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14405 (PLBG)w r . ;Yez., 414 • P.O. BOX 1504, ' No. 14405 Buildingy 78-495 CALLE TAMPICO. Address 46.775 Wa shingto.n LA QUINTA, CALIFORNIA 92253 Owner Ms. Phylliseter Pollard Mailing BUILDING: TYPE CONST> OCC.,GRP. Address Same A.P. Number .City Zip Tel. • Ls -Q"wt--ai 9s. �.3. Legal Description 4 Contractor " Sewer -.Connect Denbcer ' dng_.neer.ing a Construction Project Description Ad W-175nii�rras tour -- City'c'.athedra'd C1 Vp CA 9223 Tel sig)—2 State Lic. City & Classif.. ,it'; B 684563 Lic. # Sq. Ft. Size • Arch.; Engr., Designer New O Address Tel. City Zip State Lic: # LICENSED CONTRACTORSTECLARATION.. I hereby affirm that I am jcensed under provisions of, Chapter 9 (commencing with Section 4 7,000) 00f Division 3 of th?.siness and(Professi ns Code, and my licens tsirrfull force and c effect! / ! W, . d wbi ei f r No. ' - No: Dw. Stories Units Add O. Allier O• Repair ❑ ' OWNE -B IL`DER DECLARATION ' Estimated Valuation I hereby affi that I am exempt from the Contractor's License Law for the following - , reason: (Sec. 703.1. 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 .PERMIT ' the provisions of the Contractor's License Law, Chapter 9'(commencing with Section •7000) of . Demolition ❑ AMOUNT. Division 3 of the Business and Prolessfons Code, or that. heJs 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 five hundred dollars ($500). , ' - • . - ' - ' - . . Plan Chk. Bal. ❑ 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 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 •: EleCtflCal of proving that he did not build or improve for the purpose of sale.) _ ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-- Plumbing struct the project. (Sec. 7044, Business and Professions Code:'.The Contractor's License Laiv. does not apply to an, owner of propertywhobuilds or improves thereon, and'who contracts for • S.M.I.' . • - such projects with a contractor(s) )icensed•pursuant to the Contractor's License Law.) - Grading ❑ I am exempt under Sec. B. 8 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_ Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) - - PolicY,No Company d0bopy is filed with the city. ❑ Certified copy is hereby furnished. TOTAL 30 . ou CERTIFICATE OF EXEMPTION FROM REMARKS • • WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars (S100)- valuation or /ass.) - I certify that in the pertormance'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 Dite Owner NOTICE TO APPLICANT: ff, after making this Certificate of Exemption you_shouldjbecome ' ZONE: '- BY: subject to the workers' Compensatlon provisfons of.theLabor Code, you must -forthwith. • comply with such provisions or this permit shall be deemed revoked. 'MIf11R1Un1 Setback Distances: ' _ Front Setback from Center Line Rear Setback from Rear Prop. Line WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND • " . '' Side Street Setback from Center. 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 Property Line DAMAGES AS PROVIDED FOR IN SECTION3706 OF THE'.LABOR CODE, INTEREST, AND ATTORNEY'S FEES.. ' FINAL DATE - INSPECTOR•- This is a building p`errtiit when properly. filled out, signed -and validated;.and is subject'to - expiration it work thereunder is suspended for 180 days. I certify that 1 have read this,.applioation and state that the above information is correct. Issued by: 'Date Permit w I agree to comply with all city and county ordinances and state laws relating to building construction, hereby and authorize representatives •of this city to enter. the . above -i. mentioned property for inspection purposes: Validated by: ! Signature of applicant ate Date- Mailing Mailing Address - '� Validation: i i, �+r • - City, State, Zip , CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBIPO FEES 1ST FL. SO. FT. ® $ 2ND FL. SO. FT. POR. SO. FT. ® GAR. SO. FT. ® CAR P. SO. FT. WALL SO. FT. ® SO. FT. ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING NOTE: Not to be used as property tax valuation - ^ • FLOOR DRAIN MECHANICAL FEES - WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED- OTHER APPJEOUIP. LAUNDRYTRAY AIR HANDLING UNIT CFM TEMP. POLE 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 ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR ® 3/ac HOUSE SEWER REMARKS: " 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 OR SEPTIC TANK ROUGH WIRING - DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. 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 SIGNATURE&INITIALS GARDEN WALL FINAL CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES L. 2ND FL.. POR. GAR. CAR P. WALL ESTIMATED CONSTRUCTION SO. FT. N $ UNITS SLAB GRADE SO. FT. YARD SPKLR SYSTEM SO. FT. (u MOBILEHOME SVC BAR SINK SO. FT. it 1POWER OUTLET- ROOF DRAINS SO. FT v DRAINAGE PIPING SO. FT /ft DRINKING FOUNTAIN SO. FT. (n. URINAL VALUATION S WATER PIPING NOTE: Not to be used as property tax valuation HEATING (FINAL) FLOOR DRAIN MECHANICAL FEES GAS (FINAL) WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER WATER HEATER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FINAL INSP. LAUNDRY TRAY AIR HANDLING UNIT CFM WATER SYSTEM 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. c BATH TUB ' SO. FT. Gp c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RES ID @p 1 !A c SEWAGE DISPOSAL SO.FT.GAR @ ?,c HOUSE SEWER FIREPLACE GAS PIPING PERMIT FEE SPARK ARRESTOR PERMIT FEE PERMIT FEE DBL TOTAL FEES T 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 R SE/� ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus xb =$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ��5 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 f.OAMMER PUMPING INC. JOB INVOICE • P.O. Box 2448 CATHEDRAL CITY, CALIFORNIA 92235-2448 IC7^I OCf% 7AA0 IV J1.71 JVV -f TT%a (619) 321-7448 CUSTOMER'S ORDER NO. DATE ORDERE ORDER TAKEN BY DATE PROMISED O A.M. 0 P.M. BILL TO PHONE ADDRESS MEC k. CITY HELPER JOB NA fjND L," D G ,C �� l/L_ / DAY WORK 0 CONTRACT DES (TJION OF WORK ❑ EXTRA r.; QUANT. DESCRIPTION OF MATERIAL USED PRICE . AMOUNT f 0100 Gallons Pumping Fee per 1000 gal. K p ,�� ]S- o a-- (QD� Dumping Fee per 1000 gal. I ,SDS Out of Area Fee Locating / Opening Fee (per hour) Size System: F ` 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,p Q I herebyacknowledge the satisfactory completion ofrihe above described ork: TOTAL LABOR TAX ' SIGNATOR _ a� DATE COMPLETED 02� G(� TOTAL �- _ 14'. NOTICE TO OWNER' Under the California Mechanics Lien Law any contractor, 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 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 claimants such as subcontractors or material suppliers are required to provide you with a document entitled "Preliminary Notice." Original (or 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:n6t aid: General) the maximum time allowed for filing a claim or lien against ourpropeF ' P Y, 9 9 Y ti:. �, .. ;. ninety (i90) Days after completion of your project. ry �.: TO INSURE EXTRA PROTECTION FOR YOURSELF AND YOUR PROPERTY, 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 addendufn 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 belbre niakfnty* any further payments, require your contractor to provide you with unconditional tien:releases signed by each material supplier, subcontractor and laborer involved in that poMop'of the .. work for which payment was made. On projects involving improvements to a.. ing%�fahthy residence or a .duplex owned by individuals, the persons signing these releases.lose the :fgh.,t to file a claim against your property. In other types of construction this protection may sbit be important, but may not be as complete. TO PROTECT.YOURSELF UNDER, THIS-ORTION YOU MUST BE CERTAIN THAT ALL MATERIAL SUPPLIERS, SUBCONTRACTORS.QR LABORERS, HAVE SIGNED. ,^ r`.