001457 (SFD).�i
Building
Address '
Owner
4 44
hf
P.O. BOX 1504
44-376 W. 9xiblm CZ06t D= LA QUINTACCALIFORNIA 92253
Mailing --
Address 1001
City
Contractor
Address
No. -'001 457°
`ent . BUILDING:., TYPE CONST. V N OCCt:GRP: • i 3
��' ''St. Mite 2700 A.P. Number
Zip C;Pl Tel. ;�
:
—NO--367T;5iO3 Legal Description
Project Description n=lzcn. Palms..,
196 -UaJtS i art fal' I t3
City.
Zip
M
TO'.
340--55n
} State Lic.
& Classif. 442a22
City
Lic. # 237
Sq. Ft.
Size C�% 4 -
No. No. Ow.
Stories • - ' Units
,� ..
Arch., Engr.
Designer.
New - Add ❑
Alter ❑- Repair ❑, Demolition ❑
Address
_... 340 S. ra=eu .
Tel.
_
3236-7M
_
City
Zip
State
•c,EI3it
92262- ..
Lic..# . w
_ LICENSED. CONTRACTOR'S DECLARATION. ,
'
hhereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section -•
7000) of Division 3 of ftjhe'/Business and Professions Code, and my license is in full force and -
effect. f J s3�+ %+�~'.'! : .^ 2 /. y.
.i !
SIGNATURE .0 v ' p ' DATE
.' OWNER'BUILDER DECLARATION
:I hereby affirm that I am exempt from the Contractor's -License Law.for the following
t reason: (Sec: 7031: 5,Business and Professions Code: Any' city or county .which requires• a -
-permii.to construct, alter,,.jmprove, 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 provisionsrof the Contractor's License Law, Chapter 9F(commencing with.Section 7000) of
' Division 3 of the Business and Professions 'Code, or ihat.'fieas.'6xemphtheratiom, 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 rive hundred dollars ($500):' '
❑ I, as owner of the property, or my employees with wages as their sole compensation, will.
.. do: the work; and the structure Is not Intended or offered for sale. (Sec. 7044, Buisness and
Professions Code: The Contractor's License Law does not apply to -an owner of property .who ,
' builds• or Improves thereon and who does such work himself or. through his own employees,,.
. , provided that such improvements are not intended or offered for. sale. If, however, the building
or Improvement is sold within one year of completion, the. owner -builder will have the burden,
of proving that he did not build or improve for the purpose of sale.)
Estimated Valuation
: �..aq.�-�
l rid
'. PERMIT.
-• - -
.•. 'AMOUNT
- -
-
Plan Chk.. D6p..
- •' _
PIan,Chk': Bal..24
COf1St.
�. °367.00 ,
Mech:
.7 J. kiilT
Electrical •'
inn
Plumbing
,
❑ I, as owner of the property, am exclusively contracting with licensed contractors to.con•
` struct the project. (Sec: 7044; Business and Professions Code: .The Contractor's License Law-
,. does not apply to an owner of property who builds or'improves thereon, and who contracts for
• suchprojects with a contractor(s) licensed pursuant to the Con tractor's• License Law.) -
O 1 am exempt under Sec.- B..& P.C. for this reason
S.M.I.-
..
Grading
.
Driveway Enc.
Date Owner
Infrastructure
nta d ft as aMVMMft
-Wit "moi
WORKERS' COMPENSATION DECLARATION
I'hereby affirm that I have a certificate of'consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec: 3800, Labor Code.)
Policy No. Company
'i .❑ Copy is filed with the city., ❑ Certified copy is hereby furnished.
TOTAL
REMARKS
' CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE .
(This section need not be completed if the permit is for one. hundred, dollars. ($ 100) valuation
... or less.)
' I certify that in the performance of 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:,
Mlnlm.um Setback', Distances:
Front Setback from Center Line
-
Rear Setback from Rear Prop..Line
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.)
Side Street Setback from Center.Line '
Slde'Setback, from Property Line --
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.
FINAL DATE
INSPECTOR
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 inspectlldh purposes. -
Signature of applicant ! J ai +;P i % r t Date y/ "
Mailing Address %
Issued by:
"
Validated by:
Validation:
Date Permit
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CARP. SO. FT.
WALL SQ. 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./EQUIP.
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.
SO. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/4c
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./EQUIP.
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 SIGNATURESANITIALS
GARDEN WALL FINAL
r
PERMIT APPLICATION
City of La Quinta
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 tic. 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: Ahy 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 sect ion 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 live hundred dollars (5500.):
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.
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. (Attached Certificate).
Date Owner
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell -insure, or a
certificate of Workers' Compensation Insurance . or a certified copy thereof (Sec. 3800. lab. Q.
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. MI)
JL Clnnstruction ' •
ADDRESS
P.O. Box 173
CITY/COMMUNITY/STATE/ZIP
Nestor, CA 92053
JOB SITE ADDRESS/SPACE
CITY/ MWLINITY/STATE/ZIP
lia,Quinta, CA 92253
BOK I
PAG
PRC
I C
mech. Fee 37.00
TWN
FIND
se
S
TRACT
19903
LOT
0
.czff Fee 5.46.
MOO
SB
TRACT NAME
HORIZON PALMS
OWNER NAME (L. F, MI) Gmeral Management Corp. '
CONTRACTOWFIRM NAME
J.L. Construction
ADDRESS
above
CITY/COk MUNITY/STATE/ZIP
PHONE I
LICNC I
.
ARC/ENG FIRM NAME
Michael Buccino Assoc.
AODRESS
340 S. Farrell Dr. A212
Cf TY/CCMMUNITY/STATE/ZIP
'Palm rips CA 92262.
PHONE I LICNC I
323-7877
USE OF PERMIT
Single Family M11in
BL
ZON,
FSB
SSB
SSB
RSB
DEC
ZONE ORD I
- LOT SZ
END
SIDE
the permit is for one hundred ($100) o. less. l 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: 11, 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 feet 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, falsework, or
demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap 3.2 Grp 2 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
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. l 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. 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
APPL/PRMT 10 r DATE E
Permit to construct 1247 sq. ft.
of
living area and 433 sq. ft. of qaage
as M approved plans.
mech. Fee 37.00
Plan Check Fee 307.96
Const. Fee 367.00
Elect, Fee 60.18
.czff Fee 5.46.
.Plurrbing Fee 85.00 .
Trifrastructure
862.60
105:72 DEP. PAID
756.88
* a een-litint
with (Immmity t De
t
TOTAL .
FEE
862,60
A.11/7 5 23 75
F VALUATION 77,948.00