14401 (PLBG)i
Building'
Owner
P.O. BOX 1504 N o • 14401,
51-817 Ave. Velasco LA QUINTA, CALIFORNIA 9253
Fir. & .rs. Jorge Navarrete
BUILDING: TYPE CONST. OCC. GRP..
Mailing
Address same
CiLs1 . Q13inta, Zip92253
Tel.
Contractor r
benVoer- Engineering & Consstruotion
Adt,p175, Berros Court -
Cit ZipTel
t"athedral Ci y, CA 9223'! (619)327-22
State Lic. City
& Classif. B 1984563. Lic. #
Arch:;Engr.,
Designer
Address
City
1 hereby affirm thati
,l am licensed and
7000) of Division 3 of the Business and
effect, f f
Tel.
State
Lic. #
9
Number
Legal Description .
Project Description Serer Connect
Sq. Ft. No. No. Dw.
Size - Stories Units
New ❑ . Add ❑ . Alter ❑ Repair ❑ Demolition ❑
icing with Section
is in p II force and
a M1
DATE
tt11 OWNER -BUILDER DECLARATION
I hereby affirrtf:ttf t 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, 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 riot'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. ownemployees,
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 corn
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) (tensed pursuant to the Contractor's License Law.)
❑ 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.) -
Po lic o. 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 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 *any person In any manner so as to become subject to the Workers' Compensation
Laws of California
Date Owner
NOTICE TO APPLICANT: It, 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's 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
;timated Valuation
PERMIT AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
w
Plumbing 3 ' 91
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL` 30.90
REMARKS
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 l
Validated by:
NV �
Validation: . a t
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM -
2ND FL. SO. FT. p
FORMS
SEWER OR SEPTIC TANK
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
FIREPLACE
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LATHING
LAUNDRYTRAY
AIR HANDLING UNIT CFM
FINISH GRADING
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 ® 1 Va 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 GOND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
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.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
SA'1�'/✓ A;rA�REMARKS:
/VENTILATION�v — „' V l T
FIRE ZONE ROOFING '
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
HAMMER PUMPING l4gj JOB INVOICE
P.O. Box 244
,CATHEI)RAL CITY, CALIFORNIA 92235-2448
IQ1A1 OCA 7AA0
i---- --- - ---
(619) 321-7448
DESCRIPTION OF MATERIAL USED
CUSTOMER'S ORDER NO.
DATE ORDERED
1-5 �- `5
'ORDER TAKEN BY
DATE PROMISED O A.M.
❑ P.M.
BILL TO
7�.� - SIC�
PHONE
ADDRESS
Pumping Fee per 1000 gal.
MECF{}ty11C {'
µ�i lA:.•
CITY
HELPER
JOB NgME A Or TION
C ^/
DAY WORK
DESCRIP Nc.<OF WORK
1n� �.. t C_
Dumping Fee per 1000 gal.
❑CONTRACT
❑ EXTRA
QUANT.
DESCRIPTION OF MATERIAL USED
PRICE
AMOUNT
000
Gallons
60 (9
Pumping Fee per 1000 gal.
60Uo
Dumping Fee per 1000 gal.
Out of Area Fee
Locating / Opening Fee (per hour)
Size System:
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
1 hereby acknowledge the satisfactory
completion of the above described work:
TOTAL LABOR
TAX
SIGNATURE
�_:��j �
DATE COMPLETED
5_ T
TOTAL
r a,
O
Underlhe California Mechanics Lien LaW, any contractor, subcontractor, laborer, supplier
or other person who helps to improve youde.property, but is not paid for�his/her work or.
'
supplies, has a right to enforce a claim against your property. his 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 can happen even if you have paid your contractor in full -if the
subcontractors, laborers or suppliers remain unpaid.
To preserve their. Tight to file a claim or lien against your property, certain claimants such
as subconi:ractors or material suppliers are required to provide you with a document entitled
"PraNmmary Notices" Original (or prime) contractors and laborers for wages do not have to
provide ti`tis notice. A Preliminary Notice is not a lien against your property. Its pucpos�a 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 Tien against your property is
ninety (SSU) Days alter completion of your project.
TO INSURE EXTRA PROTEfITION FOR YOURSELF ANO YOUR PROPERTY,
YGU MAY KNISH TO TAKE ONE OR MORE OF THE FOLLOWING STEPS:
1) Require that payments be made directly to subcontractors and maierial 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 ou,1 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 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.