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15237 (RR)Building Address 53-^770 Ave abre on Owner Trygue R Lodrup Mailing ' Address P.O. BOX 340808 City • Zip ArIet a, 91334 Contractortyal 6 Braswell Address 10018 So liairz S , Lys Angeles zip 90003 State Lic. &IClassif.9 663111 Arch.- Engr., Designer 44 P.O. BOX 1504 N 0 .4 5 2 31 78-495 CALLE TAMPICO e? LA OUINTA, CALIFORNIA 92253 BUILDING: TYPE CONST. OCC: GRP.• - A.P. Number Tel. i3©0e-SSS-445 , Legal Description Project Description • 'Ii-StUCbO e.;: a ic3r SQ>i£3 ' Re -Roof `and re �ia�t aaffiaal`c3 dr -mill. Tel.: ,' - 713-979'-2959 City Lic. #e Address Tel. City '- • Zip State Lic: # ' a LICENSED CONTRACTOR'S DECLARATION I herebyy,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 and SIGNATURE DATE OWNER -BUILDER 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 construct, atter, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to rile a signed statement 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 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 penahy of not more than rive hundred dollars ($500). ❑ 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,'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 of proving that he did not build or improve for the purpose of sale.) O 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.) O 1 am exempt under Sec. B. & P.C. for this reason - Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy .-- ) Company I@ Copy is filed with the -city,. ❑ 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 the work for which this permit is issued, I shall not employ any erson in any manner so as to become subject to the Workers' Compensation Sq. Ft. ar' E " No. Size • Stories New ❑, ,',Add:❑ '` Alter ❑ Estimated ;Valuation PERMIT• r .1 Plan Chk.. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Eric.. Infrastructure TOTAL REMARKS . No. Dw.' -• • Units RepairY�k.' ' ,,:Demoiition ❑ 'f -AMOUNT *45.00 104 UO Laws of California , Date Owner NOTICE TO APPLICANT:. It, after making this Certificate of Exemption you should become. ZONE: BY: '+ sub/ect to the Workers' Compensation provisions of the•Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Minimum Setback. Distances:• - •f' _ Front Setback fromCenterLine Rear Setback from Rear Prop., Line - WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND Side Street Setback f� m Center Line SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE r r/� HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, Side Setback.from Pr perty Line'. DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND " V ATTORNEY'S FEES. "his DATE 1 SPECTORy T is a buildingFINAL permit when properly filled out, signed and validated, and is subject.to expiration if work thereunder is suspended for 180 days. / i� V I _ -Permit certify that I have read this application and state thal'lhe above information is correct. Issued by: Date + I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives -of this city to enter the above-. f , 9- 1/ . mentioned property for inspection purposes. Validated by: Signature of applicant Date Mailing Address Validation: City, State, Zip _ - V CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBINU FEES 1ST FL. SQ. FT. ® $ UNITS SLAB GRADE 2ND FL. SQ. FT. BONDING YARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. SQ. FT. ® GAS (ROUGH) DRAINAGE PIPING WALL SO. FT. OTHER APPJEQUIP. DRINKING FOUNTAIN SO. FT. ® TEMP. POLE URINAL ESTIMATED CONSTRUCTION VALUATION is 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 WASH ER(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. SQ. FT. ® c BATH TUB Awlaoss, SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL GAR. FIREWALL SQ.FT.GAR ® 3/ac HOUSE SEWER LATHING S 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 6 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. ROOFINGA 1 1 / // / lrr / REMARKS: VENTILATION ! .Yma 77 co FIRE ZONE ROOFING FIREPLACE 47-X.4-1 4�-�,--70 Awlaoss, SPARK ARRESTOR GAR. FIREWALL LATHING S MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIONATURESlINITIALS GARDEN WALL FINAL