13417 (PLBG)11�/�/; ,
' Y
` P.O. BOX 1504
No. 1349.7
P. Building 78-105 CALLE ESTADO
Address 54840 AVENIDA DIAti LA QUINTA, CALIFORNIA 92253 t
Owner
-THOMAS F. BRAY
!BUILDING: TYPE CONST. OCC: GRP.
Mailing
Address 54840 DIAD
City
Zip
Tel.
%A QttI11'A
92253 _
Contractor
Const.
$30.00
A-1 CESSPOOL
SERVICE#
INC*
Address
Plumbing
P O BOB 183
Grading
City
• %ESERx HOT SIIp
WGS 9224)
Tela '
329--6875
State Lic.
City
& Classif. C-42 265214
Lic. # 386
Arch.; Engr.,
Designer
-530.00
REMARKS
Address
Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
Ihereby affirm that I em licensed under Provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I 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, 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
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).
O 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 sold within one year or completion, the owner -builder will have the burden
of proving that he did not build or improve 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 property who builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 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 No. Company
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
r 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 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
subject to' the Workers' Compensation provisions or 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. $097, Civil Code.)
Lender's Name
Lender's Address
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 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 applicant Date
Mailing Address
City, State, Zip
A.P. Number
Description
Project Description
SEWER HOOKUP
Sq. Ft. No. No. Dw.
Size Stories Units
New ❑
Add ❑
Alter ❑
Repair ❑ Demolition ❑
ZONE: BY: --
Minimum Setback Distances 1''" ,
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from -Center Line
Side Setback from Proper y L e�_
FINAL DATE ; INS
Issued by: Date f� L F/P-@qnl>_
Validated by: x/10, 1 .y 22
I
Validation:
a
Estimated Valuation $1.,.025
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
$30.00
Mech. ti '
Electrical
Plumbing
.S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
-530.00
REMARKS
ZONE: BY: --
Minimum Setback Distances 1''" ,
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from -Center Line
Side Setback from Proper y L e�_
FINAL DATE ; INS
Issued by: Date f� L F/P-@qnl>_
Validated by: x/10, 1 .y 22
I
Validation:
a
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. S0. FT.
FORMS
SEWER,
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. S0. FT. ®
GAS (ROUGH)
METER LOOP
GAR. SQ. FT. p
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.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
VENTILATION
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, 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.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/4c
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 APP./EQUIP.
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 L �Z-42
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
EA -1 Co s*pocl Service. Inc.
P.O. Box 193
Desert Hot Springs, CA. 92240
(
August 3, 1994
Mr. Armon Sharp
54840 Ave. Diaz
La,Guinta, CA. 92253
Dear Mr. Sharp,
On Monday, August 1, 1994, you called the city of La Oui.nta
complaining that you have a problem with the sewer hookup we
performed at the above address last spring. You spoke with t
Lonnie at the building department stating that you have tried to
call us to no avail.
Lonnie had no trouble reaching me by phone and I immediately
called you_ You said that you did not like your front yard and
that there was some settling that has occurred. Although you did
not mention the following to eye, Lonnie stated that you were
unhappy with the fill dirt used to abandon your septit system. I
told you that I would go by and take a look_
c
I took a look at your front Yard yesterday. I did observe an
inch or two of settlement. It appeared to nae that _a few shovels
of dirt would solve that problem. A-1 would be happy to deliver
a 5 gallon bucket of dirt for you. ,
It seems to me that you have more of a weed problem than
anything_ If it were my house,. I' d %pond some time caring for
the yard_ Go pull the weeds before they go to seed and you
compound the problem. Weeds have taken over your entire yard
including the rose bushes. It"s obvious that you've neglected
the yard.
If you have a problem with our work, please feel free to call me.
We have had the samo phone number for 36 yearn and it rimgs at.
our office and at any home and you may call at any reasonable
time.
Respectfully Submitted
Hutch Spillman
General Manager
L
cc/Lonnie...City of La Dui nta
I
(�CASH
Received From: RAM _ / >�l �l't1fiS
Address:S//`iN�B�f 6 ALA-,.
2)1/4
COACHELLA VALLEY WATER DISTRICT
RECEIPT DETAIL
�- �l�i h't I S
z.� L,� . u /A(T71 ��,
Date:
9Z -7 5�
0-,74
Account No.
Lot(s)
Tract UC
7 7
Service Address ��Lf — 9110 /4
(/F
IA Z
G.A. Code
❑ Meter(s)
$
❑ Service(s)
❑ Backflow(s)
❑ House Lateral(s)
❑ Detector Check(s)
❑ Meter Surcharge
(p, anitation Capacity Charge 0/
❑ W.S.B.F.C.
❑ Temporary Construction Meter
❑ Turn on Charge
❑ Uncollected Account - Name
❑ Inspection Fee - Tract -
Fee -
❑ Plan Check Fees Water / Sewer -
Tract -
❑ Bond Payment - A.D. - Bond
Assmt.
❑ Customer Deposit
❑ Other
@ TOTAL $ I `7
Remarks: C-14 S !?_ W ( L( W /t I L / rT�-/ lin /l )
Adz- 2 S/-/� 4f!),-3%�/e<-1S
❑Copy to:
Cash I I I,I
Check Oi 5; /
Money
Order
0
Water Service
Cashier ;��
CVWD-438 11189)