05347 (RR)Building
Address
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
JACK HETNZ.
Mailing
Address SAMM
City Zip Tel.
LA O LWA 92253
Contractor
Address
540 WILLUM RD
Tel:
State Lic. I City
& Classif. 409619 Lic. # 326
Arch., Engr.,
Designer
Address I Tel.
CityI Zip I 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 Businessand Professions Code, and my license is in full force and
effect. f;'frz�t1� vol" .✓ +R '. 1+
SIGNATURE k _ `" DATE
V i OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,13ussess and Professions Code: Any city or county which requires a
permit to construct, after, improve, demolish, or repair any structure. prior to its issuance also
requires the applicant for such pemtit to fie a signed statement that hes 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 Sewn 7031.5 by any applicant for a permit
subjects the applicant to a civil penally of not more than five hundred dollars ($500).
❑ 1, 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 Cordradoes License Law does not appy 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 inteded or offered for safe. ff. however, the building
orimprovement is sold within one year of completion, the owner -builder wig have the burden
of proving that he did not build or improve for the purpose of safe.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Bisiress and Professions Code: The -Contractors License Law
does not appy to an owner of property who builds or krproves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec R, & 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
Workers Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No.ComPanY is r.,..,. s7
❑ Copy is filed with the city. ❑ Certified copy is erchy furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the pend is for one hundred dogars (EI00) valuation
or less.)
I certify that in the performance of tlig work for which this permit is issued, I shall not
employ any person in any manlier so as to become subject to the Workers' Compensation
Laws of California.
Date Owner
NOTICE TO APPLICANT: ff, after makig this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shag be deemed revoked.
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- (Sac- 3097, Civil Code.)
Lenders Name
Lenders Address
This is a building permit when property filled oil% signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certity 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 relating to building
construction, and hereby authorize representatives of this city to enter the above.
mentioned property for inspection purposes
Signature of applicant Date
Mailing Address
City, State, Zip
LDING: TYPE CONST
No.
P. Number ME TY RRTATE1.9
Description
Project Description _ PIP -•1 tywy
OCC: GRP.
05347
Anr ; 410, -CA 4'211:+, -44'? -3 4.-S7r)4 in
.a t) t.•",`44 A a u •ria. a .., ++...,
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
Issued by: Date 2/14/89 Permit
Validated by:
Validation:
Sq. Ft. No.
Size Stories
No. Dw.
Units
New ❑ Add ❑ Alter ❑
Repair ❑ Demolition ❑
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
i53 �ti
Mech.
Electrical
Plumbing
S.M.I.
AR
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
V
Anr ; 410, -CA 4'211:+, -44'? -3 4.-S7r)4 in
.a t) t.•",`44 A a u •ria. a .., ++...,
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
Issued by: Date 2/14/89 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL SO. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL SO. FT. @
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING.
MOBILEHOME SVC.
BAR SINK
POR. SO. F7, ®
GAS (ROUGH)
METER LOOP
GAR. SO. FT. ®POWER
OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. SO. FT. ®
GROUT
WATER HEATER
WALL SO. FT.
FINAL INSP.
DRINKING FOUNTAIN.
BOND BEAM
WATER SYSTEM
URINAL
SO FT ®
=$
LUMBER GR.
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
VENTILATION
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FIRE ZONE ROOFING
i
LAUNDRYTRAY
AIR HANDLING UNIT CFM
FIREPLACE
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11% c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
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 APPJEGUIP.
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
i
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION -
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
License409619 CONTRACT PROPOSAL
Contractors are required by law to be
licensed and regulated by the Contractors'
DEW ROOFING, INC. State ggla nsecont Board. Any referred
con-
esrnln a contractor ms be referred to the
registrar of the board whose address It:
640 Williams Road - P. O. Box 914 Contractors' State License Bard
1020 "N" Street
PALM SPRINGS, CALIFORNIA 92263 Sacramento, California 96814
PHONE (619) 327-3393
Contractor: Address:37 La Cintilla , Grinda , CA 94563
Owner: Jack R. Heinz ('564-4.242) Job Site: 4.9-787 Coachella Dr, La Quinta, CA 9 25
WE PROPOSE AND AGREE to furnish required labor and material for Remove old z•oof and reroof.
ANY BAD SH]!TTINC DISCCV�?FD V111L BE R.ITLACED AT MGT INCLUDED IN THIS DID I
for the above named building using see below... .
y in accordance with submitted plans and specifications, for the sum of
BID =inf No inch Urethane ns a ion, Z layers e
All 3 above bids have 2. Year Roof Guarantee. �------
IF YOU WISH THE WORK TO BE DONE, SIGN THE CONTRACT PROPOSAL BELOW THE DATE AND ALSO ON THE BACK OF THE
SECOND SHEET, WHICH IS THE "NOTICE TO OWNER." WE ARE SENDING TWO (2) COPIES EACH OF THE CONTRACT PROPOSAL
AND NOTICE TO OWNER. PLEASE RETURN ONE (1) COMPLETE SET TO US.
Approximate starting date:
Approximate completion date:
ALL PAYMENTS TO BE 100% ON COMPLETION UNLESS OTHERWISE SPECIFIEI
NOTICE
"Under the Mechanics' Lien Law (California Code of Civil Procedure, Section 1181
any contractor, subcontractor, laborer, supplier or other person who helps to imp
property but is not paid'for his work or supplies, has a right to enforce a claim agamni your
property. This means that, after a court hearing, your property could be sold by a court officer
and the proceeds of the sale used to satisfy the Indebtedness. This can happen even If you have
paid your own contractor in full, if the subcontractor, laborer, or supplier remains unpaid."
This agreement shall become binding only upon the Contractor's written acceptance hereof or upon the Contractor's commencing
performance and upon such acceptance or commencement of performance this shall constitute the entire contract and be binding upon the
parties hereto, there being no covenants, promises or agreements, written or oral, except as herein set forth.
It If further understood that:
(A) The Contractor shall not be responsible for damage or delay due to strikes, fires, accidents or other causes beyond his reasonable control.
(B) The proposal is limited to days acceptance from date hereof.
(C) The Purchaser is dealing with the Contractor as principal and that the Contractor Is not acting hereunder as the agent or representative
of any person, firm, or corporation.
PRICE SUBJECT TO CHANGE AT ANY TIME TO REFLECT INCREASED MATERIAL PRICES.
ate
12/7/BB
accept the above proposal.
DEW ROOFING, INC.
ISI ?,3P
a