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10959 (RR)Building' , 52--83€b..�endoza'• ., Address •_ Owner Frank Zaragoza 'Mailing Address Gamy' ' TyaQuinta Zip 92253 Contractor - lelson Roofing Address . 923 Wellwo6d Ave City Zip Beauiu©92223 P.O. BOX 1504 No. -10959 78-105 CALLE ESTADO• LA QUINTA; CALIFORNIA 92253 �. ' �•. BUILDING: TYPE CONST: � OCC: GRP.- A.P. Number Tel. Legal Description . Project Description Tel.: 7141345-2048 State Lic. & Classif. C39 516,729 City Lic. # I654 Sq. Ft. No. No. Dw. Size - Stories Units Arch., Engr., Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State Lic. # // {t LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed undevwovisions 4f Chapter 9 (commencing with Section 7000) of D7v 4ion 3 of the Businesv nd-ProfessionsCode, and my license is in full force and . 1ffact. A a _r 'SIGNATURE'DATE ' OWNER -BUILDER DECLARATION' 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.counly. which requires a 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 licensed•pursuant to 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, end the basis for. the alleged exemption.. Any violation of Section 7031.5 by 'any, applicant for .a...p_ermit - - subjects the applicant to a civil penalty of not more than five hundred dollars.($500).;Plan O 1, as owner of the property, or my.employees with.wages as their sole compensation, will L. `i do the work, and the structure is not intended or offered for. sale. (Sec.- 7044,' Bulsness and.. Professions Code: The Contractor's Ucense 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.' /f, however, the' building .: ..or Improvement is sold within one year of completion, the rowner-builder will have the burden of proving that he did not build or improve for the purpose or safe.) Estimated Valuation B ®(� , - - AMOUNT. PERMIT - •- - . Plan Chk.".Dep. - Chk.. BaI. _ . !S nn �1 COr1St: 20 - - •04 -. Mech. ' Electrical <Plumbing '• O I, as Owner of the property, am exclusively contracting with licensed contractors to con- • 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 such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) 0I am exempt under Sec. B& P.C. for this reason r . S.M.L.- Grading. ,. Driveway Enc. Date Owner Infrastructure 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.certified.copy thereof (Sec.. 3800, Labor Code.) . Policy No. Company Copy is filed with the city. ❑ Certified copy is hereby furnished. I9r3� ii 6i??+ rig— imrKh { TOTAL 4Y.1 t1V . - CERTIFICATE OF EXEMPTION FROM _ WORKERS' COMPENSATION INSURANCE .-' -. -. REMARKS: - (This section need notbe completed if the permit is for one hundred dollars ($100) valuation or less.) 1 certify that in the performance of the work for which this permit is issued, I shall not - , employ any prson in any manner so as to become subject to the Workers' Compensation . Laws of Cal ifeni ora Date . • Owner . NOTICE TO APPLICANT: If, after making thisCertifrcate of Exemption you should ' 'subject`to the Workers' Compensation provisions of the Labor Code, you must forthwith' comply with such provisions or this permit shall be deemed revoked. - ZONE:` BY: Minimum Setback Distances: " Front Setback.from Center Line Rear Setback from Rear Prop. Line 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.) e . Side Street Setback from Center Lin;. Side Setback from Property, Line Lender's Name Lender's Address . This is a building permit'when properly filled out; signed and validated, and is subject to expiration it work thereunder is suspended for 1110 days: - FINAL DATE INSPECTOR I certify. that 1 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. Issued by: Date '- Permit s Validated by: Signature of applicant Date Mailing Address Validation: City, State, Zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. @ $ 2ND FL. SQ. FT. POR. SQ. FT. @ GAR. SO. FT. @ CARP. 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 FLOOR DRAIN MECHANICAL FEES HEATING (ROUGH) WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER DUCT WORK GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM HEATING (FINAL) 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 BOND BEAM SQ. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID @ 1+/4 c SEWAGE DISPOSAL LUMBER GR. SQ.FT.GAR @ 3/ac HOUSE SEWER FRAMING FINAL INSP. 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. DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. 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 Zwm REMARKS: VENTILATION FIRE ZONE ROOFING: FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION - CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL