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15284 (PLBG)w P.O. BOX 1504 No. 15284 Building78-495 CALLE TAMPICO Addres524748 Ave. ®bragon LA QUINTA, CALIFORNIA 92253 Owner oto Tarbell Realtors Mailing Address 211 .• Palm Canyon City Zi Tel. kylm Springs, ICA 92262 325-0931 Contractor A -1 Casspool Service, Inc. Address .Box 183 Zip . I Tel.: iJeu4J 3rv_. .$t r— °Y l,.OU 3AV_ State Lic. City & Classif.. C42 265214. Lic. # 386 Arch., Engr., Designer Address I Tel. City ( Zip ( State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 71,000) of Division 3.2f -the Business and.Professions Code, and my license is in full/force and OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Busi7ass and Professions Code: Any city or county 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 rile a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) or Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than rive hundred dollars ($500). ❑ 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, Buisness and Professions Code: The Contractor's License Law does not apply to an owner or 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. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he did not build or bnprove for the purpose of sale.) ❑ 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) (fcensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I herebyaffirm that I have a certificate of consent to self -insure, or a certificate of Worker's rAmpensation Insurance, or a certified copy thereof. (Sec. 3800,.Labor Code.) Policy �g Company ©Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed IF the parit is for one hundred dollars ($100) valuation 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 - 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 ATTORNEY'S FEES. This is a building permit when properly filled but, signed and validated, and is subject to expiration it 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 Dale Mailing Address City, State, Zip LDING: TYPE CONST. OCC: GRP.: A.P. Number Legal Description Project Description Connect ZONE: BY: Minimum Setback Distances: Front Setback from Center L h) `�\a Rear Setback,from Rear.Roo. Line Side Street Setback from Center Line- - Side Setback from Propertt Line - ! FINALDATE INS Issued by: Date P i1 t '�O_ X 1 Validated by: Validation: '� Sq. Ft. Size No. Stories No. Dw. Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ . Estimated Valuation $3,950.00 PERMIT AMOUNT Plan' Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing 30..00 S.M.I. Grading Driveway Enc. Infrastructure TOTAL 30. 00 REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center L h) `�\a Rear Setback,from Rear.Roo. Line Side Street Setback from Center Line- - Side Setback from Propertt Line - ! FINALDATE INS Issued by: Date P i1 t '�O_ X 1 Validated by: Validation: '� CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBNWQ FEES 1ST FL. SO. FT. @ $ UNITS F 2ND FL. SO. FT. @ BONDING YARD SPKLR SYSTEM v, STORAGE TANK MOBILEHOME SVC. BAR SINK ; POR. SO. FT. @ DUCT WORK ROCK STORAGE GAR. SO. FT. @ POWER OUTLET ROOF DRAINS HEATING (FINAL) OTHER APPJEOUIP. DRAINAGE PIPING CAR P. SO. FT. @ TEMP. POLE WALL SO. FT. @ GROUT DRINKING FOUNTAIN. SO. FT. @ FINAL INSP. URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER SYSTEM WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES FRAMING WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER REMARKS: GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY 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 SO. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID @ 11/4 c SEWAGE DISPOSAL SO.FT.GAR @ 3/ac HOUSE SEWER INSULATIONISOUND 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 SE 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. r��/ FINAL INSP. FRAMING FINAL INSP. %/ t' aO JJ l ROOFING r REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL . COACHELLA VALLEY WATER DISTRICT ' CASHiRECEIPT DETAIL Received From: 1-- l "� c: ��'.I,iJ { _7C Y t/ 1 c G L `Up. Address: ,G.A. Code Account No. "SJ �' O •, Lotlsl - Service Address oZ �u7 'T Y� t<( •'.__ C>b Yf'Scr ❑ Meter(s) ' ❑ Service(s) e ❑ Backflow(s) ❑ House Laterals) ❑ Detector Check(s) ❑ Meter Surcharge Q,fanitalion Capacity Charge nt --�5 ❑ W.S.B.F.C. ❑ Temporary Construction Meter 0 Tum on Charge ❑ Uncollected Account - Name ❑ Inspection Fee - Tract - Fee - ❑ Plan Check Fees Water I Sewer - r Tract - 13 Bond Payment- A.D.- Bond Assmt ❑ Customer Deposit ❑ Doer TOTAL 1- 1 Remarks: t -c t t• r I u -fa lir— 1 P. I� Check Money Order i • Tract' ci" '?• -. Y` . ,G.A. Code -. . e TOTAL CC% i'I ' Water Service - r; Cashier \.� -a3alfiiesl; ;' -IM,MER PUMPING INC. P.O. Box 2448 '''CATHEDRAL CITY, CALIFORNIA 92235-2448 4(61% 360-7448 CU lr%l 01 291'7 JOB INVOICE CUSTOMER'S ORDER NO. Q 448 •ORDER TAKEN BY DATE PROMISED 'SNICA.M. Gallons- I 1 0 P.M: ,BILL TO 60 PHONE ADDRESS f MF. CITY HEL7R"- �' JOB NAME AND'LOO—N- �0 DAY WORK� 0 CONTRACT DESCRIPTION DESCRIPTI?N,OF WOR 0 EXTRA Ou6RLingfee pq! IOMgal. • QUAINT. DESCRIPTION OF MATERIAL USED PRICE AMOUNT Gallons- rPumping Feeper 1000'gal. Ou6RLingfee pq! IOMgal. Out -of Area,Fee- - t j! Locating /-Opening-Fee (per hour) 7 Size System: co 4j 6•rFj QC— A SERVICE CHARGE OF $20 WILL BE DUE ON ALL RETURNED CHECKS. A FINANCE CHARGE OF 11/20/6 PER MONTH, 18% PER YEAR WILL BE CHARGED ON PAST DUE ACCOUNTS OVER 30 DAYS. HOURS LABOR AMOUNT TOTAL', MATERIALS MECHANICS @ HELPERS. @ TOTAL LABOR I hereby acknowledge the satisfactory completionofthe above described work: TOTAL LABOR' TAX J SIGNATURE DATE COMPLETED FA' V r ,r 4 MT Frtr E�.{�y((�;{� MOM ..4 Under the California Mechanics Lien Law alty pontractor, subcontractor, taborer, supplier '"3r other person who helps to improve your property, but is not paid for his/her work or supplies, has a right to enforce a claim against your property. This means that after a court hearing, your property could be sold by a couNtsffirer and the proceeds of the sale used to satisfy the indebtedness. This can happen even if4ou have paid your contractor tit full if the subcontractors, laborers or suppliers remain unpbld. To preserve -their right to file a claim or lien against your property, certain claimants such as subcontractors or material suppliers are requited to provide you with a document entitled "Preliminary'Notice." Original (or prime) contractprs and laborers for wages do not have to provide this notice. A Preliminary Notice is not a lien against your property. Its purpose iz to notity you of persons who may have a right to file,a lien against your property if they are not paid. Generally, the maximum time'allowed for filing a claim or lien against your property is ninety (90) Obys after completion of your project. TO INSURE EXTRA PROTECTION FOR YOURSELF AND YOUR PROPERTY, YOU MAY WISH TO TAKE ONE OR MORE OF THE FOLLOWING STEPS: I ) Requiro that payments be made directly to subcontractors and material suppliers through. a joint control. Any joint control agreement should include the addendum approved by the Registrar of Contractors. 2) Issue joint checks.for payment, made out to both your contractor and subcontractors or material suppliers involved in the project. This will help to insure that all persons due payment are actually paid. 3 After UPON makin ) g payment on any completed phase of the project, and before making any further payments,. require your contractor to provide you with unconditional lien releases signed by each material supplier, subcontractor and laborer involved in that portion of the Work for which payment was made. On projects involving improvements to a single family residence or a duplex owned by individuals, the persons signing these releases lose the right to file a claim against your property. In other types of construction this protection may still be important, but may not be as complete. TO PROTECT YOURSELF UNDER THIS pPTION YOU MUST BE CERTAIN THAT, ALL MATERIAL SUPPLIERS, SUBCONTRACTORS OR LABORERS HAVE SIGNED.