PLBG (15065)P.O. BOX 1504 N o • 15 06 5 . -
Buildingt 78 495,CALLE TAMPICO
Address 52A_900 Ave. Navarro LA QUINTA; CALIFORNIA 92253
Owner . Nadine LOT33ielly
BUILDING: TYPE CONST: OCC: GRP.
Mailing
Address lame
A.P. Number •
City Zip Tel.
La Quinta, CA 92253 Legal Description
Contractor Project Description Sewer connect
Denbaer Engineer ng & Ct ins t�etion
Address
6$--1-75 E �erros Court
City " . y Zip Tela
Cathedral City ��23� 32i-2200
State Lic.g684563. City��
& Classif.. Lic. #
Arch:, Engr.,
Designer
Address Tel.
City Zip State
Lic. # "
LICENSED CONTRACTOR'S,DECLARATION
I hereby affirm'that I am licensed, -Rer provisions orf Chapter9-(commencing with Section
70pp) of Div' "ion 3 of,.the Business and Professiohs, ode, and my license is in. f II fopr,,Cte and
- effect.f / sort
SIGNATURE DATE
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, after, 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) 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 five 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.)
O -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 contractor(s)(icensed pursuant to the Contractor's License Law.)
D 1 am exempt under Sec B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Co�1,npensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Polixcy-P!, .Company
L9n!Copy is filed with the city, ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM.
WORKERS' COMPENSATION INSURANCE
(This section need *not be completed i1 the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of thg 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. 8, 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' COMPENSATIONCOVERAGE 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 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 Date
Mailing. Address
City, State, Zip
ZONE:
BY: `
Minimum Setback Distances:
Sq. Ft.
Size
No.
Stories -
No. Dw.
Units
New ❑ Add -0
t Alter ❑
Repair.❑ Demolition ❑
Side Setback from Property,Line
FINAL DATE
INSPECTOR—
NSPECTOR
Issued
Issued by:
Date , -Permit(s
Validated by:
%Q
Cy.
Estimated Valuation
$1,.700.x00
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 Rear Prop bin
' Side Steeet Setback. from Center Li e
Side Setback from Property,Line
FINAL DATE
INSPECTOR—
NSPECTOR
Issued
Issued by:
Date , -Permit(s
Validated by:
%Q
Cy.
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
1ST FL. SO. FT. ® $
2ND FL. SQ. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CARP. SD. FT.
WALL SO. FT.
SO. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
1.
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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.
SO. FT. ® c
BATH TUB
BOND BEAM
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1 Va c
SEWAGE DISPOSAL
LUMBER GR.
SO.FT.GAR ® 3/ac
HOUSE SEWER
FINAL INSP.
ROOFING
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
SEW R S 0
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_ $
LUMBER GR.
Ay4wawkl / / 16 FINAL INSP.
!C
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
72
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC. 71
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
ro ��{},�,,,i,11..�a. .i.fv.. ',�•7, wa .y,y; ia,m..%'.�"7 n«C"1'n..t� •h
TRI=STAR CONSTRUCTION
P.O. BOX 542
CATHEDRAL CITY, CA. 92235
ph. (619)• 321-0898
fait. (619) 321-7798
June 15, 1995
TO; CITY OF LA QUINTA
RE: 52-900 NAVARRO
PER MY AGREEMENT WITH -TRI -STAR CONSTRUCTION I WILL RE -SEED OR
OTHERWISEkCOMPLETE MY YA:Rb AFTER THE INSTALLATION OF THE SEWER.
TRI -STAR HAS FURTHER LEFT,_A,STOCKPILE OF FILL MATERIAL FOR MY USE.
THANK YOU,,
signature
please print name'
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, UOY WAFT
HAMMER PUMPING INC. JOB INVOICE
P.O. Box -2448"
CATHEDRAL CITY, CALIFORNIA 92235-2448
rCIO 'cn 7AAO
QUANT.
waar vvv-i -- —
CUSTOMER'S ORDER NO.
DATE ORDERD
ODD
(619) 321-7448
—
000
ORDER TAKEN BY
DATE PROMISED ❑ A.M.
C
❑ P.M.
BILL TO
. _ -^
/ V
PHONE
ADDRESS
�(� Q
MEQf,1ANIC
CITU
HELPER `
JOB SSD LVVV V ip O
Q• C
[]SAY WORK
DESCRIPTION
K
F�
(\
CONTRACT
-.P—�
�
K/
O (Of"❑EXTRA
Locating / Opening Fee (per hour)
G O
—
QUANT.
DESCRIPTION OF MATERIAL USED
PRICE
AMOUNT
ODD
Gallons
000
Pumping Fee per 1000 gal.
C
Dumping Fee per 1000 gal. '
�(� Q
Out of Area Fee
Locating / Opening Fee (per hour)
Size System:
0 44
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 Qa
HELPERS Q
TOTAL
LABOR
,
I hereby acknowledge the satisfactory TOTALLABOR
completion of the above described work: (�,.
TAX
\GN - URE -�
TE CO; _PL/"
- TOTAL
-TOTAL,
—
'�—
NOTICE TO OWNER
Under -the California Mechan_ ics Lien Law'i3ny*contractor, shbcontrdctor,.laborer; supplier
or other person who helps to improve your property, but is not paia"for his/hpr work or
supplies, has a right to dMorce 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
satisfy the indebtedness. This carr 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.", Originai (pr 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),nays after compietiorl 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 invoh3ed in that portion of the
work for which payment was made. bn -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.
•