001459 (SFD)otyl 4
P.O.
Building f�78-105 CA
Address 44-416 W. � br. LA QUINTA, C,
Owner
'Mailing
Address 1001 Riabap St. S12.ta 'M
City
Contractor .
..,.Address .. ...
Zip? Tel.
Mi
.66M... 1-800-367-
BOX 1504 No.: 00.459
LLE ESTADO .
A,LIFORNIA 92253
BUILDING: TYPE CONST. •OCC. GRP...
A.P. Number
Legal Description
Project Description 'a'.>in Palm
p F'1 _ 1'71
City. .... ..... ..
Zip
Tela
2
92053
340-55.1.
State Lic.
& Classif.
442822
City
Lic. #
237
' 1247
Sq. Ft..
Size lCM .433
No. No. Dw.
Stories. Units
Arch:;'Engr., ..
Designer
New [ . Add ❑ -
Alter ❑:•• :.- Repair ❑ .Demolition ❑
Address
Tel.
30- S.. X11
323; 7877 ,
�• City
Zip
State "
Palm �°m�! :
�.. 9226.2..
Lic: #
LICENSED CONTRACTOR:S_DEC LARATION ;
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 ano
.effect. � -
/ +
�-
...
_ .. .
_
SIGNATURE J - r.. / DATE
OWNEWBUILDER 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 constiuct, alter, improve, demolish, or repalr any. structure, prioi-to..its issuance also.
�,.-. requires the applicant for permit to Zile a signed stalament.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, or 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 -applicant to a civil penalty of not more than five 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. 704.4, 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
r° ... of proving that he did not build orjMprove-for the purpose of sale.) • '
Estimated Valuation
-
c
-9dlb �?RA
..
� PERMIT' -i-. ..
-
-
- .. AMOUNT -
_ -
-
Plan Chk. Dep.'.
.. .
- -• .�5..�4�
..
_Plan Chk. Bal...
.. 2p^ �t
� •��ifGs2� -
Const.
3V.0
'Medh.
�f /�!! •'
3 .WEf
Electrical-
- 1�iT-
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.) .
❑ 1 am exempt under Sec:. B.•8 P.C. for -this reason • -
..
, S. M. 1. ..
-. .,.4
Grading
Driveway Enc.
Date ' Owner
Infrastructure
'y =Ted , .-'t„
WORKERS' COMPENSATION DECLARATION
I hereby affirm'that'1'have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, ora certified copy thereof. (Sec: 3800, Labor Code.)
Policy No. Company
❑ Copy is filed with,lhe city... O Certified copy is hereby furnished..
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 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., 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.
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.)' _.
Lender's Name
Lender's. Address
This is a building' permit when properly filled out, signed and validated, -and is subject to
expiration it work thereunder is suspended for 180 days. `
I certify that I have read (firs application and state that the above information. is correct.';.
I agree to comply with'all city and county ordinances and state laws relatingto building:..
construction, and hereby authorize representatives of this city to enter the above
mentioned property for inspection purposes.
Signature of applicant; 3��'J,/ /1 r _ Date
I7 Mailing Address f
City, State, Zip `
I•'i
l HARD COPY
TOTAL 862.6€3 1 756.88
REMARKS-
ZONE- _ BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from -Center. Line"
Side. Setback from. Property Line
FINAL DATE INSPECTOR
Issued.by: - Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING -FEES
IST FL. SO. FT. ® $
UNITS
SLAB GRADE
2ND FL. SO. FT.
BONDING
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO, FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT.
GAS (ROUGH)
DRAINAGE PIPING
WALL SO. FT.
OTHER APP./EOUIP.
DRINKING FOUNTAIN
SO FT ®
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, 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.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
GAR. FIREWALL
SO.FT.GAR ® 3/ac
HOUSE SEWER
LATHING
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.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./EOUIP.
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 SIGNATURES/INITIALS,
GARDEN WALL FINAL
PERMIT APPLICATION
City of La Uuinta
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 Sof the Business and Professions Code, and my license is in full force
and effect.
License Class Lic. Number
Date - Contractor
OWNER-BUILOER DECLARATION: I hereby affirm that 1 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) 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 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five 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.).
❑ 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.).
❑ 1 am exempt under Sec. B. 8 P.C. (Attached Certificate).
Date Owner
WORKERS' COMPENSATION DECLARATION: I hereby affirm that 1 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
❑ 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 Oonstruction
ADDRESS
P.O.-Box 173
CITY/COMMUM ITY/STATMIP
Nestor; CA 92053
JOB SITE ADDRESS/SPACE
CMICOMMUNRY/STATE/ZIP
La.Quinta, CA 92253
6OK
PAI;
PRC
I C
mech. Fee 37.00
TWN
FINDsE
s
TRACT
LOT
SMI Fee 5.46.'-
Moo
Set
19903
862.60.
105.72 DEP.. PAID
756.88
TRACT NAME HORIZON PALMS
OWNER NAME (L. F. MI) General Management Corp. '
CONTRACTOR -FIRM NAME '
J.L. Construction
ADDRESS
above
CITY/COMMUNITY/STATVZI P
PHONE a
LICHC .
ARC/ENG FIRM NAME
Michael Buccino Assoc.
ADDRESS
340 S. Farrell Dr. A212
CITY/COMMUNITY/STATMI P
Palm Sjorincrs, CA 92262 -
PHONE . LIC14C I
323-7877
USE OF PERMIT'
Sin le Family Dwelling
BL
ZON.
'FSB
SSB
SSB
RS8
-OFC
ZONE ORD .
LOT SZ
'END
- SIDE
k
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: 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 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, 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.
❑ 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. C.).
Lender's Name
Lender's Address
I certify that 1 have read this application and state that the above information is correct. I agree to comply with all
Icily 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 buidling
construction, and authorize a *representative of the City of La Ouinta Department of Building and Safety to enter
upon the property for which 1 have applied for this permit for the purpose of making inspections.
Signature of Applicant or Agent Date
'Print Applicant/Agent Name
APPUPRMTGATE
`r 5-22-85
S.F.D.
Permit to construct 3247 sq. ft.
of
living area and 433 sq. ft. of gaage
as r. a roved plans.
mech. Fee 37.00
P]m Check Fee 307.96
Const. Fee 367.00
60.18
SMI Fee 5.46.'-
.21urrbing Fee
In f ra structure *
862.60.
105.72 DEP.. PAID
756.88
* agreembnt
t.Department
TOTAL .
FEE
862.60
A i I / / D LS /SGtiiS LK
FINANCE VALUATION 77,948.00