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15051 (PLBG)7_. c% 4 Qum& Building Address 52-799 Arte Owner fir. �E?T1�i�G Address 52_799 Ave Carra.nza City 2ip Tel. La' - Quinta 92253 Contractor Econo Sewer Address P.O. Box Box i32 P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Palm Desert 92261 346-2733 State Lic: City & Classif. C42 480961 Lic. # 342 Arch., Engr.; Designer Address Tel. City (Zip ( State Lic. # [[yy// IfICENJSED CONTRACTOR'S DECLARATION Ihe�Syaffirm that,l am licenyfad under provisions of Chapter 9�(commencing with Section 7 of bbi4ii3ionr of the 8�si,�ess and Professions Codes cense is in full force agd• ,effect. _ a d1{�r' �. E.- JOWNEWBUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 703.1.5,BusinAs and Professions Code: Any city or county which requires a permit to construct, 'after, imhove, demolish, or repair any structure, prior to its issuance also requires the applicant fdr,sqo 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 live 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 withii 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.) ❑ 1, 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) licensed pursuant to the Contractor's License Law.) ❑ I aim exempt under SqcQa8 P.C. for this reason WORKERS' COMPENSATION DECLARATION I hereby affirm that I Kave,a,certifi4te of consent to self -insure, or a certificate of Worker s Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. 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 it 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 any parson in any manner so as to become subject to the Workers' Compensation laws of California. Date Owner NOTICE TO APPLICANT.- tl, 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 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 No. 1505. BUILDING: TYPE CONST. OCC. GRP. A.P. Number Legal Description Project Description :"a Rc)nk mp Sq. Ft. No. No. Dw. Size Stories - Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ 5timated Valuation $900.00 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. ;38.00'.'- 0 -•.Mech. Mech. Electrical Plumbing S.M.I. Grading . Driveway Enc. Infrastructure TOTAL *30.08 REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rea' o Line Side Street Setbac/eCent Line Side Setback fro y ' FINAL DATE INSPEO'TO v Issued by: Dat y �R�e'7,7 it Validated by: \� Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES• 1ST FL. SO. FT. ® $ UNITS SLAB GRADE ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL. SO. FT. p FORMS C n2 OR S ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SO. FT. ® GAS (ROUGH) METER LOOP GAR. SO. FT. ® POWER OUTLET ROOF DRAINS GAS (FINAL) TEMP. POLE DRAINAGE PIPING CARP. SO. FT. ® GROUT WATER HEATER WALL SO. FT. FINAL INSP. DRINKING FOUNTAIN. SO. FT. ® WATER SYSTEM URINAL ESTIMATED CONSTRUCTION VALUATION $ - _$ WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL . FURNACE UNIT WALL FLOOR SUSPENDED VENTILATION LAUNDRYTRAY " AIR HANDLING UNIT CFM FIRE ZONE ROOFING 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 1BATH TUB LATHING SQ. FT. ®c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1+/. c SEWAGE DISPOSAL SO.FT.GAR ® 3/ac HOUSE SEWER 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 C n2 OR S ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP./EQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ - _$ LUMBER GR. �w FINAL INSP. FRAMING FINAL INSP.9r v ROOFING 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 ECONO SEWER SERVICES P.O. Box 192 PALM DESERT, CALIFORNIA 92261 45444 PHONE 328-7760 346-2793-7RDER TOTAL MATERIALS CUSTOMER'S ORDER NO. PHONE MECH HELPER STARTING DATE PLEASE PA:1�11�1-101 NO STATEMENT WILL BE. MAILED —ool TAX BILL TO ORDER TAKEN BY ADDRESS $ DAY WORK CONTRACT CITY EXTRA JOB NA ND LOC ION w QiVI JOB PHONE i✓ ION OF PAV PAYMENT TERMS NFT 30 DAYS FROM DATE OF SERVICE 1%% PER MONTH CHARGE AFTER 30 DAYS ❑ No one home 0 Total amount due Total billing to Signature for above work. or be mailed after PRODUCTees Ina I hereby acknowledge the satisfactory completion completion of work Croon Maa01t01171. of the above described work TOTAL MATERIALS TOTALLABOR PLEASE PA:1�11�1-101 NO STATEMENT WILL BE. MAILED —ool TAX DATE COMPLETED WORK ORDERED BY TOTALAMOUNT $ ❑ No one home 0 Total amount due Total billing to Signature for above work. or be mailed after PRODUCTees Ina I hereby acknowledge the satisfactory completion completion of work Croon Maa01t01171. of the above described work