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13078 (PLBG)T 0 4hf 4 4 a" Building Address 53-605 Bermudas Owner Address same City Zip i _La Ominta, CA 92253 Contractor Eccmo serer service Address P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 ILDING: TYPE CONST Number No. OCC: GRP.: Legal Description Project Description Sewer Rook Up' 13078 P.O. Box 192 Cit Zip Falm Desert, fA 92263 Tela 346-2793 1 State Lic. ik Classif. 480961 City Lic. # 342 Sq. Ft. Size No. No. Dw. Stories Units Arch:, Engr., Designer New ❑' Add ❑ Alter ❑ Repair ❑ Demolition ❑ 'Address Tel. City, - Zip State Lic. # + A LICENSED CONTRACTOR'S DECLARATION I hereby affirm thatrl am licensed under provisions of Chapter 9 (commencing with Section 7000)0 -Di ision,3 of the Business and Professions Cod ,and my licenseri is in full force an i effect. SIGNATURE y y{OWNER-BUILDER DECLARATION I hereby affirm that I arrtr`hqexempt 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, alter, 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, provkletl _ 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; asowner 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.) 0 I am exempt under Sec. B. & P.C. for this reason Estimated Valuation $650 . Qm PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech.- . Electrical Plumbing 30.00 S. M. 1. Grading 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, or a certified copy thereof. (Sec. 3800, Labor Code.) Policyy� No. Company Q (;opy is filed with the city. ❑ Certifiedcopy.is hereby furnished. ' — -. TOTAL CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation _ ,., ., , r -, „ ,a as r- r _ .t , _ ,n ^• _ + or less.) .�yr -- ,, ,, d r I certify that in the performance of the work for which this permit is issued, I shall not � V NASD If employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT., 11, after making this Certificate o1 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. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address 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: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validati CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS COLL. AREA r h ROUGH PLUMB. YARD SPKLR SYSTEM 2ND FL. SQ. FT. STORAGE TANK FORMS MOBILEHOME SVC. BAR SINK POR. SQ. FT. p ROCK STORAGE GAR. SO. FT. ® POWER OUTLET ROOF DRAINS HEATING (FINAL) DRAINAGE PIPING CAR P. I SQ. FT. ® GAS (FINAL) TEMP. POLE WALL SQ. FT. DRINKING FOUNTAIN SQ FT ® WATER HEATER URINAL ESTIMATED CONSTRUCTION VALUATION $ - WATER PIPING NOTE: Not to be used as property tax valuation WATER SYSTEM FLOOR DRAIN MECHANICAL FEES - WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY 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 SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER MESH GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEEPLUMB. 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 0 SEWER65iS{#i6SACLK��/ -4930UGH WIRING /METER DUCTWORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) 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. FINAL INSP. FRAMING FINAL INSP. ROOFING Cb REMARKS: c G VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION'S ��_ /J CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL COACHELLA VALLEY WATER DISTRICT RECEIPT DETAIL NOW 4�.�� CASH Received From: dZ /n ( CN U�� 1 J Q , • C__ �'i �� Date: —! 67V Address: '^ (7 d riiLks--,60 3 �••�- C 2_ �' C 1017-26e) Account No. ( .L� z Lot(s) cS T 4 ^1 Tract �Service Address Address S O g(%F A�n n4 U >:�A-� G.A. Code ❑ Meter(s) $ ❑ Service(s) ❑ Backflow(s) ❑ House Lateral(s) ❑ DetectorCheck(s) ❑ Meter Surcharge �^-� -^� anitationCapacity Charge 9V / ❑ W.S.B.F.C. ❑ Temporary Construction Meter ❑ Turn on Charge ❑ Uncollected Account - Name ❑ Inspection Fee - Tract - Fee - ❑ Plan Check Fees Water I Sewer - Tract - 0 ❑ Bond Payment - A.D. - Bond Assmt. ❑ Customer Deposit ❑ Other ��- •r '— TOTAL $ d Remarks: / L t-K A t / I ❑Copy to: Cash Water Service Check �l Money '(.J Cashier Order 1 ;Mi ,� CVWD-438(11189)