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002659 (RR)Atyl 4 P.O. BOX 1504 Building ' ` 78-105 CALLE ESTADO Address �3s" s 'l1 8 ��� LA QUINTA, CALIFORNIA 92253 Owner Designer New Q Add ❑ ' Alter ❑. Repair ❑ _ Demolition ❑ Address Mailing Address h City CityTip Zip Tel. .. l t2igi 92253 Lic. # Contractor LICENSED CONTRACTOR'S DECLARATION. hereby affirm that I am licensed under provisions of°Chapter 9 (commencing with Section .E Address . 7000) of Division the Business and Professions Code; and my license is in full force and ' . 78--550 Darby Tbad effect• �3;of . City .. ..Zip .. Tel.: ' Ter 44 49 til AI;- State Lic. F hereby affirm'that I am exempt from the Contractor's License Law for the. following City & Classif:274 921 Lic. # /; BUILDING: TYPE CONST. OCC; GRP;- A.P. RP; A.P. Number Legal.Description Project Description ..o -'girl Sq. Ft. No. No. Dw. Size Stories Units • ••• Arch.,-Engr:, Designer New Q Add ❑ ' Alter ❑. Repair ❑ _ Demolition ❑ Address Tel. CityTip State Lic. # LICENSED CONTRACTOR'S DECLARATION. hereby affirm that I am licensed under provisions of°Chapter 9 (commencing with Section .E 7000) of Division the Business and Professions Code; and my license is in full force and ' effect• �3;of SIGNATURE c__ r ^r^- .. "c..•r. ev^w-"- DATE OWNER -BUILDER DECLARATION EStlmated ValUatlOn F hereby affirm'that I am exempt from the Contractor's License Law for the. following ¢c' p� v I 00 reason: Sec. 7031.5,Business and Professions Code: •Ancit ,or count which requires a permit, to construct, alter, improve, demolish, or repair any structure, prior to its issuance also •t9 • +a ,requires the applicant. for 'such permit to rile a signed. statement that huts licensed pursuant to -PERMIT" - AMOUNT the provisions o/ the Contractor's License Law, Chapter 9 (commencing with Section 7000) of - Division 3 of the Business and Professions Code, or fha8 he 'is exempt therefrom: and the basis... for the Any Section 7031.5 by 'any for. Plan Chk. Dep. - ' - '. alleged exemption. violation of applicant a permit ' subjects the applicant to a civil penalty'ol 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,.will do the work, and the structure is not intended or offered for sale: (Sec. 7044, Buisness and " Confit. . 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.. If,. however, the•building or improvement is sold within one year of completion,, the owner -builder will have the burden Electrical - - of proving that he did not build or improve for the purpose or sale.). . . - , O I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 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. - a - such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading ❑ 1 am.exempt under Sec. B. & P.C. for this reason - Driveway Enc. Date Owner Infrastructure WORKERS' COMPENSATION DECLARATION Thereby 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 O Copy is filed with the city. . ❑ Certified copy is hereby furnished. TOTAL a�i3 CERTIFICATE OF EXEMPTION FROM REMARKS, 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 lhg work for which this permit is issued, I shall not -employ any person in•anymannerso 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 BY: ' subject to the Workers' Compensation provisions of' Labor- Code, yomust forthwith comply with such provisions or this permit shall be deemed revoked. .ZONE:' Minimum Setback Distances: ' Front Setback frcm Center Line Rear Setback. from Rear Prop. Line CONSTRUCTION LENDING AGENCY Side Street SetbEck from Center Line 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 fron Property Line Lender's Name • Lender's Address ' FINAL DATE IIJSPECTOR 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. '. 'city Issued by: Date-- Permit I agree to comply with all 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 purpose Validated by: Signature of applicantqfrf f_.. :Date a ^n ? Mailin Address A�4�c '`� •� v 9. .. � `> Validation: City, State, Zip ' A5597 1 29 ;L5�i [� HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS SLAB GRADE 2ND FL. SQ. FT. ® BONDING YARD SPKLR SYSTEM POR. SQ. FT. ® MOBILEHOME SVC. BAR SINK GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS CARP. SQ. FT. ® GAS (ROUGH) DRAINAGE PIPING WALL SQ. FT. ® OTHER APP./EQUIP. DRINKING FOUNTAIN SQ. FT. ® TEMP. POLE URINAL ESTIMATED CONSTRUCTION VALUATION $ GROUT WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. BOND BEAM WATER SYSTEM 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 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 SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11A c SEWAGE DISPOSAL LATHING SQ.FT.GAR ® 3/ac HOUSE SEWER MESH GAS PIPING PERMIT FEE INSULATION/SOUND 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./EQUIP. 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 3 CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS, GARDEN WALL FINAL Proposal Proposal No. FROM Custom Roofing Company Sheet No. 78 550 Derby Road Indio,California 92201 Date Oct.28,1986 34.5-3751 Proposal Submitted To Work To Be Performed At Name Wm. Barnes Street Street City State CityZa Qt» nta Date of Plans State C -a l i f o rn i s Architect Telephone Number 564-6610 We hereby propose to furnish all the materials and perform all the labor necessary for the completion of Clean roof off and re -roof com-plete house using,new ++;fetal on edges, 1 laver 75 lb. glass base sheet nailed on and 2 lavers glass ply, hot mopped,crushed rock and coated white. Five 5 ,year gurantee on leaks. All material is guaranteed to be as specified, and the above work to be performed in accordance wi$r the drawings and specifications submitted for above work and completed in a substantial workmanlike manner for the sum of Dollars ($1880.00 ). with payments to be made as follows: In full upon completion of roofing. Any alteration or deviation from above specifications involving extra costs, will be executed only upon written orders, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, tornado and other necessary insurance upon above work. Work -men's Compensation and Public Liability Insurance on above work to betaken out by Custom Roofing, Company "NOTICE TO OWNER" (Section 7019—Contractors License law) Under the Mechanics' Lien Law, any contractor, subcontractor, laborer, materialman or other person who helps tD improve your Paul Williams and is not paid for his labor, services or material, has a Respectfully submitted right to enforce his claim against your property. Under the law, you may protect yourself against such claims by filing, before commencing such work or Improvement, an ori�'nal Per Custom Roof J_ng Co ;pany contract for the work of Improvement 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 274 921 percent (50%) of the contract price and shall, In addition to any State License No. conditions for the performance of the contract, be conditioned for phone--- 3,; 5— J �Sl the payment in full of the claims of all persons furnishing labor, sere• ices, equipment or materials for the work described in said contract. Note — This proposal may be withdrawn by us if not accepted within days ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Accepted Signature Date Signature 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,. Contractors State License Board, 13132 Bradshaw Roadj Sacramento, California. [Mailing Address: P.O. Box 26000, Sacramento, California 95826.] TOPC FARM �AKn _ - . LITHO IN U. S. A.