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INST (0700)PERMIT APPLICATION City of La Ouinta Department of Building and Safety �� a_ q � This permit becomes void if work not commenced within 180 days from date of issuance. OR, if work has been suspended or abandoned for a period of 180 days. LICENSED CONTRACTORS DECLARATION: I hereby 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 effect. License Class Lic. Number Date Contractor 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 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 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) orthat 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 five hundred dollars ($500.): 0 1, as owner of the property, or my employeesswith wages as their sole compensation, will do the work, and,the structure is not intended or offered for sale (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 does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the bu ilding o r i mprovemnt is sold within one year of completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale.). 0 I, as owner of the property, am exculsively 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 contractor(s) licensed pursuant to the Contractor's License Law.). 0 1 am exempt under Sec. B. 8 P.C. (Attached Certificate). Date Owner ' WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Workers' Compensation Insurance , or a certified•copy thereof (Sec. 3800. Lab. C.). Policy No. Company 0 Certified copy is hereby furnished. I Certified copy is filed with the City Building Inspectio DepartmenCor City � Department:: Date r� s Applicant%t'L� APPLICANT ILUF. MMI)P���'^ 60 ADDRESSLL�j I CITY/COMMUNITY/STATE/ZIP JOB DRESS/SPACE5lI(E/ r3��`✓Z Vn✓ CITY/COMMUNITYISTTAATE/ZIP c.a, u 1.,�;. %BOK�j PAG PRC%� C =M)1340 61 L -i TWN RNG SE 1 S TRACT LOT MOD se TRACT NAME r OWNER NAME (L. F. MI) Z k % rr\ LJ IR CONT, I (0 1 e- NAME jA �J \�1A% (I A ADDRESS ,.,. CITY/COMMUNITY/STATE/ZIP ' PHONE 3#/ - 3(10 019 LICNC AARC/ENGRRCEENG FIRM NAME ADDRESS t CITY/COMMUNITY/STATE/ZIP _ PHONE • LICNC • USE OF PERMIT , BL l5�- ZON FSB SSB SSB RSB OFC ZONE ORD N LOT SZ - TOTAL . FEE END SIDE ty a CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATIOWINSURANCE: This section need not be completed it the permit is for one hundred ($100) o, 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 Applicant NOTICE TO APPLICANT: ;IL alter 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. ' DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: 0 I hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap 3.2, Grp 2, Art 2, Sec341, Title8: C.A.C.) • 0 As owner -builder; I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from that division. 0 Division of Industrial Safety Permit No. Date Applicant 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, Civ. C.). Lender's Name Lender's AddrE I certify that I have read this application and state that the above information is correct.) agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes. Signature of Applicant or Agent Date CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have read this application and state that the information given is correct. I agree to comply with all state laws and county ordinances relating to buidling construction, and authorize a'representative of the City of La Ouinta Department of Building and Safety to enter upon the property for which I have applied for this permit for the purpose of making inspections. Signature of Applicant or Agent Print Applicant/Agent Name Date APPL/PRMT DATE n _ nn5-y4 ?k.1mb M �-; --r> > �5 j PLL G095 L -i W 1s LJ tl rt.�Cl N1+NA �E-C: l5�- TOTAL . FEE + DO VALUATION BLDG. DEPT. NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back o 33 Ventilation System 2 Ftgs & Frms 34 Plenums & Ducts 2A Slab Grade 35 1 Furnace Compart. 3 Steel 36 Inlets & Outlets 4 Grout Blocks 37. Combustion'Air 5 Bond Beams 38 Compressor 6 Roof Deck 39 Appl. Clearance 7 Framing 40 Fire Damper 8 Vents 41 Smoke Detection Device 9 Garage Fire Wall 42 Commercial Hood 10 Fireplace P. L. ❑ 43 Final 10A fireplace T.O. ❑ OWN ADDITIONAL INFORMATION SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Lath 12 Internal Lath'`' 12A Drywall 13 Finish Grade INSULATION Thick R Value 7A Walls (Batts) 126 Ceiling (Batts) 12C Ceiling (Blown) 14 Final PLUMBING APPROVALS 15 Ground Plumb 16 Water Piping 17 Rough Plumb 18 Vents .. ._. 19 Sewage. Disposal 20 Sewer 21 Water Heater 22 Water Softener 23 Water Service 24 Gas Test 25 Final Tank Pit L. Line ELECTRIC APPROVALS REAR OF PROPERTY LINE PSL PiI STREET NAME 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service 32 Final s HAMMER PUMPING INC. JOB INVOICE ' P.O. Box 2448 CATHEDRAL CITY, CALIFORNIA 92235-2448 IC'1 01 OCrl_7A AD 1ViJ� JVV'/-r-rV (619) 321-7448 CUSTOMER'S ORDER NO. D19- ORDERED 7 ORDER TAKEN BY DATE PROMISED O A.M. ❑ P.M. BILL TO ,w - PHONE ADDRESS '000 C CITY — HELPER JOBry(Q�ME AND LOCATION J e l/`A0 z (m- j La VC tlC 0' WORK ❑ CONTRACT DESC n TION OF WORK DDD 0 EXTRA S ^ /T00 t-71 r QUANT. DESCRIPTION OF MATERIAL USED PRICE AMOUNT 'OOD Gallons '000 Pumping Fee per 1000 gal, O S — 00 DDD Dumping Fee per 1000 gal. S ^ s-0 r Out of Area Fee Locating / Opening Fee (per hour) Size System: rr(, ` h re_ r / A SERVICE CHARGE OF $20 WILL BE DUE ON ALL RETURNED CHECKS. A FINANCE CHARGE OF 11/2% PER MONTH, 18% PER YEAR WILL BE CHARGED ON PAST DUE ACCOUNTS OVER 30 DAYS. HOURS LABOR AMOUNT TOTAL MATERIALS MECHANICS HELPERS Q TOTAL LABOR I hereby acknowledge the satisfactory TOTAL LABOR com tetion of the above described work: TAX SIGNAT _ G7j � DATE COMPLETED L/ oZ0 TOTAL I 1 Y v (' i NOTICE TO OWNER t Under -the California Mechanics Lien Law any contractor, subcontractor, laborer, supplier or other person who helps to improve your property, but is not pald.for•hls/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 court officer and the- proceeds of the sale used to �satisfyAhe indebtedness.'?his can hal'Ven-even if you ;have pai#,.yoy.g_W Iractor in.fuU if the subcontractors, laborers or suppliers remain unpaid. s To preserve their right to file -a claim or lien against your property, certain claimants such as subcontractors or material suppliers are required to provide you with a document entitled "Preliminary Notice.” Original (or prime) contractors and laborers for wages do not have to provide this notice. A Preliminary Notice is not a lien against your property. Its purpose Is to notify 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 cla' nn or lien against your pr6perty is ninety (90) Days after completion of your project. TO INSURE EXTRA PROTECTION FOR YOURSELF AND YOUR PROPERTY, YOU MAYVISH TO TAKE ONE OR MORE OF THE FOLLOWING STEPS: 1) Require that payments be made directly to subcontractors and material suppliers through a joint control. Any joint control agreement should include the addendufn approved by the Registrar of Contractors, 2) . Isspe joint checks for payment, made out to,.both your contractor.and*suboo►ilreetors or mateolved in the pr'ojecl.'This Vill help to insure that all persons due payment 3) After UPON making 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 OPTION YOU MUST BE CERTAIN THAT ALL MATERIAL SUPPLIERS, SUBCONTRACTORS OR LABORERS HAVE SIGNED.