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15066 (PLBG)Building Address 51'-451D 451D Ave. Vallejo Owner Mr. Mrs. Rt text Lee Mailing Address same. P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 City Zip Tel: La Quinta, CA 922.53 Contractor be�hb©er Engineeking a Construction Address 68-175 Berros Court CityZip T I.' Cathedral Ci CA 92234 h7-2200 State Lic. A 68456.3 City 3577 & Classif. Lic. #. Arch., Engr:, Designer Address Tel. City Zip State Lic. # �•-LICENSED CONTRACTOR'S DECIIRATION I hereby affirmAiat I am licensed unde p.Ch rovisions ofap1ter 9 (commencing with Section 7000) of Division 3:of the Business and. Professions Cdde✓and my license is in f II fo ce and effect. r Fsr ;. , g J i / ',Pl J(t /i ii Ir 3+�i_ !! SIGNATURE I.IX I OFl.- ` DATE /OWNER -BUILDER DECLARATION I hereby affirm that4 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 file 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 or 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 five 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 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 of proving that he did not build or knprove for the purpose or sale.) - ❑ 1, 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 propertywhobuilds or improves thereon, and who contracts for such projects with a contractors) licensed pursuant to the Contractor's License Law.) O 1 am exempt under Sec. B. & P.C. for this reason Date Owner 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 Nq:A"~ Company {0xCopy Is filed with the city. O Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need be completed if the permit Is for one hundred dollars ($100) valuation or less.) I certify that in the performance of thf 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: N, after making this Certificate * of Exemption you should become subject to the Workers' Compensation provisions of the Labor Codes you must forthwith comply with such provisions or this permit shall be deemed revoked. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND 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, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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,l 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, Zlp No. 15066 11LDING: TYPE CONST: • OCC: GRP. P. Number (Legal Description Project Description Sever Connect Sq. Ft. Size • No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $1,,700.00 PERMIIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const.' Mech. - Electrical Plumbing 30.00 S.M.I. Grading Driveway Enc. Infrastructure TOTAL 30.00 REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center -Line Rear Setback from Rear Prop Line Side Street Setback fro nterLin Side Setback from PPrrrooe y Ling.._ _--ie FINAL DATE INSPECTO�R2 Issued by Validated Validatior CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBIW4.FEESI\ 1ST FL. SO. FT. ® $ UNITS COLL. AREA SLAB GRADE YARD SPKLR SYSTEM 2ND FL. SO. FT. HEATING (ROUGH) 'STORAGE TANK FORMS MOBILEHOME SVC. BAR SINK POR. SO. FT. ® DUCT WORK ROCK STORAGE GAR. SO. FT. ® POWER OUTLET ROOF DRAINS METER LOOP HEATING (FINAL) DRAINAGE PIPING CAR P. SQ. FT. ® GAS (FINAL) WALL SQ. FT. DRINKING FOUNTAIN. GROUT URINAL SO. FT. ® FINAL INSP. ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation GRADING Cu. yd. $ -Plus-X$-=$ FLOOR DRAIN MECHANICAL FEES �� FINAL INSP. WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY 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. SQ. FT. ® c BATH TUB GAR. FIREWALL SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1% c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ec 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 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 REMARKS: VENTILATION FIRE ZONE ROOFING: FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL ,.!..DAMMER PUMPING- INC. JOB INVOICE P.O. Box 2448 CATHEDRAL CITY, CALIFORNIA 92235-2448 (619) 360-7448 (619) 321-7448 DESCRIPTION OF MATERIAL USED CUSTOMER'S ORDER NO. DATE ORDERED -7 d 00 Gallons ORDER TAKEN BY DATE PROMISED Z A.M. 000 Pumping Fee per 1000 gal. r� ❑ P.M. BILL TO PHONE L� OQ O ADDRESS ' j ME NIC CITY 3 HELPER I. Out of Area Fee JOB NAM€7A r'ATION f ' Z' gV"AY WORK �J PJ O L '0... DESCRIPTI OF WORK pp t •, ❑ CONTRACT V- O EXTRA loo Size System: QUANT. DESCRIPTION OF MATERIAL USED - PRICE AMOUNT d 00 Gallons 000 Pumping Fee per 1000 gal. r� - L� OQ O Dumping Fee per 1000 gal. Out of Area Fee Locating / Opening Fee (per hour) Size System: © rCC j 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 th above described ork, TOTAL LABOR TAX SIGNATURE �/e DATE COMPLETED s' TOTAL NOTICE TO OWNER Under the California Mechanics Ued Law,any contractor, subcontractor, laborer, supplier or other person who helps.to"Improve your property,•_btit is'not.paid for his/her work or supplies, has a right to enfo`rce_, a claim against your property. This ,means that aftir 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 claimants such as subcontractors or material suppliers are required to provide you with a document entitled' "Preliminary Notice." Original jor 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 against your property if they are not paid. Generally, the maximum time allowed for filing a claim or lien against your property is ninety (90) Dbys after completion of your project. TO INSURE EXTRA PROTFCTIM*OR YOURSELF AND -YOUR PROPERTY---_ -. YOU MAY WISH TO TAKE ONE OR MORE OF THE FOLLOWING STEPS: t) 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 rKade. 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. I