001428 (SFD)r
f P.O. BOX 1504 No:. 001428
Buildingh 78-105 CALLE ESTADO
Address 44-425.R. Sladoi4 Croft Dr. LA QUINTA, CALIFORNIA 92253
Owner
GINUMI
Mailing .
w Corp.mimt BUILDING: TYPE CONST. • OCC: GRP: R' 3
Address a _ Fklitn i A.P. Number
City Zip''t`.j Tel.
ff
1 � i�., 9 1-800-367-5054Legal Description
Contractor . Project Description
3,
146 MAtS2.
Address
P.O. S= 173
City Zip _ .. ...: Tela
$? 0 3A_ TIL
State Lic. City
& Classif., 442 LiC. #� Sq. Ft. X47 No. No. Dw.
Arch.,,Engr:, Size Gklq . 4-M -Stories Units
Designer NewX" -Add ❑'' Alter ❑ Repair ❑ Demolition ❑ . -
Address Tel.
City Zip State :.._... .,
J
r•
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I.am.licensed under provisions of Chapter 9 (commencing with' Section
7000) of Division 3
r
of the Business and Professions Code, and my license is in full force and
effect.
t
SIGNATURE DATE
' - OWNER -BUILDER DECLARATION
Estimated Valuation
-,I hereby affirm that I am exempt from the Contractor's License Law forthe following,
7031.5,Business Any 'a'
77 .
„ reason:_(Sec: and Professions Code: city or.county which requires
pemiit to construct, alter, improve, demolish, or repair any structure, prior to -its issuance also-
•• requires the applicant for such permit to -file assigned statement.that he is licensed pursuant to
PERMIT AMOUNT
the provisions of the Contractor's License Law,•Chapten9(commencing with Section 2000) of..
Divisloh 3'of the.Business andProfessions Code, or that:-he:is. exempt' therefrom" and th'e'basis
• for the -alleged 'exemption. Any violation of Section 7031.5% by 'any applicant for.
-
Plan Chk. Dep..
a permit
subjects the applicant to a civil penalty of not more than rive hundred dollars ($500).
' I, owner
- w�/�
Plan Ctik,� Bal. pp
❑ as 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 '
rr.Y1`�r�°.t
const., `
Professions Code: The Contractor's License Law does not. apply to an owner of property -who
" '
a
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
Mech. ' 37.00
or Improvement is, sold within one year of completion, the- owner -builder will have the burden
"Electrical" }y'
6Wr 19
.. of,proving that he did not build or improve for the purpose of sale.) . .. .. .. . . - .
' 0, 1, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing 83.00
• struct the project. (Sec. 7044, Business and- Professions Code: The Contractor's, License Law
does not -apply to an owner of property -who -builds orimproves. thereon, and who contracts for
'. S.M.I.' - '• 5-46 .
• such projects with a contractor(s) licensed pursuant to the Contractor's License Law:) -
Grading
❑ 1 am exempt under Sec. - B. & P:C. for this reason
Driveway Enc.
Date ' owner
Infrastructure pamt as em
y ed,MML Din
WORKERS' COMPENSATION DECLARATION
I hereby affirm' that I 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 the city. . 0 Certified copy is hereby furnished: :
�n
TOTAL 862.60 756.88
CERTIFICATE OF EXEMPTION FROM
REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not becompleted if the permit is forone hundred dollars 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 '
'to
ZONE: � By:, '
' subject the Workers' Compensation provisions of the Labor Code, you 'must forthwith
comply with such provisions or this permit shall be deemed revoked. -
-Minimum Setback, -
Front Setback.from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
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.) . -
'$Ide 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, and is'subject to
expiration it work thereunder is suspended for 180 days.'
I certify that I have read this. application and state that the above information is -correct.
Issued by: Date Permit
agree to comply with allrcity and county ordinances and state laws relating to building'
construction, and hereby` authorize representatives -of this- city to enter the above-.'
mentioned property for inspectio.J'-Oturposes.
Validated by:
�~
t
Signature of applicant .l�li'ft lr i -.! —bate—,
�* •Mailing Address
.
ValldatlOn:
City, State, Zip
HARD COPY I
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEE2
1ST FL. SQ. FT. ® $
UNITS
SLAB GRADE
2ND FL. SQ. FT.
BONDING
YARD SPKLR SYSTEM
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ, FT, ®
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT.
GAS (ROUGH)
DRAINAGE PIPING
WALL SQ. FT.
OTHER APPJEQUIP.
DRINKING FOUNTAIN
SO FT ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax va'uation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTOKDISH)
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.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
GAR. FIREWALL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
LATHING
GAS PIPING
PERMIT FEE
PERMIT FEE
IPL.CK.FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.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 APPJEQUIP.
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 SIGNATURES11NITIALS,
GARDEN WALL FINAL
APPLICANT NAME (L. F. MI)
JL Construction
ADDRESS
P.O. Box 173
CITY10DMMUNITY/STATE/ZIP
Nestor; CA 92053
JOB SITE ADORESSISPACE
CITY/COMMUNITY/STATE/ZIP
La.Quinta, CA 92253
SOK I
PAG
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.
S.E
CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATIONINSURANCE: This section need not be completed it
LICENSED CONTRACTORS -DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9
the permit is for one hundred ($100) o. less.) 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 Lf c. Number
Date Applicant
Date Contractor
NOTICE TO APPLICANT: If, after making this Certificate o1 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
'following
Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall
be deemed revoked.
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
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
such permit to file a signed statement that he is licensed pursuant tothe provisions of the Contractor's License Law
01 hereby certify that no excavition five (5) or more feet in depth into which a person is required to descend, will be
(Chapter 9(commencing with section 7000) of Division 3 of the Business and Professions Code) or that 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 of Section 7031.5 by any applicant for a permit
demolitionor dismantling thereof, will be more than thirty-six (36) feet high. (Chap 3.2. Grp Z Art 2, Sec341, Title 8,
subjects the applicant to a civil penalty o1 not more than five hundred dollars (MOO.):
C.A.C.)
0 1, as owner o1 the property. or my employees with wages as their 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 safe (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 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
0 Division of Industrial Safety Permit No.
building or improvemni is sold within one year of completion. the owner -builder will havethe burden of provingthat
Date Applicant
he did not build or Improve for the purpose of sale.).
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance
0 1, as owner o1 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
builQs 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. 8P.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 self -insure, or a
certificate of 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 lepresentative 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.
Date Applicant
Signature of Applicant or Agent Date
Print Applicant/Agent Name a /o/ ; g
APPLICANT NAME (L. F. MI)
JL Construction
ADDRESS
P.O. Box 173
CITY10DMMUNITY/STATE/ZIP
Nestor; CA 92053
JOB SITE ADORESSISPACE
CITY/COMMUNITY/STATE/ZIP
La.Quinta, CA 92253
SOK I
PAG
PRC
I C
I
TWN
I FIND
S.E
s
TRACT
Elect. Fee 60.18
SIVIT Fee 5.46
MOD
SB
19903
862.60
105.72 DEP. PAID.
756.88
TRACT NAME
HORIZON PALMS
OWNER NAME (l. F, Mill Ganeral Managemmt -Corp.
CONTRACTOR -FIRM NAME '
J. L. Construction
ADDRESS
abcve
CITYPCOMMUN I TY/STATE/Z I P '
PHONE .
LICNC .
ARVENG FIRM NAME
Michael Buccino Assoc.
ADORESS
340 S. Farrell'Dr..A212
CITY/COMMUNITY/STATE/ZIP
Palm Sbrings, CA 92262
PHONE • LICNC •
323-7877
USE OF PERMIT '
Single Family Dwelling
BL
ZON.
'FSB
SS8
SSB
'RSB
OFC
.—
ZONE ORD •
LOT SZ
END
- SIDE
APPIJPRMTT ` 5 2-2=85
S.T.D.
Permit to construct 1247 sq. ft.
of
living area and 433 sq. ft. of garage
as per approved plans.
Mech. Fee 37.00
Plan Check Fee 307.96
Const. Fee 367.00
Elect. Fee 60.18
SIVIT Fee 5.46
.Plimbing Fee 85.00
TnfrastrUCtUre
862.60
105.72 DEP. PAID.
756.88
* ggreentint
t Departnimt
TOTAL •
FEE
862.60
h 1 1 4 0 J L / 5& 8 8 CK
FINANCE VALUATION 77,948.00