001444 (SFD)Building
Address 44—i01'W
s Owner
Mailing
Address ion iuo
City
WgeW=t Mrp.
Zip 3`68 Tel.
92M , 1-80
Contractor
Address
P.O. BOX 1504 Nu.-. U1, 4,
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
- - BUILDING. TYPE CONST. V 14 OCC: GRP. R I
A.P..Number
—367 Legal Description
-...
Project Description F -00-49M
. - . .. .... Iii - 0.J7�t!�.t IM81dimt-iAl Via.
P.O. BW 173
City - ._,
Zip
Tel.. .. ,
920.
340-5�
State Lic.
City
&.Classif.
Li442Mc. # .�
Sq. Ft.' 1247 No. No. Dw:
• Arch.; •Engr.; .. • .. _ .. ..
Size as Stories -Units
-
Designer
New fl Add ❑ Alter O ` . Repair ❑ Demolition ❑ -
Address
Tel.
3"'7 -
City
State
�TO.. , .. ., . 4a
Lie. # .. _
_�. LICENSED CONTRACTOR'S DECLARATION
hereby affirm that I am licensed under provisions of Chapter 9 (commencing with�Section
7000) of Division 3d'of the Professions Code, and my license.is inyfull force and
)Business /and
.. effect. .. f�1'�! f /-:J >'
SIGNATURE ti --..>i+' " - r — f _ `DATE
- -
' ' OWNER -BUILDER DECLARATION °'
t
Estimated Valuation
I: hereby affirm•that I am exempt from the Contractor's License Law for the following
77
reason: (Sec. .703 1.5, 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
'PERMIT .. ?. AMOUNTS -
the provisions of 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
(��+ ry�¢
PlantChk..Dep.. - 1056 2 -
105672
" subjects the applicant to a civil penalty of not more: than five hundred dollars'(S500).
o
Plan Chk. Bal... 202.24
❑ 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
.
Const. ��
• Professions Code: The Contractor's, License, Law does not apply 'to -an' owner of property who
..
builds orImprovesthereon and who does suchwork himself or through his own employees,-
.
Mech. '.';.l
provided that such improvements are not.intended or.offered.for sale. If, .however, the building:.
- .or improvement is sold within one year of compleflon,� the owner -builder will have the burden
,
EIBCirICdl - ��.,�
. of,proving that he did not build or improve for the purpose of sale.) - . -- -
-
• .0 I, as owner of the property, am exclusively contracting with licensed contractors to con-
Q
Plumbing '5.00
Strutt 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:)- ..
S.M.I•. - - • - - - 6,46 ^
Grading
-... O I am exempt under Seca - B: & P.C. for this reason
Driveway Enc.
bate owner
Infrastructure t as' aaw*
wWh CtwymitV Demls' D
WORKERS' COMPENSATION DECLARATION
' Thereby 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. Cornpany
❑.Copy is filed with the city. . O, Certified copy.is hereby furnished. .. ..
t�!
TOTAL 86240 I e us
CERTIFICATE OF EXEMPTION FROM
WORKERS'. COMPENSATION INSURANCE '
REMARKS
(This section need not be completed -if the permit is for. one hundred dollars (S 100). valuation .
• -or less.) .. _ ..
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
'to 'of
ZONE: BY:
subject the Workers' Compensation provisions the' Labor ' Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked..
.Minimum Setback Distances: -
Front,Setback-from Center Line
„
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 Property Line
Lender's Name
Lender's Address
'
FINA.L'.DATE - INSPECTOR. -
. This'is'a buildingpermit when properly filled out, signed•and validated, and is'subject to
expiration if work thereunder is suspended for 180 days.
I certify that 1 have read this application'and state that the above information is correct.
'city
Issued by: - - Date •- ' Permit
I'agree to comply with all and county ordinances and state laws relating to building
- construction, and hereby authorize representatives sof -this city to _enter the above-:
mentioned property for inspec`tio%n}pu�rrpposes. }%
Validated by:
Signature of applicant•Date ` '-'��
Mailing Address l
Validation:
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES.
IST FL. SQ. FT. p $
UNITS
{
2ND FL. SQ. FT. p
BONDING
YARD SPKLR SYSTEM }
POR. SQ. FT. p
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. p
POWER OUTLET
ROOF DRAINS '
CAR P. SQ. FT. p
GAS (ROUGH)
DRAINAGE PIPING
WALL SO. FT. p
OTHER APP.IEQUIP.
DRINKING FOUNTAIN
SQ. FT. p
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT . WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
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. p c
BATH TUB
SQ. FT. p c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID p 11/4 c
SEWAGE DISPOSAL
GAR. FIREWALL
SO.FT.GAR p 3/ac
HOUSE SEWER
LATHING
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBLTOTAL
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.IEQUIP.
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 SIGNATURESIINITIALS.
GARDEN WALL FINAL
PERMIT APPLICATION
City 61 Le Ouinta
Department of Building and Safety
This permit becomes void if work not commenced within 160 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.) am licensed under provisions of Chapter 9 the permit is for one hundred ($100) o. less. I certify that in the performance o1 the work for which this permit is
(commencing with Section 7000) 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 as to become subject to the Workers'Compensation Laws of
and effect. California.
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 Contractor's License Law
(Chapter 9(commencing with section 7000) of Division 3 o1 the Business and Professions Code) or that heisexempt
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 five hundred dollars (E500.):
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 o1 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 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.).
❑ 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. 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 C,Dnstruction
ADDRESS '
P.O. Box 173
CITY/COMMUNITY/STATE/ZIP
Nestor; CA 92053
JOB SITE ADDRESS PACE
CITY/COIi1UNITY/STATE/ZIP
La . to .: CA 92253
Bac
PAG
PRC
C
TWN
AND
SE
S
1 03
LOT
Plect. Fee 60.18
I MGD
-Plim-bing Fee 85.00
TRACT NAME HORIZON PALMS
OWNER NAME (L. F. MI) iiGlal Management agemelt Co
CONTRACTOR -FIRM NAME
J. L. Construction
ADDRESS
CITY/COMMUNITY/STATE/ZIP
ahipm
PHONE • '
i
LICNC •
* gqreentnt
ARC/ENG FIRM NAME
Michael Buccino Assoc.
ADDRESS
340 S. Farrell Dr. A212
CITY/COMMUNITY/STATE/ZIP
Palm Sorincirs, CA 92262
PHONE . LICNC •
323-7877
.
113E OF PERMIT '
Single Fami1v Dwelling
BL
ZON,
FSB
SSB
SSB
-RSB
OFC
ZONE ORD •
'LOT SZ
'END
SIDE
Date Applicant
NOTICE TO APPLICANT: II, 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. Sec341, Title B.
C.A.C.)
❑ As owner -builder, 1 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 s permit to do such work from that division.
0 Division of Industrial Safety Permit No.
Date Applicant
CONSTRUCTION LENDING AGENCY: 1 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
1 certify theft 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 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 buldling .
,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
Print • Applicant /Agent Name
Date
APPL/PRMT 3 DATE
ulflAi
Pe uit to construct 1247 sq. ft.
of
living area and 433 sq. ft. of gaage
as approved plans..
Mech. Fee 37.00
Plan Check Fee 307.96
Const. Fee 367.00
Plect. Fee 60.18
cW Fee 5.46.
-Plim-bing Fee 85.00
*
Infrastructure
862.60
105:72)DEP. PAID
756.88
* gqreentnt
with inimmm= t Department
TOTAL
•
FEE2.60
A 1 1 6 1 Z3 75688 CK
CINONCE VALUATION 77948.00