002692 (RR)Ti4 4QuiWAA
�f
Bde6s g
'AdddrresXAim
650 a, 3&
Owner
Mailing
Address Sam
City Zip
....-TA Qmtfta 92253
Contractor.
P.O. BOX 1504 -
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Tel.
564—U28
Address
City ... Zip. Tel...
dao 92201 342-1141
BUILDING: TYPE CONST.-
-A.P. Number
Legal Description
Project Description'
State LIc. City
& Classif. 2g95f Lic. #7 Sq. Ft.
Size
Arch., Engr.,
• Designer New 13
�a
Address Tel.
City Zip State
..... _ _ Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby 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
effect. li ! yt;� t e Fj.• : t{ . �f/ i'/ - i.
SIGNATURE'S r - .f DATE
y OWNER+BUILDER DECLARATION
Valuation
' I.hereby affirm that I am exempt from the Contractor's License Law for the following Estimated, - y•
reason: (Sec, ..7031.5, Business and Professions, Code: -Any city or county which requires •'a • .4o.11820..
permit to construct, atter, improve, demolish, or repair any structure, prior to its issuance also - .c •. ..,. -
requiresthe applicant, for ,such permit to file a signed statement that he is licensed pursuant to -PERMIT i
. the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of ' -
'Division'3 of the 'Business and Professions Code,-or-lhaf-he is exempt therefrom, and the basis
for the alleged exemption. Any violation of Section 7031.5 by' any .applicant for, a permit Plan Chk. Dep.
subjects'the applicant to a civil penatty'of not more than five hundred dollars ($500) - -
No. No. Dw.
-Stories ' Units
Arid Fl" Altpr FT Rpnnir F-1 . 'Demolition Fl
J F! •
-AMOUNT
0 I, as owner of the property, or my employees with wages as their sole compensation; will
Plan Chk..Bal.
do the work, and the structure is not intended or offered for sale. (Sec. .7044, Bulsness and.
Cdnst. �^
Professions Code: The - Contractor's License Law does not apply. toan owner of . property who,.-
' •
�4
builds or'iinproves thereon and who does such work himself or through his, own employees, - •
Mech..
•, 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'-
EI2CtrICdl -�
of proving that he did not build or improve for the purpose of sale.).. - -
. 0 I, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing,-` �•-o,,;. - - .•
- slruct the project.. (Sec. 7044, Business andProfessionsCode: TheContractor's License -Law
• does not apply to an owner of property who builds or improves thereon, and 'who contracts for.
_
S M 1
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
..❑ I am exempt under Sec. - B. 8 P.C. for. this reason
Driveway Enc.
Date Owner Infrastructure
WORKERS' COMPENSATION' DECLARATION
I hereby affirm'that I have a certificate of consent to self -insure, ora certificate of. '
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) •.
Policy No. .Company ..
0 Copy is filed with the city. , 0 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 )-. .... _.. _
TOTAL
REMARKS
I certify that in the performance of thip 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
'subject
ZONE:-
' BY:
to' the' Workers' Compensation provisions of the Labor Code,' you'musr forthwith
comply
comply with such provisions or this permit shall be deemed revoked. - -
Minimlirrt Setback '
- - '
Front Setback from Center. Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line '
I 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.) -
Side 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 if work thereunder is suspended for 180 days. �- •• -
I certify I.have
Z�-•"="" Perm
,that read this application and state that the above information is correct.-
agree to, comply with
ISSuedby:',
•Date it .
all city and county ordinances and, state laws relating -to building
construction, and hereby authorize representatives of this'city to enter the above-. '
_•
mentioned property for inspection purposes. ,I ' _ =
Validated by:
'
Signature -of applicant ! N, : =.r Date
Mailing Address v
Validation:
City, State, Zip
;
A6691.
11. 12 30.06 U
HARD COPY
..
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
2ND FL. SO. FT. p
POR. SO. FT. ®
GAR. SO, FT. ®
CAR P. SO. FT.
WALL SO. FT. ®
SO. 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
SLAB GRADE
FLOOR DRAIN
MECHANICAL FEES
BONDING
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
DUCT WORK
LAUNDRY TRAY
AIR HANDLING UNIT CFM
GAS (ROUGH)
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.
SO. FT. ® c
BATH TUB
WATER HEATER
SO. FT. ®c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
BOND BEAM
SO.FT.GAR ® 3/ac
HOUSE SEWER
GRADING
cu. yd.
$ plus x$
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.IEOUIP.
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
C
DEC 17
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
117aYC1:1VR"aaimmmA1 Vnrom 111ALa,
GARDEN WALL FINAL
342-1141 I M E L ROOFING CO ■ 82-180 Verbena
•;'ess Imel Indio, CA 92201
PROPOSAL and CONTRACT
Date
TO
Dear Sir:�i-
1. propose to furnish all materials �and perform all labor'necessary to comple the following: -7
;adr/ 1_/H1—i-
�^ / /' / fir_ 7 �f/
'� • %'a• r Com'/ .C7 S f es/ /11� % L l�Fip K ry /�Gir (fi+�IAd / .!/ �/ �il l) �'2
r
All of the above work to be completed in a substantial and workmanlike manner according to standard practices for the
""1. �-•-/ / ice'
sum of / V f . I % tt Si7�� f� iC'�>r// 1�c�jYifr ��f ldJFfiY���. Dollars ($
Progress payments to be made
as the work progresses
to the value of per cent,.�C' %) of all work completed. The entire
amount of contract to be paid within u ler /�c� ,�J ivy days after completion.
Any alteration or deviation from the above specifications involving extra cost of material or labor will only be executed
upon written orders for same, and will become an extra charge over the sum mentioned in this contract. All agreements must
be made in writing.
Name and Registration Number of any salesperson who
solicited or negotiated this contract:
Name No.
Contractors are required by law to be licensed
and regulated by the. Contractor's State License
Board. Any questions concerning a contractor may
be referred to the registrar of the board whose
address is:
Contractor's State License Board,
3132 Bradshaw Rd.
Sacramento, California 95826
Respectfuily submitted,
Address
Telephone
Contra(•tnr•s St.ite License No.
You, the buyer, may cancel this transaction at
any time prior to midnight of the third business day
after the date of this transaction.
ACCEPTANCE
You are hereby authorized to furnish all materials and labor required to complete the work mentioned in the
above proposal, for which _
and according t e terms
ACCEPTED
agree to pay the amount mentioned in said proposal,
�4 k
. NOTICE TO OWNER
Under the Mechanics' Lien Law, any contractor,
subcontractor, laborer, materialman or other person who
helps to improve your property and is not paid for his labor,
services or material, has a right to enforce his claim
against your property.
Under the law, you may protect yourself against such
claims by filing, before commencing such work- of
improvement, an original contract for the work of improve -
Date 'Knr �L , 19 V&
ment or a modification thereof, in the office of the county
recorder of the county where the property is situated and
requiring that a contractor's payment bond be recorded in
such office. Said bond shall be in an amount not less than
fifty percent (50%) of the contract price and shall, in
addition to any conditions for the performance of the
contract, be conditioned for the payment in full of the
claims of all persons furnishing labor, services, equipment
or materials for the work described in said contract"