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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.