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15062 (PLBG)Building Address Owner P.O. BOX 1504 N o . 15062 ` 78-495 CALLE TAMPICO 51--877 Ave. -Vallejo LA_OUINTA, CALIFORNIA 92253 Ms. Beverly S.2awson. mailing Address Salty . City Zip Tel. La Qui fitir C& .92253 Contractor Dessider Zngineez ing & Cons -ruction Address 68--195 . Ber3ros Court City [1Zip „� Tel.: Cathed ra.l C€ fir C 9aA.34 . 327-2200 State Lic. ':A ,684563 City 3577- & Classif..'. Lie. # Arch., Engr:, Designer Address Tel. BUILDING: TYPE CONST. - OCC:"GRP. A.P. Number Legal Description Project Description sewerCormi�ect Sq. Ft. No. Size k • < Stories New O Add ❑ " Alter O No. Dw. Units - Repair ❑ Demolition:O City Zip State ` Lic. # LICENSED CONTRACTOR)'S. DECLARATION I hereby affirrrCthat I am licensed under provisiobs of Chapter 9 (commencing with Section 7000) of Div slon 3t.of t_he Business and Professions Code, and my license is in 1till forc/e.'andd 7 effect. r✓li�ari9 / r�is SIGNATOR � SDA E ' OWNER -BUILDER DECLARATION. Estimated Valuation, of I hereby affirm that I am exempt from the Contractors License Law for the following $3, 160 a 00 reason: (Sec. 7031.5,Business and Professions ,Code: Any cityor county which requires,•a permit to construct, atter, improve, demolish, or repair.any structure;-pdor to Its issuance also*- - requires the applicantforsuch,permil'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 ' DNislon 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 or not more than five 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 suchwork 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 EIBCtfICal ' of. proving that he did not build or knprove for the purpose of sale.) _ . . ❑ 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.I. - ' such projects with a contractors) pcensed pursuant to the Contractor's License Law.) - Grading ❑ 1 am exempt under Sec: • ` B. & P.C. for this reason 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 Co pensation' Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy N : Company t opy is filed with the city, O Certified copy is hereby furnished. i TOTAL 30000, CERTIFICATE OF EXEMPTION FROM REMARKS 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 Varson in'any manner so as to become! .subject. fo the Workers' Compensation _ Laws of California Date Owner NOTICE TO APPLICANT:_ If, after making- this Certificate of., Exemption you. should become ' ZONE: • BY: gyp,- subject to the- Workers' •Compensation provisions of the Labor- Code; you must forthwith .Minimum Setback Distances: Comply with such provisions or this permit shall be deemed revoked. - - ' Front Setback from Center Line fRear Setback from Rear prilj Line WARNING: FAILURE TO SECURE WORKERS'COMPENSATIONCOVERAGE ISUNLAWFUL;AND Side Street Setback fro en% Line 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 from Prov fay Lin ` DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND - . _ ATTORNEY'S FEES. This Is a buildi'n properly g 1 FINAL DATE - _ I �PEC�TOR g permit Whenfilled out, si ned.and validated, and is subject to ' v� 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. Issued by: Dat A,�P�eT�mit ,f I agree to comply with all city and county ordinances and state laws -relating to building d construction, and hereby authorize representatives -of this city to enter the , above-. Q mentioned property for inspection purposes. Validated by: 1"•Q/` v Signature of applicant Date Mailing Address Validation:, City, State, ZIP CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBINU FEES IST FL. SO. FT. ® $ UNITSC SLAB GRADE ROUGH PLUMB. t. HEATING (ROUGH) 2ND FL. SQ. FT. FORMS YARD SPKLR SYSTEM ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® GAS (ROUGH) METER LOOP GAR. SO. FT. ® POWER OUTLET ROOF DRAINS GAS (FINAL) TEMP. POLE DRAINAGE PIPING CAR P. SQ. FT. GROUT WATER HEATER WALL SQ. FT. FINAL INSP. DRINKING FOUNTAIN. SQ. 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.0OOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM FIRE ZONE ROOFING 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. SO. FT. RESID ® 1% c SEWAGE DISPOSAL SQ.FT.GAR ® 3/.c 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 SEWER RS ROUGH WIRING DUCTWORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIF. 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 INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIONATURESlINITIALS GARDEN WALL FINAL 7d JOB INVOICE QUANT. DESCRIPTION OF MATERIAL USED PRICE AMOUNT 6 �U Gallons 0 Pumping Fee per 1000 gal. i /0.00 Dumping Fee per 1000 gal. I Out of Area Fee Locating / Opening Fee (per hour) Size System: 1 Com- r c C /51- / /f- 11-/ 1 1 1 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 MECHANICS Q MATERIALS TOTAL HELPERS Q LABOR I hereby acknowledge the satisfactory TOTAL LABOR completion of the above described work: TURE DATE COMPLETED 7 TAX TOTAL �� CUSTOMER'S ORDER NO. DATE O— /RED_ 721-7448 ORDER TAKEN BY D(Aj/TjE PROMIISSE��D'' O A.M. O P.M. TO PHONE ADDRESS MECH IC c._j c y CITY HELPER .JOB NAME ANDI,O7C TION �( � / U E © O 46l t„L c� @-BAY-WORK DESCRIPTION OF Sc ❑ CONTRACT ❑ ♦O�RK /` C_ EXTRA -� 0 i' SC L,%/ �r //7Q..v D t� <—K 'F QUANT. DESCRIPTION OF MATERIAL USED PRICE AMOUNT 6 �U Gallons 0 Pumping Fee per 1000 gal. i /0.00 Dumping Fee per 1000 gal. I Out of Area Fee Locating / Opening Fee (per hour) Size System: 1 Com- r c C /51- / /f- 11-/ 1 1 1 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 MECHANICS Q MATERIALS TOTAL HELPERS Q LABOR I hereby acknowledge the satisfactory TOTAL LABOR completion of the above described work: TURE DATE COMPLETED 7 TAX TOTAL �� ono wao� o U� Under the California Mechanics Lien Law any contNctor, subcontractor, laborer, 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 ec aim 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: paad 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 claimants such as subcontractors or material suppliers are required to provide you with a document entitled "Preliminary Notice," Original dor prime) contractors and laborers for wages do not have; to provide this notice. A Preliminary Notice is not a lien against your property. Its purpose is to notify you of persons who may have a right to file a lien 6gainst your property if 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. TO INSURE EXTRA PROTECTION FOUR YOURSELF AND YOUR PROPERTY, YOU MAY VVISH TO TAKE ONE OR MORE OF THE FOLLOWING STEPS: 9) 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) Atter 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.