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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