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06100 (RPL)TW�l 4 4 a" Building Address 53"300 Obregon 1 �' Owner Rob Bre Address Sa C r City Zip P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Contractor Dodson Pcols Address , 68-805 Perez Road. Sufte. �:-9..... _ .. . State Lic- City & Classif_ 455607 = -Lic. # 1044 - Arch-, Engr_, Designer Address Tel. CityZip State Lica# LICENSED commurOR'S DECLARATION' 1 Rereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7gpp) of Division 3 of the Business and Professions Code, and my license is in full force and effect i r: r' • , it SIGNATURE ' " DATE OVMEWMR DIER DECLARATION I hereby affirm that 1 am exempt -horn the Contractors License Law for the following reason¢ fsec 7031.5,11lusiness and Ro/essiors Code: Any city or county which requires a permr3 to consOncl, after, improve. I IisI or repair any structure.'prior to its issuance also regvues the applicant for such pemfd AD Me a signed statement that he is licensed pursuant to the pmvWwm of the Contractors License Law, Chapter 9 (commencung with Section 7000) of Waarr 3 of the Busirress and Protess+urs Code, or that. he is exempt therefrom, and the basis for the alleged exemption. Any vinbtion of Section 7031.5 by -any applicant for a permit st4ects the appftmd to a civilperially of not more than rrvo hundred dollars (E500). 0 1, as owner of the property, or my employees with wages as their sole compensation, will do the wadi, and the stricture is not intended or offered for sale. (Sec. 7044, Buisness and Professions Codi— The Contractors License Law Wes not apply to an owner of property who budt6 or unproves thereon and who aloes such work himself or through his own employees, provided the such &nprovements are not intended or offered for sale. lf, however, the building or improvement is sekf withinr ane year of completion, the owner -builder will have the'burden o1 proving that he did Trot build or improve for the purpose of sale.) .. ED 1, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project (Sec 7044, Business and P►otessiors Code: The Contractor's License Law does net appy to an owner of property who Lunids or wWroves thereon, and who contracts for such gWects with a contractor(s) 1111 prnwad to the Contractor's License Law.) . El I am exempt under Sec ---------R & P -C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION 1 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, Labor Code.) Poticy.Ko� Cgrnpary ��Colti1/ is filed with the city.. ❑Certified copy is hereby furnished. CERTIFICATE OF EKEIIIPTION FROM 11(ORKERS' COMPENSATION INSURANCE 117ft section need net be completed d the permit is for one hundred dollars ($100) valuation or?ess-) I certify that in the perforinance of Urp work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of Calif i mia, Mate Owner NOTICE TO APPUCAM: 0, after making this Certificate of Exemption you should become sablect to the Nrbrkess' compensation provisions of the tabor Code, you must forthwith eompy with such provisions or firs Permit shah be deemed revoked. CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a'co sWction lending agency for the performance of the work for which this permit is issued (Sec- 3097, Civil Code.) Lenders Name Lenders Address This is abuilding permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. 1 certify that 1 have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building eOnsbuctioq and hereby autfrorae representatives .of this city to enter the above-. mentioned property for inspection purposes Signature of appiicant Date tlt�iliruy Addt�s . City. SIdG Zip No. 06100 BUILDING: TYPE CONST. OCC: GRP.- A.P. Number ��b•�7�-a Legal Description Project Description Pao. t4tMAHKS.•a rtc.k :1•i _,6..!a "7 ui:J.$. ra0 .i1 a„�.,'•;Y"'?,1T3' iGYS 94$..43 f ZONE: - BY: Minimum Setback Distances: Sq. Ft. Size No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR 7/13%89 Issued by: Estimated Valuation $9.500 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. $ 76.fc05 Const. 117.00 Mech. 30.00 Electrical 24-00 Plumbing 27.0 S.M.I. r �� Grading Driveway Enc. Infrastructure TOTAL t4tMAHKS.•a rtc.k :1•i _,6..!a "7 ui:J.$. ra0 .i1 a„�.,'•;Y"'?,1T3' iGYS 94$..43 f 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 7/13%89 Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ UNITS SLAB GRADE ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL. SQ. FT. ® FORMS SEWER OR SEPTIC TANK ROUGH WIRING. MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® GAS (ROUGH) METER LOOP HEATING (FINAL) POWER OUTLET ROOF DRAINS GAR. SO. FT. ® TEMP. POLE GROUT DRAINAGE PIPING CAR P. SQ. FT. ® FINAL INSP. WALL SQ. Fr. WATER SYSTEM DRINKING FOUNTAIN. GRADING cu. yd. $ plus x$ =$ URINAL SQ Fr ® FINAL INSP. FRAMING ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation REMARKS: FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER 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. ® c BATH TUB SQ. Fr. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1+/a c SEWAGE DISPOSAL FINAL INSPECTION'S CERT. OCC. SQ.FT.GAR ® V4c HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PLCK.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'S CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESlINITIALS ' GARDEN WALL FINAL