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14935 (PLBG)Ft P.O. BOX 1504 No. 14935 Building 78-555 Calle Ultimo 78-495 CALLE TAMPICO Address LA QUINTA, CALIFORNIA 92253 Owner La Quinta Palms, Mailing BUILDING: TYPE CONST. OCC. GRP. - Address P.O. Bok 346 A.P. Number City Zip Tel.. La..Quinta, .CA . 92233 564-1338 Legal Description Contractor Project Description 'S8PlIYe •Connect 14UMbiI Inc.. Address P.O. Box 1555 Lity a Quinta., CA zip 92253 Te1564-1338 State Lic. City & Classif. A,,B 537333 Lic. # 2526 Sq. Ft. No. No. Dw. Arch., Engr.,' Size Stories Units - ' ' ' Designer New ❑ Add ❑ Alter D., Repair ❑ -Demolition ❑ Address Tel. City Zip State Lic. # LICENSED CONTRACT,9R'S DECLARATION I hereby affirmthat ) am licensed under provis ons of Chapter 9 (commencing with Section 7000) of D15,-sion 3 4f Business.and Professi ns Code, and my license is in full force and effect . f f� •+"„ SIGNATURE! i!S DATE OWNEWBUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for the following Estimated Valuation $11000-.00 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 PERMIT AMOUNT ' 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 Plan Chk. Dep. - - 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 Plan Chk. Bal. do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. 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, Mech. 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 Electrical - of proving that he did not build or improve for the purpose of sale.) - O I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 30.00 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 S.M.1. such projects' with a contractors) Ikensed pursuant to the Contractor's License Law.) ❑ I am exempt under Sec. B. 8 P.C. for this reason Grading 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 No. Company O Copy is filed with the city. ❑ Certified copy is hereby furnished. TOTAL 30.00 CERTIFICATE OF EXEMPTION FROM - REMARKS WORKERS' COMPENSATION INSURANCE (This section need not be or less.) completed it the permit Is for one hundred dollars ($100) valuation , 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: If, -after. making this 'Certificate of Exemption you should become ZONE: BY: subject to the Workers' Compensa0on provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Minimum Setback Distances: - Front Setback from C Lin Rear Setback from rop. ' WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND' Side Street Setb fro Cen e i e 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, -. Side Setback f m Pro 'eine DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND . L1 ATTORNEY'S FEES. CT Tts is a building permit when properly filled out, signed and validated, and is subject to FINAL DATE SPECTORI? expiration if work thereunder is suspended for 160 days. 9 I certify that I have read this application and state that the above information is correct. Issued by: - Date Permit. 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. Validated by: Signature of applicant Date Mailing Address Validation: City, State, Zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLU9BIW FEES UNDERGROUND A.C. UNIT ` 1ST FL. SO. FT. ® $ UNITS BONDING HEATING (ROUGH) YARD SPKLR SYSTEM f 2ND FL. SO. FT. SEWE OR 10 ROUGH' WIRING MOBILEHOME SVC. BAR SINK POR. SO. FT. ® GAS (ROUGH) GAR. SO. FT. ® POWER OUTLET ROOF DRAINS REINF. STEEL GAS (FINAL) DRAINAGE PIPING CAR P. SO. Ff. WALL SO. FT. WATER HEATER DRINKING FOUNTAIN. SERVICE FINAL INSP. URINAL SO. FT. ® WATER SYSTEM ESTIMATED CONSTRUCTION VALUATION $ GRADING cu. yd. $ plus x$ WATER PIPING NOTE: Not to be used as property tax valuation A� � /� Py 3 FINAL INSP. "/FINAL FLOOR DRAIN MECHANICAL FEES ROOFING WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED VENTILATION LAUNDRYTRAY AIR HANDLING UNIT CFM I 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 LATHING SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. S0. FT. RESID ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR ® VAc 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 COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWE OR 10 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. A� � /� Py 3 FINAL INSP. "/FINAL FRAMING INSP. d J ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING ' FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL / A Received Frorti,"' / �i�i�J -�t[ �.f' n Address: �-a'-/,� �._l'i�,rG'c.� COACHELLA VALLEY WATER DISTRICT CASH RECEIPT DETAIL (� .Q` a C" 1 �' t.+�r'i�'7"ie �.q7� �; x)•71 it (.1 r�-1-,+ ■ W_ • � 4 6 i G /Date, Account No. _ % �1 _ , Loi(s) Tract Service Address' — c .V17'1 G.A. Code ❑ Meter(s) S ❑ Service(s) ❑ Backflow(s) ❑ House Lateral(s) ❑ DetectorCheck(s) ❑ Meter Surcharge ,X Sanitation Capacity Charge ❑ W.S.B.F.C. ❑ Temporary Construction Meter ❑ Tum on Charge ❑ Uncollected Account - Name ❑ Inspection Fee -Tract - Fee - ❑ Plan Check Fees Water I Sewer - Tract - ❑ Bond Payment = A.D. - Bond Assmt. ❑ Customer Deposit e ❑ Other TOTAL S �� Remarks: ❑Copy to: Water Service Y: _ �Ceshler � CVWD-438 (11169) Cash Check E-� money Order -HAPAMER PUMPING INC. P.O. Box 2448 CATHEDRAL CITY, CALIFORNIA 02235-2448 Ictn1 -TAA;b ' JOB INVOICE (619)321-74.48 CUSTOMER'S ORDER NO.RDERED• . -A Dy 0 000 ORDER TAKEN BY DATE PROMISED 0 A.M. P.M.❑ F BILL TO 'M Lk k-,. b —T-U— PHONE ADDREQ 13 _5__ L,4j 4� MEM:Cj k CITY HELPER D u m`p i� Tee' g6l JOB NAME�lgr 0 DAYWORK ICONTRACT DESC F WORK [3 TRP(" '/,/-0 6 QUANT. 1, 1 DESCRIPTION OF MATERIAL USED PRICE AMOUNT 000 Gallon"s' Pumping Fee per. -1000 gal. L —T-U— D u m`p i� Tee' g6l Out of�Ar'ea Fee�Al 4, Locating Open i'ri g "Fee (per hour) Size System: A A A SERVICE CHARGE OF $20 WILL BE,DUE -ON ALL RETURNED CHECKS. A FINANCE CHARGE OF lx' MOER MONTH, 19% PER YEAR WILL BE CHARGED,ON PAST DUE'ACCOUNTS OVER 30 DAYS. HOURS .LABOR-- AMOUNT TOTAL MATERIALS MECHANICS • HELPERS TOTAL LABOR ckno edge the satisfactory I hereb;a ifactory TOTAY LABOR -1 comple the above deAcribed work:,,, TAX SIG , NAT DATE Q0,MPLETFr) -4 fTOTAL Undyp flee Caiitornia Mechanics Lien Law any contractor, suLpopiractor, laborer, supplier or ufiher pLrsun who ijelps to property, but is not paid for his/her -work or ,suppl`aes, i,as a right to enforce a claim against your property. This means that after a court heacina , your p6•operty could be sold by a court officer and the proceeds of the sale used to szatisfy the indebtedness. This can happen even if you have paid your contractor in 10 if the subcontractors, Laborers or suppi'sers remain unpaid. To preserve their night to file a,c&aim or litre against your property, certain claimants such, "as saatacontractw,)rc (N. maHerlal sup'p#k r%,- are required to provide you with a document enUVed "Prmirnv rary NoVice." Original Qr': 'time) contractors and laborers for gages do not hays tr) g)r*y;da 5his notice. A Prelhninaz%,,+.-Ad ice Is not n lien against your property. Its purpose is to na® 4y yuu of persons Frsho may a right to Siie a lien against your property of they are not paid. Generally, the maximum fii�p,,allowed for filing a claim or /lin against your property is at�vic-,.1y (9'3) Days, Sner comrl.eildn "of your project:- , 6f,�iD�F E��?b3£a PPiOY'ECTi©Ev F�@ Y®C9�EEbF Et�ti y0tl hf;tEEEATYI YOU vSJ�y WISH YO TACHE ONE f16�'aV CRE OF THE F0L'�OWMG STEPS', B) Roquirc, a EE rpayr�iacWf, be ;DE"ds +lureciiy is Saa'-,--jnivactors aPtd materia! §aa{a 9ilers through a )©iw csaV. joint conlrol aquCnment iGa -:,3 "laciude the Eddendum mpproved by the Retigtvav 0,G 0,^a'i!: 2) issue join'S for paayrtar-;ni, ntrde cart as meth your contractor and subcontractors or Materia9 sarp 6�'so��s involved in Vho prope::L TMvviil Greif to ln6urre that ail Oemcos due payment - OGe achually Pail. 3) At4ea° liar I'd wmCzora yus,jnt Ora psi;+ rnraspleted phase os 44a prrqoi, ono d befove.RaaM09 any fuAhev paymc,,ajts, rreWre ydur iacr€;� i to ptovidre you 60,li unc0n64ruv4i ok�vu � signed by each motorial supplier, subcra iiractor and laborer involved In that portion of nhc u7oc% for tvhich payment °spas made. On prop ects involving imro;Tiements to a single-family,. residence or a duplex okwned by indrviduaals, ^,Ve persons signincj the,f�Weases lose the right" to file a c0Q im ag&41st yrw, ptioperty in ofhee apes of conwuce-ion this protection may'aWl kte imaortant, bvd ma37 nn2 �s as complete, i@ PROTEC? f 3R���f.� Uti�Ds� R TFlI3�OFT8�?tl YOU MUST BE CERYAIM T¢W ALL MATERIAL SUPPLIERS, SWCON7RAti` ORS -OR LABORERS )•iAVE SIGNED.