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10802 (SPIN)ing Adddes9 54-540 JUA.REZ Owner DIXIE MORTGAGE Mailing Address City Zip 'ALM DESERT Contractor 4 P.O. BOX 1504 No. 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Y 10802 WING: TYPECONST.4 a OCC: GRP, P. Number_ al. Description ect Description SPECIAL INSPECTION PAID BY BUYERS OF ROME City Zip Tel.: Distances: Front Setback from Center Line Rear Setback from. Rear Peop. Line State Lic. City & Classif. Lic. # - Sq. Ft. No. No. Dw. Arch:, Engr., Size - Stories - Units Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. Validation: 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. - SIGNATURE DATE OWNER -BUILDER DECLARATION Estimated Valuation' 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, after, 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 exemption. Any violation Section 7031.5 by any for Plan Chk..Dep. - of applicant a.permit subjects the applicant to a civil penalty of not more than five hundred dollars.(8500). . . ' . - Plan Chk. Bal. O 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, 0uisness and Const. 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 Mech. or Improvement is sold within one year of completion, the owner -builder. will have the burden Electrical o/ proving.that he did not build or Frrrprove for the purpose of sale.) . O I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing struce 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.I. such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) - Grading ❑ I am exempt under Sec. B. !f P.C. for this reason -- .. ,Z e''` .; •i-; Driveway Enc. Datpfr owner Infrastructure SpoxCia I In&p Y .. WORKERS' COMPENSATION DECLARATION I hereby affirm that 1 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. corny O 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 ($100) valuation. or less.) - I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date - Owner NOTICE TO APPLICANT: - If, after making this Certificate of Exemption you should become subject 'to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. , CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.).. Lender's Name Lender's Address This is a building permit when property filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. ' I certify that I have read this application and state that the above information is correct: t agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives -of this city to enter the above-. mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip • � •Vii �`S�•�� i�":`�9'��F3ttt��. L`ti'$",fft t_%��'"'�� 41i� i?4'x� TOTAL _ .REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from. Rear Peop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE i INSPECTOR Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ 2ND 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 ROUGH PLUMB. 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 GAS (ROUGH) 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 BOND BEAM SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1% c SEWAGE DISPOSAL SQ.FT.GAR @ V4c HOUSE SEWER FINAL INSP. 4HPERMIT GAS PIPING PERMIT FEE PERMIT FEE FEE DBL TOTAL FEES MICRO FEE MECH.FEE ��.PL.CK.FEEELECT. 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 Aff /71�elk V, JT C, P LAYZo- FIREPLACEh ou" / ` [ « T SPARK ARRESTOR -( GAR. FIREWALL 3 tirPC LATHING At- T T ��Zvey MESH C -e �p INSULATION/SOUND FINISH GRADING Ito 4A FINAL INSPECTION - CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL ti April 15, 1992 RE: Special Inspection 54-540 Avenida Juarez ; A special inspection was done on the above referenced property April 14, 1992. The findings are as follows: 1. Miscellaneous stucco repair around,3 windows not complete in both baths and garage. 2.' Master bath remodeling not complete; sink, vanity, toilet and tub/shower are missing.. 3. TV and telephone wires are hanging in rear of house not connected. 4. Washing machine drain appears clogged; washer drain backs up into kitchen sink. 5. Entry patio cover approximately 12' x 30' metal structure was built without permits; seems to meet code. 6. Wiring to F.A.U. and a/c condenser is not to code. Both are potential hazards. 7. Several switch and receptacle covers are missing and one light fixture. These could be hazards as well. 8. Structural members and roof seem to be in good shape and present no problems. If you have additional questions, please do not hesitate to contact me. Sincerely, BUILDING AND SAFETY DEPARTMENT Lonnie Day Building Inspector I lec W O Z Y.. _ r1 2502 Morongo Trail Palm Springs, CA 92264 (619)327-8859 N2 - 10260 SOLD jTO/ 1. ral, Y �i-s1 rL..!"r SNl1 PPED TO / +//{�.r: �i J r `.•!rte ' t}- ��F STREET NO. �, �,,, • � � D �'�, ,. /STATE cry. 1 ,-IT .n � .. STREET NO. . C I TY,,r lt' STATE- ZIP CITY S ATE ZIP ll ��R. Jt� ��/�[�1, �A..n.[a�i-P..',#`. ..,A.�?.�!-w, /`�.ii'7�lsr*t-f�-�'a.r•C CUSTOMER ORDER SALESMAN TERMS ATE l ��R. Jt� ��/�[�1, �A..n.[a�i-P..',#`. ..,A.�?.�!-w, /`�.ii'7�lsr*t-f�-�'a.r•C � /.l�?'.l �•l�� 1 � � 1 1 1 1 • I I 1 1 1 , 1 � � � 1 1 i PAYMENT DUE UPON RECEIPT