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9517 (RER)T4-tyl 4 4 Q" Building Address 53-900 Diaz Dick Poole Mailing Address same City Zip Tel. . %a Qwinta 92253 P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Roncin Construction Co., inc. No. 9517 LDING: TYPE CONST. OCC: GRP. P. Number Description Project Description Repair damaged exterior walk. - framing 46-351 Goldenrod lane window, insetation, drywall & stucco City Zip Tel.: Palm Dsrt 1 92260 568--1-772. State tic. City & Classif. B1 449822 Lic. # 580 Sq. Ft. No. No. Dw. Size ' Stories Units Arch., Engr., ' Designer New ❑ Add ❑ Alter ❑ Repair ❑ 'Demolition'❑ Address Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I her by 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 eif�'ct SIGNATURE _ /' •+ ,r' DATE OWNER -BUILDER DECLARATION . Estimated Valuation I hereby affirm that I am exempt from the Contractor's License Law for the following5355.00 reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a - I' 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, icensed pursuant to �'' PERMIT • AMOU NT - 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 ' Any Section 7031.5 by 'any fora Chk. Dep. p the alleged exemption. violation of. applicant permit subjects the applicant to a civil penalty of not more than Ove hundred dollars ($500). ! .Plan Plan Chk.. Bal. - ❑ I, as owner of the property, or my employees with wages as their sole compensation, will- I do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const.81.00 . 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, I I. 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 burdens Electrical - or proving that he did not build or bnprove for the purpose or sale.) .. ❑ 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.I. ID such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) `reason Grading � ❑ I am exempt under Sec. B. & P.C. for this " i Driveway Enc. Date Owner 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 vo. Company O ,Copy is filed with the city. O Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION.1NSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) vafuaUon 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 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. 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. Signature of applicant Date Mailing Address City, State, Zip Infrastructure TOTAL I IV $'14: l-7 4^ t t-111 HL. I. - — tZ i wo REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center. Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line - Side Setback from Property Line FINAL DATE Issued by: Date Validated by: Validation: INSPECTOR Permit 4 CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS COLL. AREA 2ND FL. SO. FT. ROUGH PLUMB. YARD SPKLR SYSTEM MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® SEWER OR SEPTIC TANK ROUGH WIRING. 3 $/ GAR. SO. FT. ® POWER OUTLET ROOF DRAINS GAS (ROUGH) METER LOOP DRAINAGE PIPING CAR P. I SQ. FT. OTHER APPJEQUIP. REINF. STEEL WALL SQ. FT. TEMP. POLE DRINKING FOUNTAIN. SO FT ® URINAL ESTIMATED CONSTRUCTION VALUATION $ SERVICE WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES FINAL INSP. WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FRAMING �i� 119/ Au 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, TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER. B.T.U. SO. FT. ® c BATH TUB SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1 Va c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ec 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 GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING. 3 $/ 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 FINAL INSP. $ GRADING cu. yd. plus x$ _$ LUMBER GR. FRAMING �i� 119/ Au FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH Q INSULATIONISOUND �-3-7� FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL