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PLBG 15068-. Address.. ..68-475'. 36rioa court City,& Cathed i �i � ZiC;p o � i 234 Tel .: ' 327d-2200 . State Llc `�rJ33. Cityi�...:, ... & Classif ic. # Arch Engr ;' Sq. Ft.. ;No. -,..!'-""No. Dw - Size Units '- '.Designer J` ' New ❑ - ' .".. Add ❑ Alter❑ .. Repair' ❑ ` DemollLon 0 w Address f:: Tel. A CityZip State ,L'ic: # • ;LICENSED CONTRACTOR'S DECLARATION . ^ ' I hereby affirmdhat 1 am licensed�una' r "provisions of .Chapter 9 (commencing with Section ' 7000) 'of Diviss(ii,6�n 3 of}the�Business and Professions Code! and my,license.is inff I fforr� and effect �� s ..- .. .. .. .. j" . ' BLGNATURE• 3a...C�/' r.% //�'••' DATE 7' •OWNER BUILDER DECLARATION Lhereby affirm that I am exempt.from the Contractor's License Law for the following.• • reason:.(Set.. 7031:5;8usiness,and Professions Code: Any dty•or.county, ' which reeu(res a- • pemrit to construct, after, -improve, demolish, or repair any structure; prior to its 'issuance. also -•requires the- applicant for'such: pemtit tofile a signed. statement that he Is licensed. pursuant. to " .lhe-provisions of. the Contractor's License Law, Chapter 9?(commencing with. Sect ion_ 9000) ol-.• Divlsfon 3 of the Business and.:Protesskins 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 f&a civil penalty o/ not'more than live hundred dollars .($500).:. •. a ­ '• - ❑ I, as owner of.1he property,.or my employees with wages as theii sole compensation, will ' do the work, and.the structure is not intended or offered forsale3(Sac: 7044, :Buisness and ' Professions:Code:�.The'Contractor's License Law does not - apply, to an owner of, property who., builds or, improves thereon. mid. who does such :work himself- or through his own- employees, provided. that' such, improvements. are not intended. or offered for sale. If, 'however, the building - • or improvementissold within one year of completion, the owner -builder will have the burden of proving that he did not build or improve for, the purpose of sale:) �...:. .: ... .. 'al, as owner of the property,'am exclusively contracting:with licensed contractors to con- slruct the project. (Sec.; 7044,'9usfness and Prolessbns Code: The Contrsbtor'sLicense-Law does not apply .toan ownero/.property: who builds•or improves,thereon,-and whoi'contracts4or$-M:I::'• such projects with'a $ontiattor(s) (tensed pursuant to the Contractor's License Law:) .•.. ,- .. ❑ I am exempt under Sec: " \ ' rB. 8 P.C. for this reason - r -= Estimated Valuation'.-.,y9'�� r• _< ' PERMIT AMOUNT - -. �• - } ;, plari.:Chk ,De �• - '` - " p- A. Plan Chk BaP. " COflst.' t ' - MACtI. •, ' s.*` EleCtrlCdl ' • ' ' _ ...Plumbing '- a 00 - .... _ Gradin g Driveway Enc. " 'Date 'Owner Infrastructure ' WORKERS' COMPENSATION DECLARATION Ihereby, affirm that I .have `a certificate'of "consent to self-insure,'or,a•.certificate'of Worker s Compensation Insurance, ora certified copy thereof..(Sec. 9800; Labor Code.) Policy e•rea'"„- .. Company ,Copy is filed with.the city. ❑ Certified copy is hereby furnished. :r s TOTAL o 3 Q A Q CERTIFICATE OF EXEMPTION FROM; `, • WORKERS' COMPENSATION INSURANCE , , REMARKS . - - - - - (This section need:.not be completed if the permit is for. one hundred dollars ($100) valuation or less )' - :.. ".. - .. -.. .. �. I, certify thaam�the,perfomtance of thg'work.for which .this permit'; is issuedf l shall not employ.,any pperson tn:any'manner'so as -to become'subject.to the Workers' Compensation `. Laws of California . .. .• ;. .. Date net NOTICE - TO APPLICANT:,Bafer„mMang.dais Ce�cate'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. - • '-ZONE? "• '� "•BY:•''•' - - - ,M inlnlum, $etback.'Dlstah6es:- Front Setback from Center Line 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 LA13OR'CODE INTEREST,'AND Rear Setback from. Rear Prop Line Side Street Setback from!ee ter\Line ' - . /l/ 7 Side.Setback from Propert1 /Clrle' r ATTORNEY'S FEES: -This,is a build'inF-- g permit when p ended filled out, signed and validated and is subtecl to expiration if work thereunder.is suspended for 160 days.. .. ... •' . I.certify'that I'have read this- application and`stateahat the:above information ns 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 enterthe -above, ' mentioned property for inspection purposes. IValidated FINAL DATE INSP CTOR'/� _ . ^ U Issued -by. Date'' 2. h, Permit:, '-- by. Signature of applicant : Date 'r Mailing. Address v /�S '.Validation: ' City, State, Zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBINU FEES! 1ST FL. SQ. FT. ® $ 2ND FL. SQ. FT. p POR. SQ. FT. ® GAR. SQ. FT. ® CAR P. 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 BONDING FLOOR DRAIN MECHANICAL FEES FORMS WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APPJEOUIP. LAUNDRY TRAY AIR HANDLING UNIT CFM TEMP. POLE 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 /s Q /J` FINAL INSP. SO. FT. ®c WATER HEATER MAX. HEATER OUTPUT,'B.T.U. SO. FT. RESID ® 1 Va c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER VENTILATION GAS PIPING PERMIT FEE FIRE ZONE ROOFING ' 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 SEW R S 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. /s Q /J` FINAL INSP. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING ' FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING ��ff FINAL INSPECTION 7 9� CERT. OCC. FENCE FINAL INSPECTOR'S SIONATURESJINITIALS GARDEN WALL FINAL HAMMER PUMPING INC. JOB INVOICE P.O. Box 2448 CATHEDRAL CITY, CALIFORNIA 92235-2448 i W.. vWw-i tiv (619) 321-7448 CUSTOMER'S ORDER NO. DATE ORDERED G — ;'� 3 —% AMOUNT ORDER TAKEN BY DATE PROMISED ❑ A.M. ❑ P.M. BILL TO ♦\`\ /` - ' Pumping Fee per 1000 gal. PHONE 40 - ADDRESS MECHC ` 000 Dumping Fee per 1000 gal. CITY HELPER JOB tyU MYNpz L(�'JtCpJ�j)ON . / 1 �IZ C`. h� T{V WORK r DESCRIPTIO F WORK CONTRACT ❑ ExTRA. Out of Area Fee 17eO QUANT. DESCRIPTION OF MATERIAL USED PRICE AMOUNT 000 Gallons 06 V Pumping Fee per 1000 gal. a 40 - 000 Dumping Fee per 1000 gal. ,i. Out of Area Fee Locating / Opening Fee (per hour) Size System: r . ,TL 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 TOTAL LABOR HELPERS @ I hereby acknowledge the satisfactory completion of the above described work: _ TOTAL LABOR TAX SIG TURE DATE COMPLETED oZ3 �1S TOTAL ►. TjIlij ! Jf. E rCt 11101I -rr.. Under the ICalifornia Mechanics Lien Law any contractor, subcontractor; laborer, •supplier or 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 soWby a court officer and the proceeds -of the sate used to satisfy the indebtedness. This can happen even if you have paid your contractor in full if the subcontractors, laborers or suppliers remain unpaid. 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 claim or lien against your property is ninety (90)'Days 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: 1) Require 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 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 iniportant, 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.