001413 (SFD)Building
Address 44'4$6" E. SW
Owner
c.
Mailing
Address 101 Riabm s
City Zip
...
Contractor
J.&.
Address...
P.O. B= 173
City - ZIP
•4 -WCV
P.O. BOX 1504 No. 001413
78-105 CALLE ESTADO
43reSt M. LA QUINTA, CALIFORNIA 92253
mmt 0=P.
' BUILDING:'TYPE CONST: OCG;,GRP.
Suite 27 .. A.P.,Number .
.. Legal Description
Project Description
U6 mdta
Tel..
State Lic.
& Classif.� ..
City
Lic. # .
Sq. Ft. 1247
size • GM ._433.
No. No. Dw.
..Stories .- Units. .
Arch:, Engr.,
- Designer
New Add ❑
Alter.❑, 'Repair ❑ Demolition ❑
'
Address
Tel.
CityZip
State
�t�3�i I:"J
Lic: # _
LICENSED CONTRACTOR'S DECLARATION
,,LICENSED
I hereby affirm that I under.provisions of Chapter g (commencing with Section'
7000) of Division 3 of"the Business and Professions Code, and -my license.is;in full force and
effect ...:17�tr?R"rif7E ...... _ _.. �ttrt.l.%
... _ ..
.. .. .._ ., .."_ .. -. .,
_SIGNATURE i' d / DATE
-OWNER•BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law forthe following
reason: (Sec.- 7031.5,Business and Professions Code: Any., city or -county which requires a
peimit to construct, * after, improve, demolish, or repair any structure, _ prior to -its issuance also
requires the applicanhfor. such permit to fife a signed statement that .he is licensed pursuanCto
the provisions of the Contractor's License Law, Chapter 9. (commencing -with Section 7000) of
Division 3 of the Busirie'ss and ProfessionsCode_ or that. he is exempt' therefrom, and,the basis'
for the alleged, exemption. Any violation of Section 703.1.5• -by 'any applicant for,.a. permit
'subjects the applicant to a civil penalty of not more than five hundred dollars ($500). -`
. p I, as owner of the property, or my employees with wages as their sole compensation, will -
EStlniated V8IUatlOn
[+ �! �j A[!t - -
.7: f f s94Gi'Vo
-
.. .��.PERMIT - '
-"
_.
• _.3. 'AMOUNT
dr•.
--
-Plan Chk.�Dep:"
-
.r'1►.,`12
PIan,Chk. Bal.
202.24do
the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
•. Professions Code: n' The Contractor's License Law does not apply to aowner 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.),'
❑ 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.) - •.
❑ I am exempt under Sec. B. 8 P.C. for this reason
'-Mech.
37.00
Electrical
.
- --,� '
Plumbing'
- eUU
S.M.I.
s
- .. 5.46 '
Grading
Driveway Enc.
Date Owner
Infrastructure
'd: P 1
acreemm* with Can. -Dm1.;D1x0ct=
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate'of conserit 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. ❑ Certified.copy is hereby furnished.
TOTAL
862.60 756.88
CERTIFICATE OF EXEMPTION FROM _
WORKERS' COMPENSATIOWINSURANCE
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 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.
-
' Y .
'Dat.--L.--owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you snoald •become
,subject' to the Workers' Compensation provisioris:of- the `Labor Code, you must 'forthwith
comply with such provisions or this permit shall be deemed revoked.
ZONE: • BY:
, Nj,inimum 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,'Civi1 Code.)•
-Side ' Street Setback from Center Line
Side Setback from.Property Line
Lender's .Name
.Lender's Address
' This is building'permit when properly filled out, signed and validated, and issubject'to
expiration
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 relatingtobuilding
- construction, and hereby authorize representatives' of this city to enter :the above-.
mentioned property for inspection,pue' S. !
�;
Signature of applicant 1 r �. r� r_ .. Date ./
Mailing Address '. : %
Issued by; -
Validated.by:
-Validation:
_ . .. _
'• Date - Permit -
-
_-.......
I
City, State, Zip r
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FY. ® $
2ND FL. SQ. FT.
FOR. SQ. FT. ®
GAR. SQ. FT. ®
CAR P. SQ. FT.
WALL SQ. FT. ®
SQ. 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.IEQUIP.
LAUNDRY TRAY
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.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
REMARKS:
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.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 SIGNATURES/INITIALS
GARDEN WALL FINAL
"•-•r+-v�.....a ., r..,. (_, w—. �a�-.ten. ... �,r �•w.. ...r .. a...�.. .. �.:.. _ _ �. .��_ .-. .. ._
_ ....
- ,
` , .. .
CITY/C MMUNITY/STATE/ZIP - .. •' . ,. . .
+l -
BOK
PAG �
PERMIT APPLICATION
City of
La Duinta
Department of Building and Safety
This permit becomes void it work not commenced within 180 days from date o1 issuance, OR. If work has been suspended or abandoned for a period of 180 days.
SE
CERTIFICATE OF EXEMPTION FROM WORKERSTOMPENSATIONINSURANCE: This section need not be completed if
LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9
the permit is for one hundred (E100) o. less. I certify that in the performance of 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 Inany manner so asto become subject to the Workers'Compensation Laws of
and effect.
California.
License Class Lic. Number
Date Applicant
Date Contractor
NOTICE TO APPLICANT: If, after making this Certificli; 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
Compensation provisions of the Labor Code, you must�rthwith 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
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 Contractor's License Law
01 hereby certify that no excavationfive(5)ormorefeelindepthintowhichapersonisrequiredtodescend.willbe
(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 arty 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 ($500.):
C.A.C.)
O I. as owner of the property, or my employees with wages as their sole compensation, will do the work, and the
O As owner -builder, I will not employ anyone to do work which would require a permit from the, Division o1
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
O Division of Industrial Safety Permit No.
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 ofprovingthat
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
O 1, 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. 3D97, Civ. Q.
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
O 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-fientioned 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 l have read this application and state that
O Certified copy is hereby furnished.
the information given is correct. l 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 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
APPLICANT NAME (L. F. MI)
JL Construction
ADDRESS
P.O. Box 173
CITY/COMMUNITY/STATE/ZIP
Nestor; CA 92053
JOB SITE ADDRESS/SPACE
CITY/C MMUNITY/STATE/ZIP - .. •' . ,. . .
La.Quinta, CA 92253
BOK
PAG �
PRC
C
mech. Fee 37.00
TWNJRMG
Plan Check Fee 307.96
SE
S
LOTMoo
.
S
19903
862.60
105.72 DEP. PAID
756.88
TRACT NAME
HORIZON PALMS .
OWNER NAME (L. F. MU General Management Co
CONTRACTOR -FIRM NAME
J.L. Construction
ADDRESS
above
CITY/COMMUNITY/STATVZI P
PNONE 0
LICNC
ARC/ENO FIRM NAME
Michael Buccino Assoc.
ADDRESS
340 S. Farrell Dr. A212
CITY/COMMUNITY/STATE/ZIP
Palm Springs, CA 92262.
PHONE 9 11 .. LICNC'6
323-7877
USE OF PERMIT
Single Fami1v Dwelling
Bl
ZON,
;FSB
SS8
SSB
RSB
OFC
ZONE ORD •
LOT SZ
'END
SIDE
APPL/PRMTDATE
pos�.--g.--5-22-;L85
S.F.D.
Permit to construct 1247 sq. ft.
of
livincr 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
.
.5.46
.P11 ina Fee. 85.00
862.60
105.72 DEP. PAID
756.88
* gareentnt
t Department
TOTAL
FEE
862.60
A i I L 0 7 L L / j 6, � 8 CK
-FINANCE VALUATION 77, 948.00