001411 (SFD)P.O. BOX 1504 No. 001411.
Building' 44-380 E. S� � Dr. LA QUINOTACCALIFORNIA92253
Address '
Owner _
Mailing
Address 1001 Bisbop St. Sate 270.3
City ZipTel. - `
9681 ^- 1-80QT367--5
Contractor
. .J0.�,1' s
Address
BUILDING: ,TYPE CONST. --OCC: GRP.= - i2- A
A.P. Number
54 Legal Description. x
Project Description VEbxlmm Palm
146 u9 to RL! -A
City'. Zjp . Tel.' •.
92M 340-,5511,
State Lic. City
& Classif.s Lic. # "� Sq. Ft 7• "` No. No. Dw.
'8 �' Size 433 Stories Units -
Arch.- Engr:;
• Designer Newf • Add ❑ Alter ❑: Repair ❑
Address��++rr Tel.
. 340, S...Fatrell EX... .323-..qq78l7��eq�
City Zip State
PgLba !31 �� 43 2 Lic. #
Demolition ❑
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am-licerised under provisions of'Chapter 9 (commencing. withlSection '.
7000) of Division.3cf theIBLrssiriidss and Professions Code, .and my license'is'in full force rarid-s-`
effect.:.{. 3f �� %"t force grid,
SIGNATURE f DATE-
•OWNERBUILDER DECLARATION . I .., •.
1 hereby affirm that I am exempt from the Contractor'sLicense.Law for the following
reason: (Sec..Ml.5,pusiness and Professions Code: Any city or county. -which requires 'a
.permit to :construct,* atter, improve, demolish, or repair any structure, prior to its-Issuance*also
• •requires :the,applicant.for such permit to file a signed statement,that beds licensed pursuant to
the provisions -of the Contractor's License Law;>Chapler 9:(commencing with Section 7000) of
Division`3 of the' Business'end'Professions Code,, or that.,he is':e)empt therefrom, and'the basis-
for the alleged exemption.. Any violation •o/ Section 7031.5. by�'any. applicant for a permit
Estimated Valuation
' - 5.5: '
... PERMIT- 'AMOUNT' -
•- - - -
'
Plan-Chk. Dep..-. •. 105.7.. '
'subjects the -applicant to a'civil penally of not more than five'hundred dollars (S500).'"';--
❑ 1, as owner of the property, or, my employees with wages as their sole compensation, will
Plan Chk. Bal. 2032.24
COY1St.. " •�,
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,
. '
Meoh.. , '37X0
builds or improves thereon and who does such, work himself or, through fhis. own employees,
P rovided. that' -such impro.vements,'are not intended or offered- for .sale. If, however, the building ' - ^
Electrical -WAS
- - -
or improvement is sold within one year -o/ completion; the 'owner -builder .will have.,the. burden .
of proving that he did not build. or Improve for the purpose of sale.) • .
Plumbing 85.00
-❑ 1, as owner of the property, am exclusively contracting with.licensed contractors to. con-
strucl. the project. (Sec. 7044, Business and Professions .Code: The Contractor's License Law:
does. not apply to an owner o/ property who builds or improves thereon; and who contracts'for
_
< S.M.L. `A'
- such projects with a•contractor(s) licensed pursuant to the Contractor's License Law.) . -
_ ❑ 1 am exempt under Sec. B: & P.C. for this reason
Grading •
Driveway Enc.
Date' owner
Infrastructure Deft pa.aza-
WORKERS' COMPENSATION DECLARATION
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.
O Copy is filed,with the city.,. ❑ Certified copy is hereby furnished. .
TOTAL 8682.E '.88
_
' CERTIFICATE OF EXEMPTION FROM
.WORKERS'' COMPENSATION INSURANCE.
REMARKS.
(This section need not be' completed. if the permit is for one, hundred dollars ($100) valuation
• - or less.) - ... _ . ._ _
certify that in the performance of the work for which this permit -is issued, Ishall'not'
employ any person in any manner so as to become subject to the Workers" Compensation'
Laws of California.
' 'Date—' - Owner
' . NOTICE TO APPLICANT:. I/, 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:
Mi,nimurn Setback Distances:
Front Setback from Center. Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING -AGENCY - '••.
Ihereby affirm fliat.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'
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, andis'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 correct. -.n_
1 agree to comply with'all cityrand county. ordinances and state laws relating to building'=
construction, and hereby authorize representatives -of . this city to enter the above-
mentioned property for inns✓pepction purposes. /
Signatureofapplicant!
Issued by: _ Date Permit
Validated by:
Mailing Address
Validation:
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. ®
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.000L 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, 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 ® 3/4c
HOUSE SEWER
REMARKS:
VENTILATION
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
M=CH.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 SIGNATURESIINITIALS,
GARDEN WALL FINAL
APPLICANT NAME (L, F. Mn
JL Construction
ADDRESS
P.O. Box 173
CITY/COMMUNITY/STATE/ZIP
Nestor; CA 92053
JOB SITE ADDRESS/SPACE
CITY/COMMUNITY/STATMIP - ..
la.Quinta, CA 92253
BOK
PAG
PRC
I C
Tom
(IN0
P` PERMIT APPLICATION
City of La Ouinta
Department of Building and Safety
This permit becomes void if work not commenced within 180 days from date of issuance, OR, i1 work has been suspended or abandoned for a period of 180 days.
Elect, Fee 60.18
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be completed it
LICENSED CONTRACTORS DECLARATION: I hereby affirm that 1 am licensed under provisions of Chapter 9
the permit is for one hundred ($100) o. less. I certify that In the performance of the work for which this permit is
'(commencing with Section 70DO) of Division 3 of the Business and Professions Code, and my license Is In full force
Issued. I shall not employ any person in any manner so asto become subject tothe Workers'Compensation Laws of
and effect.
California.
License Class Lic: Number
Date Applicant
Date Contractor
NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to the Workers'
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractor's License Law for the
Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall
be deemed revoked.
following reason (Sec. 7031.5. Business and Professions Code: Any city or county which requires a permit to
ADDRESS
340 S. Farrell Dr. A212
construct. alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
such permit to file a signed statement that he is licensed pursuant to the provisions of the Contra ctor'sLicense Law
01 hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be
(Chapter 9(commencing with section 7000) o1 Division Sof the Business and Professions Code) orthat he is exempt
made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or
therefrom and the basis for the alleged exemption. Any violation o1 Section 7011.5 by any applicant for a permit
demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap 3.2, Grp 2 Art 2. Sec341, Title 8,
subjects the applicant to a civil penalty of not more than five hundred dollars (MOO.):
C.A.C.)
O I. as owner o1 the property, or my employees with wages as Meir sole compensation, will do the work, and the
0 As owner -builder, I will not employ anyone to do'work which would require a permit from the Division of
structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's license
Industrial Safety, as noted above, unless such person has a permit to do such work from that division.
Law does not apply to an owner of property who builds, or improves thereon, and who does such work himself or
ZONE ORD •
through his own employees, provided that such improvements are not intended or offered for sale. If, however, the
0 Division of Industrial Safety Permit No.
building orimprovemniissold within one year ofcompletion. the owner -builder will havetheburden ofprovingthat
Date ' Applicant
he did not build or improve for the purpose of sale.).
CONSTRUCTION LENDING AGENCY: I hereby aff irni that there is a construction lending agency for the performance
0 I, as owner of the property, am exculsively contracting with licensed contractors to construct the project (Sec.
of the work for which this permit is issued (Sec. 3097, Civ. C.).
7044. Business and Professions Code: The Contractor's License Law does not apply to an owner o1 property who
Lender's Name
builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the
Contractor's License Law.).
-Lender's Address
0 1 am exempt under Sec. B. & P.C. (Attached Certificate).
I certify that I have read this application and state that the above information is correct. I agree to comply with all
Date Owner
'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.
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell -insure, or a
certificate o1 Workers' Compensation Insurance . or a certified copy thereof (Sec. 3800. Lab. C.).
Signature of Applicant or Agent Date
Policy No. 'Company
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have read this application and state that
0 Certified copy is hereby furnished.
the information given is correct. I agree to comply with all state laws and county ordinances relating to buidling .
O Certified copy is filed with the City Building Inspection Department or City Department.
construction, and authorize a'representative of the City of La Duinta Department of Building and Safety to enter
upon the property for which I have applied for this permit for the purpose of making inspections.
Date Applicant
APPLICANT NAME (L, F. Mn
JL Construction
ADDRESS
P.O. Box 173
CITY/COMMUNITY/STATE/ZIP
Nestor; CA 92053
JOB SITE ADDRESS/SPACE
CITY/COMMUNITY/STATMIP - ..
la.Quinta, CA 92253
BOK
PAG
PRC
I C
Tom
(IN0
s.E
s
TRACT I
19903
LOT
Elect, Fee 60.18
MOD
I SB
-
TRACT NAME
HORIZION PALMS
OWNER NAME (L. F. MI) Ganeral Management Corp. '
CONTRACTOR -FIRM NAME
J.L. Construction
ADDRESS
above
CITY/COMMUNITY/STATE/ZIP
PHONE •
756.88
LICHC .
* agremitint
ARC/ENO FIRM NAME .
Michael.Buccino Assoc.
ADDRESS
340 S. Farrell Dr. A212
CITY/COMMUNITY/STATE/ZIP
Palm Springs. CA 92262
PHONE • 11. LICNC •
323-7877
TOTAL •
FEE
USE OF PERMIT
Sin le Family Dwelling
BL
ZON,
'FSB
SSB
SSB
RSB
OFC '
ZONE ORD •
LOT SZ
END
SIDE
Signature of Applicant or Agent Date
Print Applicant/Agent Name9-
APPL/PRMT } 'DATE
5-2-2=85
S.F.D.
Permit to construct 1247 sq. ft.
of
living area and 433 sq. ft. of gaage
as Per approved Plans.
Mech. Fee 37.00
Plan Check Fee 307.96
(bast- Fee 367.00
Elect, Fee 60.18
SMI Fee 5.46
.21imbing Fee 85.00 .
Infra e
862.60
105.72 DEP: PAID
756.88
* agremitint
with CYmminit�Z t Department
TOTAL •
FEE
862.60
A 1 1 L 4 D L L l j b, 8 8 R
FINONCF VALUATION 77,948.00