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08051 (SFD)i • P.O. BOX 1504r-� No. 08051 Building 78-105 CALLE ESTADO Address 54435 Val IeJo, LA QUINTA, CALIFORNIA 92253 _r)fCj Owner% t�UL.� � Mailing Robert D. Owl BUILDING: TYPE CONST. OCC: GRP. Address A.P. Number 774"122"019 911 Ma-d-rJA City Zip "' Tel. ' CarlebaA SIM 02-76S$ Legal Description tat Contractor Project Description Single Family @wailing Address AIM ity Z' Tel. r12� 3 State Lic. City & Classif. , 3 Lic. # Sq. Ft. 272 No. No. Dw. Arch., Engr., Size Stories • Units Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARftION I hereby of that I am lic a /erovi�ions of Chapt 9 ommencing with Section 7 of Di i e dens ode, and license is in full force and fe J. IG U DATE OW -BUILDER ECLARATIO Estimated Valuation I hereby affirm that I am exempt from t ontractor's License Law for the following reason: (Sec. 7031.5,Business and Profession Code: Any city or county which requires a permit to construct, atter, improve, demolish, or repair any structure, prior to its issuance also. AMOUNT requires the applicant for such permit to file a signed statement that he is licensed pursuant to PERMIT the provisions o/ 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 pbea is plan Chk. Dep. 2 Q� /or the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a subjects the applicant to a civil penalty of not more than live hundred dollars ($500). 0 I, as owner of the property, or. my employees with wages as their sole compensation, will Plan Chk. Bal. M.66 do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. 6�Q Professions. Code: -The Contractor's License Law does not apply to an owner o/ property who builds or improves thereon and who does such work himself or through his own employees, Mech. C �g provided that such improvements are not intended or offered for sale. If, however, the building 62.00 or improvement is sold within one year of completion, the owner -builder will have.the burdenElectrical 140.32 of proving that he did not build or improve /or the purpose of sale.) ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing �3�� 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 /or S.M.I. fi.� such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) sa ❑ 1 am exempt under Sec. B..4^_p C. for this reason Grading 20.00 �j / Driveway Enc. 20.00 Date _1 � Wner Infrastructure 2098..8 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 ceI. (6Ln8800, or Code.) Pokkcy``No. Company T %� /Copy is filed with the city. ❑ Certified copy is hereby furnished. //////'''"' TOTAL 13,614.45 $3.369.45 CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE - (This section need not be completed if the permit is for one hundred dollars $100 valuation - �: k�.%3�j; �r���,,�V � lu.n 1�il . w or less.) ( 1 # i 1'�`;i a iA'�.1 1..�tf+ �'S I 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 o/ Exemption you should become ZONE: BY: subject to the Workers' Compensation provisions o/ the Labor Code, you must forthwith Minimum Setback Distances: comply with such provisions or this permit shall be deemed revoked. Front Setback from Center Line Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line 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 30 30AA Permit 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. Validated by: Signature of applicant Date Mailing Address Validation: City, State, Zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES' IST FL. SO. FT. ® $ UNITS COLL. AREA SLAB GRADE 4114107Ak ROUGH PLUMB. YAR6 SPKLR SYSTEM ' 2ND FL. SO. FT. HEATING (ROUGH) STORAGE TANK POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. SO. FT. ® GAS (ROUGH) j DRAINAGE PIPING WALL SO. FT. HEATING (FINAL) DRINKING FOUNTAIN SO FT ® GAS (FINAL) URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation WATER HEATER FLOOR DRAIN MECHANICAL FEES FINAL INSP. WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GRADING cu. yd. $ plus x$ GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM ROOFING .8 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. SO. FT. ®c BATH TUB FIREPLACE SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1% c SEWAGE DISPOSAL SO.FT.GAR ® 3/ic 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 bI k* AP G 1 I INyl*' UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE 4114107Ak ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. 9/J A0 vv GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE �f r GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM FINAL INSP. GRADING cu. yd. $ plus x$ =$ LUMBER GR. FRAMING O FINAL INSP. ROOFING .8 REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND Q FINISH GRADING FINAL INSPECTION (l CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL Desert Sands Unified School District CERTIFICATION OF PAYMENT OF SCHOOL FACILITY FEES To: 0UJA, / 'n*'Ie' NOTICE: DATE: THIS DCCU11147ENT CANNOT BE DUPLICATE®L This is to . ert i. y, that , developer of a w,, , which is located atj , within this District, has paid school facility fee4 imposed pursuant to the authority enerat d by Government ode Sectiol1 53080 in the a ount of L covering a total of square feet of ( ) resi tial or ( ) industrial/commercial development and that building permits for this footage in this development may now be issued by your jurisdiction. VQ W �q for DESERT SANDS UNIFIED SCHOOL DISTRICT White - Building Department 0 Yellow - Facilities Planning • Pink - Accounting • Gold - Developer (10)-37 II ;f. ST FEDERAL SAVINGS AND LOAN ASSO FIRCIATION i n Hill Blvd., Pomona, CA 91769 ,•,y, 9�g, Pomona, CA 91769 Attn: Construction Disbursement Dept. Loan No. ,t r f •' Amount Voucher N 2 0.1- / u 19 -�-Q Off Site On Site Lots Tract F 1(11 more than.oRe lot involved, show Lot Nos1002.) Pay to t 0a i't�I DOLLARS Er (Description o r, services, equipmenbr material furnished) (Descrrtft(,on of labor, services, equipment or material furnished) (Description of labor, services, equipment or material furnished) (through date) Inhi .,� . address) ( ity ;VOUCHER MUST BE ACCOMPANIED BY PAYEE'S INVOICE. THE LABOR AND MATERIAL WAIVER AND RELEASE ON ` If MUST BE COMPLETED. 'AWNf►frrtt purpose of inducing PFF to make payment of the above sum, the undersigned certifies that the above described labor, w pM, equipment, or material have been actually performed or delivered by the persons, firms or corporations named herein, 'S` tjMbQt�1i1 they conform to the plans and specifications for the job submitted to PFF and that there is no agreement to accept any ,I *bili or of money, labor, services, equipment, or material from an 7 , y,y person or firm with respect to this Voucher. The -24 sp /fft ed also unconditionally requests PFF to pay this Voucher in full, and holds PFF harmless in connection. with such y , w • i (Borrower Name) d <. (Au orized Signature) (Telephone No.) (Date) R�%,ICMER WILL NOT BE PAID IF THE WORK COVERED BY THE VOUCHER HAS NOT BEEN INSPECTED BY A PFF k::wUCT10N INSPECTOR. I N S� Penal Code Sections 484b and 484c provide that it is a crime to willfully submit false Vouchers and/or misuse ion loan funds. A Vouchermay be mailed in or presented for payment in person during regular office hours. PFF mustme `+I IId One day prior to presenting a Voucher of $100,000.00 or more. Only) t apr.proved: Check No. Paid by Date �Mblbwing Certification is a part of the Labor and Material Waiver and Release on the reverse side of this document. I," CERTIFICATION r PJrPose of Inducing Pomona First Federal Savings and Loan Association to Issue a check In payment of the total amount I�sn On the faceof the accompanying voucher ($ amount of voucher) the undersigned Payee represents and car - 41) that the labor, services, equipment, or material, set forth below, have actually been furnished to the job site descrlb3d (or materials have been taken from Payee's stock If Indicated); (2) that unconditional payment for such labor, services, 111snt, or material (Including any fringe benefit payments due pursuant to a collective bargaining agreement) has actually !h made In full to the date Indicated on the accompanying voucher, or that if any of such amounts remain unpaid, the proceeds *0 accompanying voucher are being taken In trust for their payment; (3) that the listing below of laborers, material or equili- l+ppllers, and subcontractors Is a full and complete listing of all those who were employed (or delivered services, equip- a'dsr material) for this job In connection with the work described below; and (4) that there are no straw or dummy persons, nor b!ils, included, and that there are no rebates or "kickbacks" agreed to, or to be made to, any owner, general contractor, •contractor, or employee thereof, or any person, In connection with the work described below, or the job premises described 00w. 31iK 2310 1 C-88 i COACHELLA VALLEY WATER DISTRICTte CASH RE:EIPT DETAIL Received Fro is ° ` `'i",�_ �! �' �U V+•+d} Gt �t t Dater j " may) Y Q 1S 'xR Address: ` Y ► 1CCG�. t 1 ` "6cy Account No. (000 , C)' V Lots) Tract SG eZi aZ Service Address S3— G.A. Code n (a U 09.,Nleter(s) $�o; CSI --Services) ❑ Backflow(s) ❑ House Laterals) ❑ DetectorCheck(s) ❑ Meter Surcharge 9-19anitation Capacity Charge _ ❑ W.S.B.F.C. ❑ Temporary Construction Meter ❑ Turn on Charge ❑ Uncollected Account - Name ❑ Inspection Fee -Tract - Fee - ❑ Plan Check Fees Water I Sewer - w Tract - ❑ Bond Payment - A.D. - Bond Assmt. ❑ Customer Deposit ❑ Other �� 0 Remarks: L �� Q'IL n1A-\- TOTAL $ i ❑Copy to: + WaterService IA 'heck�! ��- !Cash oneyCashier rder nz �`,^'�''' CVWD-438(11189) r 10 V V DATE: W S • �. .AG�TUR L C I } • sl . 16) oh . isLGa� I f AL ' o OUGA LfTus LMa s-C�� (t u 1d (oututa 11 uttbtn allb 3141Pm011 This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building! Code certifying that at the time of issuance this structure was in compliance with the various ordinances of the City regulating building construction or use. For the following: BUILDING ADDRESS 53-635 Vallejo Use classification SFD Bldg. Permit No. 08051 Group R3 Type Construction VN Fire Zone Use Zone SR Owner of Building Robert Chamley Address 411 Calle Familia City Carlsbad, CA 926.72 By; Mark Harnl a � Dote; June 17, 1991 Building Official POST M A CON8PI000US PLACE