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9496 (PLBG)Building 53-251 VELASCO Address Owner ERNES A WEBB Mailing Address 53-251 9BLASCO City Zip LA QGIN,A,CA 1 92253 Tel. 444 P.O. BOX 1504 N O . 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 1SEWER BUILDING: TYPE CONST. HOOKUP OCC: GRP. r Contractor ECONO SEWER SERVICES Address P 0 BOB 192 _CityZip Tel.: PA.LK DESERT I91'2260 346-2793 State Lic. City & Classif. 480961 Lic. # 342 Arch., Engr., 'Designer Address Tel. CityI Zip I State I 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/Bu/s1'nes tan ,ioeessions.Code, and my license is in full force and effect.rz�/, r a / SIGNATURE 1' r DATE OWNER -BUILDER DECLARATION - I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Bustness 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 life 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 rive 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 or improvement is said within one year of completion, the owner -builder wig have the burden of proving that he did not bugd or -approve for the purpose of sale.) O 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 contractors) licensed 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'si_,�r�p�ngab�' g urance,oracertifiedcopbtheu,o�fisec.3800,Labor Code.) PO icy. 0. 1 !! Company 2 tiCC �rCopy is filed.with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM ' WORKERS' COMPENSATION INSURANCE (This section need not be completed ff 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. 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 property 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 Mailing Addi City, State, P. Number Description t Description SEWER ROOKIIP 9496 Sq. Ft. No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation .$1,500.00 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing $ 30.00 S.M.I. Grading Driveway Enc. Infrastructure TOTAL 5 3 J REMARKS - orf ii i. Ov . v.v 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. PLUMPING FEES IST FL. SQ. FT. ® $ UNITS COLL. AREA 2ND FL SQ. FT. ®, ROUGH PLUMB. YARD SPKLR SYSTEM POR. SQ. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. SQ. FT. DUCT WORK DRAINAGE PIPING WALL SQ. FT. 'GAS (ROUGH) DRINKING FOUNTAIN. SQ FT ® HEATING (FINAL) URINAL ESTIMATED CONSTRUCTION VALUATION $ GAS (FINAL) WATER PIPING NOTE Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER HEATER WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER WATER SYSTEM GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED GRADING cu. yd. plus x$ 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. SQ. FT. ®c BATH TUB LATHING SQ. FT. ® c WATER HEATER MAX HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1% c SEWAGE DISPOSAL FENCE FINAL SQ.FT.GAR ® 3/ic HOUSE SEWER GARDEN WALL FINAL GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PLCK.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 SEWER OR SEPTIC TANK ROUGH 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 p/�// �/ t /� �2 Y_ REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION - CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIIYITIALS GARDEN WALL FINAL - s'.✓.r_^^, 'ft` .-IrM�.:/y1� !C"r�"��7iYY!. 11;'✓.-.T�'—j (�r^�t'.;'� - f' COACHELLA VALLEY WATER DISTRICT CASH RECEIPT DETAIL Received F m: IE(nes+ 1 �✓ Date' • Address:a��"�� ►►J� ( �' l (1 J.�+�„ Account No. �`0 �•�, �' l7J Lots) lJ 1 43 It/Of.X' oUli Tract SAIJr/�C'� uE TA t/A/ Service Address J t' !:l .�<. `, G.A. Code ❑ Meter(s) S �tvro❑�.SBNICe(s) i �. �❑':Backfiow(s) L� O House Lateral(s) ❑ DetectorCheck(s) Meter Surcharge `en atlon Capacity Charge [513 p.v porary Construction Meter on Charge ❑ collected Account -Name r1❑fig nspection Fee - Tract - ��,' 'Fee ah. Ch ck Fass Water I Sewer. - r.. }' ''a}r?"•'5 Tract - F Bond Payment - A.D. - Bond tlC] Customer Deposit :4❑ : Other TOTAL S I 1 +0J arks: x ❑Copy to: �- Cash Check y Water Service Money Order Cashier CVWD-138 (11 /88