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PLBG• P.O. BOX 1504 Building s 78-495 CALLE TAMPICO Address 77-900 Calle Monterey LA QUINTA, CALIFORNIA 92253 Owner Dir. & Mrs. Martin Levine Mailing Address Same City Zip Tel. La Q&13,ntaa, CA 92.253 Contractor Denboei r vEnginedring & Construction Address 68-175 Berroa -Court City Zip rLic. gl. Cathedral Ci�t� CA 92234'327 State Lic. ��, ity 3�i' & Classif. . . # Arch., Engr., Designer Address City Zip LICENSED CONTRACTOR'S I hereby affirm that& amlicensed underproV&6ns 7000) of Division 3.6f the Business and Professions effect. . . . irk J� .. IV -- d Tel. State Lic. # No. 25457 BUILDING: TYPE CONST. OCC: GRP. A.P. Number Legal Description Project Description Sever Connect Sq. Ft. No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Section - ,rce nd '7 C .AT 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, atter, improve, demolish, or repair any. stnicture, 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) of 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 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.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 Improve 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 contractors) licensed pursuant to the Contractor's License Law.) O 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION, DECLARATION 1 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 N Company , Opy 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 permit 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 anyperson in any manner so as to become subject to the Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT: d, 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 out; signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. 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. Signature of applicant— Date Mailing Address City, State, Zip Estimated Valuation $1,9700.00 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.Line Rear Setback from Rea rop.Li e Side Street Setback)1�enter Lin Side Setback from P(`operty Line FINAL DATE ' r ZIRPECT©R. ., ` On. Issued by: Date �� Pecmj Validated by: �\ y`9s Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBIfh: FL S 1ST FL. SQ. FT. ® $ UNITS COLL. AREA 2ND FL. SQ. FT. YARD SPKLR SYSTEM FOR. SQ. FT. ® MOBILEHOME SVC. BAR SINK GAR. SQ_ FT. ® POWER OUTLET ROOF DRAINS CAR P. I SQ. FT. DUCT WORK DRAINAGE PIPING WALL SQ. FT. DRINKING FOUNTAIN SQ FT ® HEATING (FINAL) URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED GRADING • cu. yd. $ plus x$ LAUNDRYTRAY AIR HANDLING UNIT CFM ��NAL INSP. 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. SQ. FT. ® c BATH TUB SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1+A c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER SPARK ARRESTOR GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL 1 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 EWA OR ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING • cu. yd. $ plus x$ =$ LUMBER GR.� ��NAL INSP. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION /� S CERT. OCC. FENCE FINAL INSPECTOR'S SIONATURESIINITIALS GARDEN WALL FINAL '-*W PUMPING INC. JOB INVOICE a P.O. Box 2448 CATHEDRAL CITY, CALIFORNIA 92235-2448 I&Ini 9QA 7AAC jw.Jj Vww-/77,V d (619) 321-74 8 s - DESCRIPTION OF MATERIAL USED CUS !IE ORDER NO. "� DATE ORDERED S --d -r j�— ORDER TAKEN BY • DATE PROMISED ❑ A.M. ❑ P.M. BILL TO % -,.. (�_Ja N J r PHONE ADDRESS Pumping Fee per 1000 gal. MEaNIC k. CITY HELPER JOB N4 M eC&ON e / O e rte AY WORK DESCRIPTIO WORK S ^^ L /` O CONTRACT ❑EXTRA V _ ,.,/� aC> QUANT. DESCRIPTION OF MATERIAL USED PRICE AMOUNT '000 Gallons f 00 Pumping Fee per 1000 gal. f Q OO 'Pumping Fee per 1000 gal. ,.,/� aC> Out of Area Fee Locating / Opening Fee (per hour) Size System: It 4 t C r r< lit 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 ;� Q .y HELPERS Q TOTAL LABOR I hereby aZowledg�th atisfactory completioi�l°°of thea ov esgri¢ed work: TOTAL LABOR TAX SI ATU d _DATECOM�ETE.q TOTAL �� F- Under-thQ)Califortlia Mechanics Lien Law any-contractor„subcontractor`4aborer, 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 lifter a court hearing, your property could be sold by a court, officer and the proceeds of the sale 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 Pr6liminary Notice is,nof a lien against your property. Its purpose is to. notify you. of persons who may have a right to file a ilea against your property if they are not paid. Generally, the maximum time allowed for filing a claim or lien against your property is ninety (80) 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 c6ntrol 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, §ubconti`actor 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. 4 � ,