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15224 (PLBG)• P.O. BOX 1504 N o . 15,224 Building 78-495 CALLE TAMPICO Address 52 811 Ave. villa. -_LA OUINTA, CALIFORNIA. 92253 Owner Seca Tainta Palms Realty . Mailing " " - BUILDING: TYPE CONST. OCC: GRP. Address . P.O. . Box 3406 A.P. Number City Zip Tel. La Quintan. CA .922.56 Legal Description Contractor 1 C1 3TProject Description il2ibil1ACa Address P.O. Box 1555 ci La Quanta, ZIp92253 Tel.: -CA 564--1338 State Lic. City & Classif.. 53.7333 Lic. # 2526 Sq. Ft. No.: No. Dw. Size •Stories • Units -. - Arch.,•Engr., - - Designer _ New ❑ Add ❑ Alter ❑. Repair ❑ Demolition Address Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereb affirm that am licensed under -provisions of Chapter 9 (commencing with Section 000) of ivi 3 0 .tti3 Business a d Professions Code, and my license is in full force and effect f�� SIGNATURES DATE OWNER -BUILDER DECLARATION Estimated Valuation v �1 I hereby affirm that I am exempt from the Contractor's. License Law for the following $1, 00V a 00 reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a permit to construct, atter, 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 .. - ' - 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, ano 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 -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 Plan Chk. Bal. do the work, and the structure is not intended or offered for sale. (Sec: 7044, Buisness and Const. Code: The Contractor's License Law does not apply to an owner or property who builds or Improves thereon and who does such work himself or through his own employees, - n provided that such improvements are not Intended or offered for sale. If; however, the building Mech. or improvement is sold within one year of completion, the owner -builder will have Lhe burden Electrical of proving that he did not build or Improve for the purpose of sale.) ' O 1, as owner of the property, am exclusively contracting with licensed contractors to con- •Plumbing- 3 w cis 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.) ❑ I am exempt under Sec B. 8 P.C. for this reason Grading Driveway Enc. Date owner Infrastructure WORKERS' COMPENSATION DECLARATION I hereby'affirrn 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 Noi Company. y is filed with the city. O Certified copy is hereby furnished. TOTAL 30.0.0 CERTIFICATE OF EXEMPTION FROM REMARKS • WORKERS' COMPENSATION INSURANCE - (This section need not be completed N 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 peon -in any manner so as to become subject to the Workers' Compensation Laws of Californirsa Date Owner NOTICE TO- APPLICANT. N, after making , this Certificate of Exemption you should become ZONE: -BY: '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 Rear Setback from R;ar. Pi°o.p.LLine 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 SECTION .3706 OF THE' LABOR CODE, INTEREST. AND f / ' ^w ATTORNEY'S FEES. `/�/ /7 This is a building permit when properly filled out, signed and validated, and is subject to' FINAL_DATE NSPECT, V — expiration if work thereunder is suspended for 180 days.. R I certify that I have read this application and state V that the above information is correct. Issued by: - Date Permito_ 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 \ y •K. STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBINU FEES 1ST FL. SO. FT. @ $ UNITS HEATING (ROUGH) 2ND FL. SO. FT. @ FORMS YARD SPKLR SYSTEM' POR. SO. FT. @ MOBILEHOME SVC. BAR SINK GAR. SO. FT. @ POWER OUTLET ROOF DRAINS CAR P. SO. FT. @ OTHER APPJEOUIP. DRAINAGE PIPING WALL SO. FT. @ TEMP. POLE DRINKING FOUNTAIN. SO. FT. @ GROUT URINAL ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP. WATER PIPING NOTE: Not to be used as property tax valuation WATER SYSTEM FLOOR DRAIN MECHANICAL FEES _$ WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE - DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED REMARKS: LAUNDRYTRAY AIR HANDLING UNIT CFM 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 H SEWAGE DISPOSAL SO.FT.GAR @ 3/<c IHOUSE SEWER MESH GAS PIPING PERMIT FEE PERMIT FEE I 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 SEW OR� ROUGH WIRING DUCTWORK 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.mv 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 SIONATURESIINITIALS GARDEN WALL FINAL COACHELLA VALLEY WATER DISTRICT CASH RECEIPT DETAIL ��7 Received From :lr`. , r Date:L s \ Address: l— / - C „ - Y, ; a' 1", 3%Li{ r �,17'� n n Cr %i/• n �'�n Account No. �— .',? f i?/' h.. O' C Lgt(s) `' •� Tract Service Address n.�!� Z 6L1_ � /.9 ri- G.A. Code ❑ Meter(s) E ❑ Service(s) ❑ Backflow(s) ' ❑ House Lateral(s) ❑ Detector Check(s) ❑ Meter Surcharge ' Capacity Charge /Q56-nitatlon ❑" W.S.B.F.C. ❑ Temporary Construction Meter ❑ Tumon Charge ❑ Uncollected Account - Name ❑ Inspection Fee- Tract - Fee - ❑ Plan Check Fees Water I Sewer - Tract - ❑ Bond Payment - A.D. - Bond Assmt. ❑ Customer Deposit ❑ Other ' U TOTAL S Remarks:Q/%^('i ❑COpy to: - - Cash _ Water Servjce Check Money /JCJ .`. Order ` Cashier --4z— ' CVWD-438111189) Joe IPJVOICE HAMMER PUMPING INC: j P.O. Boz 2448 " CATHEDRAL -CITY, CALIFORNIA 92235-2448 (619) 360 7448 • (619) 321-7448 .. DESCRIPTION OF -MATERIAL USED CUSTOMER'S ORDER NO. DATE ORDERED -�7-Fj" ORDER TAKEN BY DATE PROMISED - O A.M. ' - AD O P.M. BILL TO f— C f' PHONE Gt.h't �, cji.h 1 ADDRES?S�'� �/3 J Jam, C61 (J MEQFI�fJI`� N CITY 't HE/L/\P/ERR JOB N/� F A� LQ QTION v . JC• SCJ L/(/ d"'J�AY WORK 'O�CONTRACT. DESCRIPTION F�WORK J �\ /c, /10 -QJ- O EXTRA Out of Area Fee � � ��D J � wL•e,�r' o ` Locating /.Opening Fee (per hour)' -QUANT. DESCRIPTION OF -MATERIAL USED - PRICE AMOUNT Gallons AD Pumping -Fee per 1000 gal. G� , Dumping Fee per 1000.gal. S -a _0e Out of Area Fee Locating /.Opening Fee (per hour)' Size System:' by t :'- A SERVICE CHARGEOF $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 HELPERS Q ' TOTAL- LABOR I ereby ackn0ledgethe satisfactory TOTAL LABOR, = .o letio �of_the above described work: TAX TOTAL - • SIGNATU - TDATECPL7ET O G � NOTICE TO'OWNER Under the California. Mechanics Lien Lawany �t;actor, 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 ofthesafe 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 fife alien against your property if they are not paid. Generally, the maximum time allowed for filing a claim or lien against your property is nine,y (9W Days after,completion of your project. TO INSURE EXTRA PROTECTION FOR YOURSELF AND YOUR PROPERTY, YOUVAY 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 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. j 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 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. r