HomeMy WebLinkAboutROOF19-0079City of Palm Desert
PERMIT NUMBER:
ISSUE DATE:
Building and Safety Department
73510 Fred Waring Drive
ROOF19-0079
3/1412019
Palm Desertt,, CCA 92260
Permit Type: RE -ROOF
Appl. Date: 3114/2019
Permit RESIDENTIAL
Subtype:
Job Valuation: $11,725.00
Appr, Date: 3/14/2019
Exp. Date: 911012019
Project Address: 28 ACAPULCO DR
Project Description: UNDERLAYMENT ONLY
APNITract/Lot No:
Owner:
Contractor:
Applicant:
624021033
CHARLES B ROOT.
B R S ROOFING INC
B R S ROOFING INC
TR 14032-1 INT IN
135 CUTTER
777 SOUTH LUGO AVE
777 SOUTH LUGO AVE
COMMON AREAS
BARRINGTON, IL 60010
SAN BERNARDINO, CA 92408
SAN BERNARDINO, CA 9240B
33
(909)884-8505
(909)884-8505
Licensed ContractorDerFee
Summary,
f hereby affirm under enal of pe6ury that I am licensed under provisions of Chapter 9
ARCHIVE FEE - 8.5XI I UP TO 11X17 GL-1100000-3411600 $0.14
(commencing with Section 7D00) of Division 3 of the Business and Professions Code,
and my license is in full force and effect.
GREEN BLDG FEE S91473 GL-6100000-2281000 $1.OD
MINIMUM iNSPECTICN FEE GL-11D0000-3221100 $159.00
PERMIT ISSUANCE FEE GL-1100000-3411400 $105.00
Owner -Builder Declaration
1 hereby affirm under Density of pe(e(ua that I am exempt from the Contractors' State
Total Fees Paid: $265.14
f herebyafrm under the penalty of perjury that there is a construction fending agencyfor the
License Law for the reason(s) indicated below by the checkmark(s) I have placed next
to the applicable item(s) Section 7031.5 Business and Professions Code: Any city or
performance of the work for which this permit Is Issued (Sec 3097, Civil Code)
county which requires a permit to construct, aNer, improve, demolish, or repair any
Lenders Name and address
structure, prior to Issuance, also requires the applicant for the permit to file a signed
statement that he or she is licensed pursuant to the provisions of the Contractors' State
Asbestos Declaration
License Law(Chapler 9(commencing with Section 7000) of Division 3 of the Business
and Professions Code) or that ti or she . exempt and the basis for the alleged
exemption. Any violation of Section by any applicant for a permit subjects the
Written asbestos notification pursuant to Part 61 of Tile 40 of the Code of Federal Regulations is required
re than
applicant lD a civil penalty of net more than Floe hundred dollars ($500}.}
when asbestos exists in buildings, or portions thereof, undergoing demolition. I hereby declare that
9
I, as owner of the property, or my employees with wages as their sole compensation,
demolition authorized by this permit is from construction that does or does not contain
asbestos, or that no demotition is authorized by this permit.
will do the work, and the structure Is not intended or offered for sale (Sec. 7044,
Business and Professions Code: The Contractors' State License Law does not apply to
NOTICE: You may protest any of the fees for this permit in accordance with CA Gov Code Sec. 66020
an owner of property who builds or improves the property, provided that the
(a). The protest must satisfy the requirements of Gov. Code Sec.66020(a) and must be filed within W
improvements are not intended or offered for sale. If, however, the building or
days of the dale of this notice. In addition, you must tender payment of the protested fees at the lime of
improvement is sold within one year of completion, the Owner -Builder will have the
the payment or provide evidence of arrangements to pay the protested fees Dr exactions at the time they
burden of proving that it was not built or improved for the purpose of sale.)
are due if they are not already due.
I, as owner of the property, am exclusively contracting with licensed contractors to
construct 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 licensed contractor pursuant to the
Contractors' State License Law,)
I am exempt from Licensure under the Contractors' State License Law for the
following reason:
DatelSignature of property owner or agent
Workers' Compensation Declaration
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100.000). IN ADDITION TO THE COST OF COMPENSATION DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
I hereby affirm under the anal of perjury ONE of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers'
compensation, issued by the Director of Industrial Relations as provided for by Section
3700 of the Labor Code, for the performance of the work for which this permit issued,
Initial
Policy No.
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 and policy number are;
In tia
Comer & Policy Number
Expiration Date
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 and agree that if I should become subject to the
workers' compensation provisions of Sect i 3700 the Labor Code, I shall forthwith
comply with those provisions.
` ' Ila VA
_
Initial
Date Applicant
City of Palm Desert
Department of Building and Safety
Building Permit Application
(For Ofty Use Only)
JOB 1D:P��Ag UC�I
PLANS FILED:
Project Address: 0 1 C_O ID !`. Suite
`dotal Value of work: S-0 I z 3,00 Note: plan Review Fees maybe adjusted after Plan Review
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City Zip
City Zip
Phone
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E-mail
License No.
License No. .
Alsoiicant Name
Signature
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Contact Te ephone•Number:.
E-Mali
PLEASE COMPLETE THE REVERSE:SIDE
73-510 Fred Waring Drive, Palm Desert, CA 92260 - (760) 776-6420 • (760).776-6392 fax • www4tvofpa1mdesert.org
=5 City of Palm Desert
" Department of Building and Safety Phone:
(760) 776-6420
www.dtvofoalmdesert.ora
SMOKE AND CARBON MONOXIDE ALARM RETROFIT VERIFICATION
1, a , and I,
(Print Property Owner's Name)
(Tenant's Name - if same as Owner write "Same")
who own andlor live in the dwelling located at: cg C <n
(Address)
verify that the smoke and carbon monoxide alarms required by the California Residential Code (CRC) have
been installed in the dwelling, in compliance with the code and with the manufacturer's instructions and further
that they have been tested and do function properly.
In an effort to enhance life safety within dwellings, CRC Sections R314.6, R315.2 and CBC 420.4 requires the
retrofit of these alarms in existing dwellings when alterations, repairs or additions requiring a permit and
exceeding $1,000 in value are made. Generally, the alarms must be hard wired (110 volt) with battery back-up
and all alarms are to be interconnected. If the installation of the alarms will require the removal of wall or ceiling
finishes or there is no access by means of attic, basement or crawl space, then alarms may be solely battery
operated and not interconnected.
Alarms must be installed in g_l_l of the following locations within the existing dwelling:
• In all bedrooms (only require Smoke Alarms)
• Immediately outside of each separate bedroom (require Smoke and Carbon Monoxide Alarms)
• In each story level of the dwelling, including basements and habitable attic rooms (require Smoke and Carbon
Monoxide Alarms)
And;
Shall be current within 10 years from the date of manufacture marked on the unit, or replaced if the date of
manufacture cannot be determined.
• Shall be equipped with a 10 year battery if a conventional ionization smoke alarm.
These safety devices must be installed by the time a final inspection is requested for your project.
l understand the above requirements an certify that we now have smoke alarms and carbon monoxide
alarms installed that comply. We a L
gre to comply with the CRC in regards to smoke alarms, carbon
5 ►-z i - 11
Date
ATTENTION OWNER - OCCUPANT:
Signature of Tenant
Date
This is a Voluntary Smoke and Carbon Monoxide Alarm verification procedure. If you prefer a Building Inspector
to perform the verification, you must arrange to have an adult present at the time of inspection.
NOTE: This Verification is only used when normal access to the interior of the dwelling by the City of Palm Desert Building Inspector is
not achieved during the course of project construction. It is normally used for projects such as re -roofing, re -siding, patio covers,
swimming pools and the like.