15298 (PLBG)Buil lIg 53^233 Ave. Carranza
T, ___
Owner
}avid Sweet
Mailing
Address P.O. BOX 2094
C�*t6sta Mesa, C1Zip 92628
CTNTley PlurJAng
.Address
P.O. Box 665
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
City Zip Tel.:
Indio, CA 92202 347-3629
State Lic. City
& Classif. C36 273068 Lic. # 101
Arch., Engr.,
Designer
Address Tel.
CityZip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
1hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section
900) of Divisiog lot the Business and ProfMIo9s Code, and my license is in full force and
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 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
orImprovement 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 contractor(s) ticensed pursuant to the Contractors -License Law.)
O 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 Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No:.,f" Company
&dopy 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 thg 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: If, 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 it 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. 15298
BUILDING: TYPE CONST. OCC. GRP
A.P. Number
Legal Description
Project Description
Sewer Cvunect
Issued by:
Date
Validated by:
Validation:
Sq. Ft.
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ .
Demolition ❑
r�
Estimated Valuation
$c •�i,%A
`Pfi>D.0I
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 Prob. Lj.�e
Side Street Setback froom/,Center Line
Side Setback fr� �/of party Line � .
r/. V/ \
FINAL DATE
4�NSPEC
Issued by:
Date
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
IST FL. SO. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. SO. FT. p
FORMS
SEW OR� .
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
CAR P. 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
FRAMING
FLOOR DRAIN
MECHANICAL FEES
,»
toj
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
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.
SO. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
INSULATIONISOUND
SO.FT.GAR ® 3/.c
HOUSE SEWER
FINISH GRADING
GAS PIPING
PERMIT FEE
FINAL INSPECTION
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 OR� .
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.
��//
/f.w ;7,// , Y FINAL INSP.
FRAMING
FINAL INSP. �J 9
J
ROOFING
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toj
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
Received From:.
Address:
Account No. -
Service Address
COACHELLA VALLEY WATER DISTRICT
CASH RECEIPT DETAIL
N_' ' $41136
❑ Meter(s) S
❑ Service(s)
❑ Backflow(s)
❑ House Lateral(s)
❑ DetectorCheck(s)
❑ Meter Surcharge
�Sanitation Capacity Charge ;4L_ :5S %�5 -L1e-7
❑ W.S.B.F.C.
❑ Temporary Construction Meter
❑ Tum on Charge
❑ Uncollected Account - Name
❑ Inspection Fee - Tract -
r_ -
Fee -
❑ Plan Check Fees Water I Sewer -
Tract -
❑ Bond Payment - A.D. - Bond
Assmt
❑ Customer Deposit
❑ Other
TOTAL S 7 7 E5 <7,, c)
Remarks /l) �/tL� �(/'! 1/ )i J //"//..�?i- L�
❑Copy to:
Water Service
Check
�Q�,�
•,.5-
if V
Money
Cashier
i Ofdef
-
CMD -438(11189)
HAMMER PUMPING INC. JOB INVOICE
{ P.O. Box 2448
K� CATHEDRAL CITY, CALIFORNIA 92235-2448,x,
1ew1n1 "Icn -FAAn
\Vi.7/ JVV-/'T'TV CUSTOMER'S ORDER NO.
(619) 321-7448
ORDER TAKEN BY
D ORDERED
_ /3 - 9 r
DATE PROMISED D A.M.
D P.M.
BILL TO ih.
^ G m
NE
ADDRESS
M'6G
��
CITY
A4
HELPER
JOB NAME AND ION
+� 3� AVC
❑DAY WORK
DESCRIPTION OF WO
f�
❑CONTRACT
❑ EXTRA
6/ r ke aj r
QUAPfr.
DESCRIPTION OF ATERIAI USED
PRICE
AMOUNT
Gallons
Pumping Fee per 1000 gal.
Dumping Fee per 1000 gal.
Out of Area Fee
Locating / Opening Fee (per hour)
Size System:
C&
A SERVICE CHARGE OF $20 WILL 8E 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
HELPERS Q
TOTAL
LABOR
I hereby acknowledge the satisfactory
completion of the above described work:
TOTAL LABOR
TAX
SIGNATURE /��,
i/�
DATE COMPLETED
TOTAL
SAV,
=� V
Under the California Meqhanicsl�enaaw. any contractor, subcQntractorLlaborer, suppiie►,
or other person who helps•to improve youi property; but is not paid for -his/her work or
supplies, has a right to enforce claim against your property. Tbis 'mearis 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 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 ajclaim or lien against your propefty,-certain claimant4such
as subcontractors or material suppliers are required to provide you with a document entitled
"Preliminar, 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) pays after completion of your project. W` t
y TO INSURE EXTRA PROTECTION FbR YOURSELF AND YOUR PROOKI,
YOU MAY WISH TO TAKE ONE OR MORE OF.THE FOLLOWING STEPS: :
1) Require that payments be made directly to subcontractors and material suppliers 'tough
a joint control. Any joint control agreement should include the addendum approved :hvAfie
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 profiects-involving improvements to a single family
residence or a duplex owned by individuals, the persons signing these`reieases rose 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.
*A r
. `-A,.