve for the purpose o1 sale.).
0 I, as owner of the property, am exculsively contracting with licensed contractors to construct 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.).
0 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.
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/COMMUNITY/STATE'/ZIP
Nestor, CA 92053
JOB SITE ADORESS/SPACE
CITT/COMALINITY/STATE/ZIP
La.Quinta, CA 92253
BOK -
PAG
PRC I
C I
TwN ,
RNO
SE
S
TRACTLOT
19903
Const. Fee 367.00
% '
Elect, Fee 60.18
MOD
SB
TRACT NAME
HORIZON PALMS
OWNER NAME IL. F. MI) Coneral Management Corp.
C)HTRACTOWFIRM NAME
J.L. Construction
ADDRESS
abimire
CITY/COMMUNITY/STATE/ZIP
PHONE a
105.72 DEP. PAID
LICNC e
.
ARC/ENG FIRM NAME '
Michael Buccino Assoc.
ADDRESS
340 S. Farrell Dr. A212
CITYICOMMUNITY/STATE21P -
_ Palm Sorinas, CA 92262
PHONE . LICNC F
323-7877
.
USE OF PERMIT
Sin le Family Dwelling
Bl
862.60
ZON,
'FSB
SS8
SSB
'RSB
DEC
ZONE ORD .
-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 five (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 Z Art 2, Sec341. Title 8,
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 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 above-mentioned 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. l agree to comply with all state laws and county ordinances relating to buidling .
construction, and authorize a' representative o1 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 /{ /
APPL/PRMT DATE
0 - 01_4�
'
Permit to construct 1247 sq. ft.
of
living area and 433 sq. ft. of garage
as per approved.plans.
Mer_h. Fee 37.00
Plan Check Fee 307.96
Const. Fee 367.00
Elect, Fee 60.18
SMI Fee/ 5.46
85.00
Trifrastructure
862.60
105.72 DEP. PAID
756.88
* agreemitint
t Department
TOTAL
'FEE
862.60
A114S 7 Z5 75688 CK
FINANCE VALUATION 77948.00
'