15071 (PLBG)Building
Address .54:^X95 Ave. Velasco,
Owner Mr._ f Mrs. Paul Rowe
Mailing
Address Same
<City Zip
%a Quints, Cr-_ I .. 92253
Contractor
P.O. BOX 1504 N u .
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number
Legal Description
Project Description Sewer Conil ect
Denboer Engineering a Construction
Address
68-175 Berros Court
City * Zip � Tel.:
CAthedral C3.ty, C� 92'234' 327-2200
State Lic. A 684553 City 357.
& Classif.. Lic. #
'Arch.; Engr., r :
Designer 1'
Address -Tel:
Sq. Ft. No.
Size Stories
New ❑ Add ❑ Alter ❑
No. Dw.
Units •� "
Repair ❑ Demolition ❑
City
Zip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirmdhat I am licensed•under provision's of Chapter 9 (commencing with Section
7000) of Divii(�hon3.o.�f,Ithe Business and Professions'Code, and my license ' .in full fo be and: .
• effect.
' ' -
SIGNATURE "" .... -SATE
�' ' OWNER -BUILDER DECLARATION'
I hereby affirm that I am exempt.from the Contractor's License Law for the following
Estimated V81UatlOn' $1e7-00.00
reason: (Sec. 703 1.5, 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 file -a signed statement that he is licensed pursuant to
=visionsof 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).
❑ 1, 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
.PERMIT - AMOUNT.
•�
-
Plan Chk. Dep.
.. -
Plan Chk. Bal.
Const. -
Mech. - r
-
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 sold within one year of completion, the owner -builder will -have the burden
or proving that he did not build or improve for the purpose of sale.) -
Electrical
_
Plumbing
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 contractor(s) licensed pursuant to the Contractor's License Law.)
O 1 am exempt under Sec IB. & P.C. for this reason
S. M. 1.
Grading
J
Driveway Enc.
Date Owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
I 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.)
Policy Nom'` Company
py is filed with the city, O Certified copy is hereby furnished.
TOTAL 30.00 -
CERTIFICATE OF EXEMPTION FROM
•• - WORKERS' COMPENSATION INSURANCE
REMARKS
(This section need not be completed ,if -the perml is for one.hundred dollars ($100) valuation
• or less.) - -
I certify that in the performance of,thp work for which this permit is issued, I shall not
" employ'any pperson 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. -
ZONE: BY:
Minimum Setback. Distances: -
Front Setback from Center Line
Rear Setback'from Rear Prop. Line
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL, AND
SHALL SUBJECT AN EMPLOYER TO CRIMINAL -PENALTIES AND CIVIL FINES UP TO ONE
Side Street Setback from Center Line '
�
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'
ATTORNEYS FEES.
Ttiis is a buildin g permit when prended for 180d a signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.-
Side Setback fr.Om.Pfoperty LInQ� '•
FINAL DATE INSPECTOR //1
I certify that I have read this application and'state that the above information is correct:Issued
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.
b Date/Permit
.. . - y v r✓/��
(J p
Validated by:
Signature ofapplicant Date
Mailing Address _
Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBW FEES
1ST FL. SO. FT. $
UNITS
COLL. AREA
2ND FL. SO. FT.
ROUGH PLUMB.
YARD SPKLR SYSTEM
'BONDING
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
SE OR
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
FOUND. REINF.
GAS (ROUGH)
DRAINAGE PIPING
CAR P. SO. FT. ®
HEATING (FINAL)
OTHER APP.IEOUIP.
WALL SO. FT.
GAS (FINAL)
DRINKING FOUNTAIN
SO. FT. ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER HEATER
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.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
/J S �r FINAL INSP.
✓
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
ROOFING
LAUNDRYTRAY
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1+/4 c
SEWAGE DISPOSAL
GAR. FIREWALL
SO.FT.GAR ® V4c
HOUSE SEWER
LATHING
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 COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
'BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SE OR
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
CU. yd.
$, plus x$
_
=$
LUMBER GR.
/J S �r FINAL INSP.
✓
FRAMING
FINAL INSP.
ROOFING
REMARKS:
_
VENTILATION
FIRE ZONE ROOFING '
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATUFESIINITIALS
GARDEN WALL FINAL
9
.HAMMER PUMPING INC. JOB INVOICE
P.O. Box 2448
CATHEDRAL CITY, CALIFORNIA 92235-2448
ICI AI'2aA_7AAQ .
waw( aww I �w
(619) 321-7448
CUSTOMER'S ORDER NO.
DATE ORDER
.S- aED `C?S-
ORDER TAKEN BY
DATE PROMIS O ❑ A.M.
❑ P.M.
BILL TO _
PHONE
ADDRESS
1
MECJ 14LJ.
Iti
CITY
C
HELPER
JOB N 1�ME/�/D LQTI
S- C� / ✓\
C O
t
L9 11AY WORK
O CONTRACT
0 EXTRA
DESCRIPTI OF WORK \r p (/
Out of Area Fee
QUANT.
DESCRIPTION OF MATERIAL USED
PRICE
AMOUNT
000
Gallons
6) 0 0
Pumping Fee per 1000 gal.
Qtgb
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 Q
TOTAL
LABOR
HELPERS Q
I hereby acknowledge the satisfactory TOTAL LABOR
completion oft a above described work:
TAX
IG TORE
DATE COMPL TED
C?S'
TOTAL
f 3A�
Q,
ZIP
r
NOTICE TO OWNER
Under the California Mechanics Lien Law any contractor, subcontractor, taborer; supplier
or other person who helps to improve your property, but -is not•paid for his/her work or
supplies, has a right to enforce a claim against your property. This 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 right to file a claim or lien against your property, certain claimanta,such
as.sub5ontractors or material suppliers are required to provide you with a document entitled
"Pxeliminary Notice." Original (or prime) contractors and laborers for wages do not Wave to
provide this notice. A Preliminary Notice is not a lien against your property. Its purposeis to.
notify you of persons who may have a right to file a lien against your property it they are not
paid. Generally, the maximum time allowed for filing a claim or lien against your property is
ninety (90) Days after completion of your project.
'M'INSURE.EXTRA PROTECTION FOR YOMEEFAIN13 YOUR PAOPERTY;_
YOU MAY WISH TO TAKE ONE OR MORE OF THE FOLLOWING STEPS:
1) Require that payments be made directly to subcontractors and material 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 out 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 sighing these releases lose the right
to file a claim against your property. in other types of construction this protection may stili 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.