0002-141 (RER)I hereby affirm under penalty of perjury that I am licensed under provisions of
k,shapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professionals Code, and my License is in full force and effect.
License # Lic. Class Exp.. Date
/;4ti�33 B 0361/20t
ate Signature of Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 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, Business & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
( ) I am exempt under Section B&P.C. for this reason
Date Signature of Owner
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
( ) I have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
(�,) I have and will maintain workers' compensation insurance, as required by
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued. My workers' compensation insurance- carrier & policy no. are:
Carrier Policy No.
O i e13
(This section need not be completed if the permit valuation is for $100.00 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�16ompensation laws of California, and agree that if I should become
subject to the workers' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with those provisions.
Zate: Applicant
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to .the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work Is performed under or pursuant to
any permit Issued as a result of this applicaton agrees to, & shall, Indemnify
& hold harmless the City of La Qulnta, Its officers, agents and employees.
2. Any permit Issued as a result of this application becomes null and vold If
Work Is not commenced within 180 days from date of Issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above Information Is
correct I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the,'above-mentioned property for inspection purposes.
VSignature (Owner/Agent) Date
BUILDING PERMIT PERMIT//
ilfyll�-X4t
DATE !? � ,7/201) VALUATION �7� J) n�i LOT. TRACT
JOB SITE
ADDRESS 77-978 CALLESONORA
APN %7Jr-23"11
OWNER
CONTRACTOR / DESIGNER / ENGINEER
p
l 1J r R.1
Milk. U 1 F1110PIFF 11
til �: t1�:��UOT ` 'ia�;:, i.i(�Av EPI,"'li & ISIIIo
4 4 ..1.1 dil A4 I- 1 i..\a i'Sll
77)78 i ALLF SUNt)RA
4310Z BURR MND10 42201
LA QU N IA. Cry 9225:3
PALM U3,SEM' CA. q?255
f 7fiU)2 [ 7-RI+�t t 0BI 14
USE OF PERMIT
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r i�� Ir- 'f� C d� ``I l rnr- h r— 1 1 1 A -�
v.r'ti(UNTION 7,500.00 LS
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ry� 1�f)�V'f�+ti
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Stu �1.MARY
C'� .N3i ttUc"1'.1C)�t PfE 10.1-000-418-titii) i t��►
A4FCF4A"AICA , FWD )Qi.-f1(O-01-000 $151111
4'.i.i�ltil13lh3Li FL. It lt��-tll�l+-�li�-t►{}t� ilei. +u
N`i'l ONO NV '100 F19 • R S11) )UI-OQU-241- b.75
LESS PRE i' VID I'E',I S
$0.1010
r
RECEIPT
DATE
BY'
DATE FINALED
INSPECTOR
�Y
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Law Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
_4
Free Estimates
St. Lic. 746718
c - FAX 76U-776-9695General Building.
MOBILE. 760-217-8841 FCS
Free Estimates
St. Lic. 746718
FAX 760-776-9695 General Building
IF - S
MOBILE. 760-217-8841 CO
Javier Munoz
FIRE RECONSTRUCTION SPECIALISTS
INVOICE
12. GRADING $
0
0
0
13. WINDOWS $
o
0
0
14. WEATHERSTRIP $
0
0
0
15. DOORS (EXTERIOR) Is kf5o
Install one exterior door with knob on the room on the We side of structure
Install exterior water heater closet door with a vent at the top & bottom of the door with hardware.
16. DOORS (INTERIOR) Is
0
0
17. PARTITION WALL (INCL. ROOM ADDITIONS) is I
Provide fire wall in water heater cabinet. Exposed framing members observed.
Seal up roof opening In the fau closet around the vent pipe and secure from water Infiltration.
0
18. PLASTERIDRYWALL $ 300
Patch drywall in. dinning room along floor on the wls and in front sls hallway between bedrooms.
Patch drywall on ceiling in the back bedroom where shagging due to water damage and texture to a finished
condition ready for painting.
L 19. DECORATING (INTERIOR PAINTING, WALL PAPER] Is I OD
Paint ceiling in the front central bedroom and in the back bedroom with paint to match existing paint
0
0
20" WOOD TRIM Is a
Replace missing doorjamb on the sle front door to bedroom.
0
0
SDrop21. STAIRS $ 75 -
Drop
down attic stairs are unsafe for use. Remove stairs and leave attic door in place.
0
0
22. CLOSETS $
0
0
0
23. WOOD FLOORS is
;C.
a
_
f Free Estimates
St. Lic. 746718
i% 'FAA 760-776-9695 General Building
FCS
MOBILE. 760-217-8841
Co Javier Munoz ,
FIRE RECONSTRUCTION SPECIALISTS
INVOICE
Manuel Flores CONTRACTOR'S
EST. AMOUNT
77-978 Calle Sonora La Quinta, Ca. 92253
s
_
• � 1. MASONARY
$ J gs b ��
Patch all holes in the exterior walls after illegal electrical has been remove then brown cost and prepare for painting..
Ext wall of fireplace.Lath, scratch, brown coat and prepare for painting. -
. Install stucco moulding around all exterior doors.
2. SIDING
$ t6-0
• Replace all missing freeze block and seal up to provide for bee stop on the north side of structure. f t.
O r ;
3. GUTTERS/DOWNSPOUTS is
0
0
0
4. ROOF is
Remove all old roofing and discard. Replace watertweather damaged sheeting (approx. 6 sheets) on rear of
structure and discard. Install new two ply rolled roofing with metal edging. Licensed roofer to inspect residence and
make necessary recommendations and corrections according to termite inspection dated 11111199. (See item #35 inst.)
5. SHUTTERS Is
0
0
0
6. EXTERIORS ( STUCCO; PORCHES, STOOPS, RAILINGS)
$ %4.5a eO-
N .
Replace wooden posts that support front patio roof: Install 6-40 wooden posts with supports on the foundation and roof eaves
0
7. WALKS
is
0
0
0
8. DRIVEWAYS
$
0
0 _f
9.,PAINTING (EXTERIOR)
T$16-19..6
paint all exterior walls with two coats good quality exterior paint. Paint eves and facia with two coats of good
quality exterior wood paint. Paint all exposed metal. The color will be of Mr Flore's choosing.
t)
S
10. CAULKING
$
0
0
11. FENCING
$
0