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10778 (RR)Building Address 78-0$4 SAN TIKSTE© Owner ELRANOR SIDNER Mailing ' Address 'SAME City IZip ITel. • �� ' - 41-4 P.O. BOX 1504 N Q . JL U 1(0 - 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA. 92253 BUILDING: TYPE CONST. OCC: GRP. A.P. Number LA QUINTA 92253 • Legal Description Contractor . REROOF Project Description M61NTYRR' ROOFING Address 43612 N JACKSON CityZip _ Tel.` .IND.IO• CA 92201 342-1466 State Lic. City & Classif. 601429 Lic. # 303 Arch., Engr., ^ Designer New ❑� ' -Add-O No. No. Dw: Stories Units " f • ` Alter 0 Repair 0 -Demolition O Address Tel. City Zip State Lic. # - LICENSED CONTRACTOR' D�CL'/U .150N ! hereby affirm that aam licensed unM pro siogs'o--t--9— Iap" ommenci g itW ection 7000) of Divis/ion of t/he`B�uvsi�ness ~. a,'ncd;Professi[fiGsy:C�de, and my license isinn ful'force and effect. Y 5, i// � — — / %i S GNATUR _ ! J / DATE / - `OWNER-BUICDE DECLARATION••' I hereby affirm that I am exempt f om the Contractor's License Law for the following Estimated Valuation , - reason: (Sec. 7031.5,Business and Professions Code: Any city of county which. r requires. a '. 3 400 ! ' permit to construct, alter, improve, -demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to file a signed statement that'he is licensed pursuant:to PERMIT - -AMOUNT 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 Any. Section 7031.5 for - - ' Plan Chk. Dep. exemption. violation of by:'any applicant a perms subjects the applicant to a civil penalty of not more than five hundred dollars ($500). '>_ '• _ Plan Chk. Bal..- ❑ I,_as owner of the property, or my employees with wages as their sole compensation, wiu do the work, and the structure Is not intended or offered for sale. (Sec: 7044, Buisness and, Const. 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, Mech. provided that' such improvements are not intended or offered for sale. N,• however, the building - or improvement is sold within one year of completion, the owner -builder. will have the. burden _ EI2CtfICa1 - - - ' 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- Plumbing 'J 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 S.M.1. - - - •• .. • • such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) - - - -O I am exempt under Sec. B. & P.C. for this reason Grading ` Driveway Enc. Date owner Infrastructure 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 No. ' Company ❑ Copy is filed with the city. , 0 Certified copy is hereby furnished.. ~1—_ "s A 'r,xr rl+•i ` 'A i TOTAL :t%1,3 kg '.t<' iPiLl11 ` 31i "V111 CERTIFICATE OF EXEMPTION FROM - •REMARKS WORKERS'COMPENSATIONINSURANCE _' (This section need not be completed if the permit is for. one hundred dollars ($100) valuation' or less.) .. _ 1 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. .. Date__! ' Owner NOTICE TO APPLICANT: If, after making this Certificate of Exemption *should become • -ZONE : BY: „you subject'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: Front Setback from Center Line -' Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY • Side Street Setback from Centerline 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 that I have read this application and state that the above information is correct.. Issued by:. Date Permit I agree to comply with all city and county ordinances and state laws relating to building 9 construction, and hereby authorize representatives' -of. this city to enter the above-. mentioned property for inspection purposes. Validated by:' ' Signature of applicant Dated . Mailing Address Validation: City, State, Zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ 2N0 FL. SQ. FT. POR. SQ. FT. ® GAR. SO. 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.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APPJEOUIP. 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/. c SEWAGE DISPOSAL SO.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 APPJEOUIP. 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 V CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL