Loading...
11132 (PLBG)14 P.O. BOX 1504 N o . 11132- Building 41132- Building 52-101 Velasco78-105 CALLE ESTADO Address LA QUINTA, CALIFORNIA 92253 Eladio Orozco Mailing �� Address City IQ1X T3 c Zip92253 Tel. Contractor ty State Lic. I City & Classif. Lic. # Arch., Engr:, Designer Address Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION -I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. _SIGNATURE DATE 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, after, 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) o1 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 o/ not more than Ove hundred dollars ($500). \as owner of the property, or my employees with wages as their sole compensation, will db the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Pro/fissions 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'saie. 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. (Seca 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 am. exempt under Sec. B. & P.C. for this reason �y Date Owne: S f --a r,` .r..,-^. r!%�+' �?'�`• !_e "'i WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, ora 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 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-- r Date Owner s NOTICE TO APPLICANT: II alter making. this Certificate' of Exemption you should-becarne subject to the Workers' Cbmpinsatiori provisions of the Labor Code,. you must - forthwith comply with such provisions of 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 BUILDING: TYPE CONST. OCC: GRP. A.P. Number Legal Description Project Description Sewer Hook Up Sq. Ft. Size No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition '❑ Estimated Valuation®.O PERMIT AMOUNT. .Plan Chk. Dep. Plan Chk. Bal. Const. Mech. , Electrical Plumbing 30.00 S.M.I. Grading Driveway Enc. Infrastructure TOTAL J U • U U 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, Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS SLAB GRADE 2ND FL. SQ. FT. BONDING YARD SPKLR SYSTEM POR. SQ. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. SQ. FT. GAS (ROUGH) DRAINAGE PIPING WALL SQ. FT. OTHER APPJEQUIP. DRINKING FOUNTAIN. SO FT ® - TEMP. POLE URINAL ESTIMATED CONSTRUCTION VALUATION $ GROUT WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SYSTEM WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP. 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, TEM/PERM 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 ® 1% c SEWAGE DISPOSAL GAR. FIREWALL SQ.FT.GAR ® 3/ic HOUSE SEWER LATHING GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE LdECH.FEE PL.CK.FEE CONST. FdELECT.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 vy SEWER Ofd-SEBIAC TAtia (� UGH WIRING. DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. 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 �- REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTIONt CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL VALLEY WIDE -PUMPING SERVICE:-- A "Your Waste Is .Our. Problem" . `,,:`.JOB INVOICE 848.1 JUI 11 lJG• YYQy JUIIC 1 JJ - DESCRIPTION OF MATERIAL USED - CUSTOMER'S ORDER NO.. - DATE ORDERED' t - PALM SPRINGS, CA 92262, Gallons D 00 ® :.� ORDER TAKEN BY DATE PROMISED. ❑ A.M. C C (760) 322=2400 • (760) 347-3545 ❑ P.M. BILL PHONE GwJI C o ADDRF'$Si MEC NIC Out of Area Fee CITY1 , �� ELPER - O� �' !% 1C/ Gi ' Locating / Opening Fee (per hour) JOB NAME AND LOCATION ;J D �..t, Ulla j Q l��I�� —` ❑DAY WORK DESCRIPTION OF WORK ❑ CONTRACT' O EXTRA �r �.I Size System: �s %'_ 114�wzz C. QUANT. DESCRIPTION OF MATERIAL USED - PRICE AMOUNT Gallons D 00 ® Q � a - Pumping Fee per 1000 gal. Dumping Fee per 1000 gal. Out of Area Fee Locating / Opening Fee (per hour) Size System: A SERVICE CHARGE OF $20 WILL BE DUE ON ALL RETURNED CHECKS. A FINANCE CHARGE OF 11/2% PER MONTH, 18% PER YEAR WILL BE CHARGED ON PAST DUE ACCOUNTS OVER 30 DAYS. ' HOURS LABOR AMOUNT TOTAL MATERIALS MECHANICS @ HELPERS @ / TOTAL LABOR I hereby acknowledge the satisfactory completion of the above described work: IOTAI !LABOR �.r TAX - SIGNATURE Al DATE COMPLETED �? TOTAL®�-- r - 4 To Reorder Call NEB$ CUSTI M -printing service TOLL FREE 1.800-888-6327 NESS, Inc., Peterborough, NH 03458. Ref. No: G 710703566 �;�I C04QC�iO Undw 2hs CaWovnia Pftd cnr cs alaao L,awe any subcoMraaaor, lalbovicer: supplip-; ©r affhw peman �Mzo E�abpe- 4o lmprovu Vouv propeow, but ss n®3 pLok+k ffrw_hL';hs;a evovh nV zuppH e2, h&&a a eight to c -)ns w a clala� against your pv®paM. This menwp 2V`@g aff2w n court 4saft9HJ, ymw Ipvopsrn-y could fa sn9d by n couwt ©fabcw and 4h pvoceeds U� uscv to Wi3iV the aoadef W'mesa. This can hvppen teem W you haus paid 31ow comrsaw bra lu H IN @h- ut�cflea4vac2®ra, Ha2�,,)revs or suppliers rcernain uapabd. rho przoevrrre CGaele right to ffale 0 cisif-a OF item againol yauF prepany, csnahs clalmans sfx�h E,e�C�c®�Qrac4�v� ®r av na eeHa1 eupplare ars vuqu➢ to proddd® youw84Ga a dauu�e�eco4 c4ba4eI " 7VeH "-n9nary Notice." O fti aal (or pvuma) contvacQom and inbwers for euages do rac4 have 4o provr de this notice. A pre iav inavy MDR® cs is not a Ilam against y®cr property. ks purpoze as 4o v o'Wy you ®4 pwsona ujho may have a rightto file a thea aagaicas2 your propzrxa if are not paid. Gerteva7Hy, 2uhe maniUliu um time zbiotjed for Piling e claim or Elora agniroz4 wfew prop9679 is ralvag4y (90) Days Eiger completion 04 your pi-o)ectt, TO MURE BURA PROTEMOR FOR YOURSELF AMD YOUR P ROPLGR , YOU WAY 4,1MN TO TME OWE OR MORE OF THE FOLLOMIG STEPS: I5 Requlra that payrr anal be Made directly to subccnWc2ors and matevlal suppPoTs 2hraugpa a floint c®w4raG. Any �oiw8 control agreement should tncWda 4he addendum approved by 2tfo Registrar ®4 Contractors. P-) Gozu® IoW checks for payment, Evade ®W to bath yaw contractor and zubcontvPCWVFI or matevici suppHlors Mvoivad in the pvol ct. Thlays111 help to Insuve 4ha4 ail paisona dua payr:eM arra aWuaafly paid. 3) "Wz0v UPON unaWng payrao®eat on any Compbe4ad phase a4 4h* projee4, and below a, anhing Zny ffuvtiCvev payMSntS, r®quir3 your pwvlde you H sn ,,eBe,—w�s elgnud by each e elerdal sappHw, and labovar involmad in that rc�u It®on W Fhe vlovh 4ov Vihiclh payment a'as nacjs. on pvzjactc iflVe ng HruaPmVGMe"M 'UD Q Gfjngla $amu fly aaoH'Swve or Q dupe sn awh'2d by MdOtrMuna s, 2u o pae�ono a9 J)Aing theca rekaLa *a lose +rdght 2C 4al a 6Ha6S-Y� eg21nS4 yoaar peop0r2y. kn Whev QVpces of coaastmeNow this prz4ecftn mni s41¢H bo LnPV'r(an% huG Facy not Pay ac, Lornp9r-'�;. 73 PROYECT YOURSELF N1wrEA 7MS OPTTOR VC -U, U 3LPST 3 M CLfRMW 7NEF ALL NGQTEIR ALS EUC'PLMRS. CUSC.cO'HTRAK ORS 0R LGSOPIMP; e 4 CO, L��, k R.DISTRICT. CASk RECEIPT DETAIL Received From: _j Y LA Cl�,j 0 L I ;:�)Ic!j= Q L—U-1—Date, ZIL s: _1� 101 Ll Addres (�,A� rt b -P cf--4 Acco6ntNo. ot(S Tract Service Addres, S de, �GA. "Y O,Meters 4: Semce(s) �-,O,.Backflow(s)' 3LO House Lateral (si, DetectorChock(s)' -77— p a Q,.MeterSurcharb 4 VSanitailon Capacity Charge 0 W.S.&F.C. 0 Temporary Construction Meter a '0 'Turn onCharg a ­d4unc'O'lle�t;d4coo6fif- am 'insOktIbn' Fee -.Tract,- �,Fee - n !Plin,Check Fees Water-ISewer- 7 7" 0 Bond'Payment - A.D. --Bond 41 Assmt.. 0. Customer Deposit r 'T Z)!�Other A ­AAemarks! kV o: a� Cash cmonoy x 7 0, 0 rder 4 �,V �K­