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14720 (PLBG)_A4 r P.O. BOX 1504 Building78-495 CALLE TAMPICO Address 54-015 Ave. Herrera LA QUINTA, CALIFORNIA 92253 Owner ia Quinta Palms Realty - BUILDING: TYPE CONST_ furor i u ry Address P.O. AOx 346 City La Quanta, CA zIp 92253 U. Inc. P.O. BOX 3555 i Cit Quint'a, CA State Lic. & Classif. Arch., Engr., Designer Address r Number No. 14720 OCC. GRP.: el. 564-4304 Legal Description Project Description Sever Co=ed Zip 92253 Tel 64-1338 City Lic. # Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION' I hereby affirm that I am 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 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 subjects the applicant to a civil penalty of not more than rive hundred dollars ($500). O 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 improve for the purpose of sale.) ❑ I, 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 O Copy is filed with the city. O Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM - 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 Verson 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 of the Labor Code, 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 cartity.that I have read this application and state that the above information is correct. I agreeto 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 Sq. Ft. No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR 3timated Valuation $1,000.00 . PERMIT AMOUNT Plari 'Chk.. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing 30.00 S. M.1. Grading Driveway Enc. Infrastructure TOTAL 30 .. O t3 REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBINi, FEES 1ST FL. SO. FT. ® $ UNITS SLAB GRADE ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL. SO. FT. FORMS SEWE R SAI Y ��I�?� ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SO. FT. ® GAS (ROUGH) METER LOOP GAR. SO. FT. ® POWER OUTLET ROOF DRAINS ) GAS (FINAL) TEMP. POLE DRAINAGE PIPING " CAR P. SO. FT. GROUT WATER HEATER WALL SO. FT. ® FINAL INSP. DRINKING FOUNTAIN SO. FT. ® WATER SYSTEM URINAL ESTIMATED CONSTRUCTION VALUATION $ =$ WATER PIPING NOTE: Not to be used as property tax valuation INSP. FLOOR DRAIN MECHANICAL FEES II WATER SOFTENER VENT SYSTEM FAN EVAP.COOL 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 ® 11A c SEWAGE DISPOSAL SO.FT.GAR ® 34c 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 SEWE R SAI Y ��I�?� ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ =$ LUMBER GR. // ��/J -54A lilNAL �"�� J INSP. FRAMING FINAL INSP. Sl,q S II 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 SIGNATURESIINITIALS GARDEN WALL FINAL n CoAc*sLLAVALLEY WATER DISTRICT ' CASH RECEIPT DETAIL ` Received From: Account No. Service Address o Meter(s) o *^usvl-oto,a/<$ � o n Meier - _-_'_- --- _----_--_ _--_-_-'___-- 9 17 Sanitation cuvu /*�un�u u w.S.B.po. • Temporary Construction Meter ________-'-____--'____-�-_-__-__ orvmo,,cxa,oe -_'---_-___'__-__-__--_-_-_---_-�'__-'_--_----- -----�-------' o Uncollected Account 'wame_'_--_-__'_-_-__----�_--______-_-_-- o Inspection Fee Two, � Fee - oPlan Check Fees Water / Sewer ' naot o Bond Payment A.D. ' A,vm,_____'_____-__ o oumvm6/oonuv/�_-_-__--_-___�__---_'____�__-_-_'-____'___ m n o'h°, _� ror^L $ oCOPY to:Money Check Order Water Service Cashier— / ti HAMMER PUMPING INC.., P.O. Box 2448, S CATHEDRAL, CITY, CALIFORNIA 92235-2448 ' ��619) 360-7448 t' JOB INVOICE a (619) 321-7448; CUSTOMER'S ORDER NO. DATE ORDERED t,+-' ORDER TAKEN BY DATE PROMISED ❑ A.M. BILL TO -„� PHONE ADDRESS ea V CHA IC CITY ,- HELPER' JOB NAME A D L ION I "T T -T •� jC�"iT . y, _w -.Q?SAY WORK' DESCRIPTION OF W K— „,,,,,,. ,-� -!'" - ,.1L`j •,• CONTRACT DEXTRA r x QUANT. DESCRIPTION OF MATERIAL USED -?1'. PRICE AMOUNT Gallons r j� Pumping Fee per 1000 gal.. "",2 .�• X DumpingfFee per 1000 gal. Out of Area Fee If' Locating / Opening Fee (per bur) Size System: _ .tY � • _ A SERVICE CHARGE OF, $20,WILL BE -DUE ON ALL RETURNED CHECKS. A FINANCE CHARGE OF 11/2% PER MONTH, 18% PER,YEAR ' ♦f , WILL BE CHARGED ON PAST DUE ACCOUNTS OVER 3Q,DAYS. HOURS .i. - LABOR AMOUNT TOTAL MATERIALS MECHANICS Q TOTAL . _ HELPERS Q • iiLABOR I hereby acknovjPdge the satisfactory —.--completion of 16e above described work: TOTAL LABOR' TAX ATURE DATE-QlNiPLETED V XLI..�.'�n4 l� . j . TOTALS r :.` . N01MCE tO ®WMEta • Under the California Mechanics Lien Law any contractor, subcontractor, laborer, supplier or other person who helps to,impr&e your property,'but•is not paid for•hislher 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 h� provide this notice. A Preliminary Notice is not a lien against your property. Its purpose is.to Ynotify 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) Days after completion of your project. m TO INSURE EXTRA PWECTiON MA.YOURSELF ANO 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 agreemOrlt should 'include the addendum approved by the . Registrar of Contractors.., 2) Issue joint checks for paiyment, madE' out to both your contractor and subcontractors or material suppliersinvolved in the. project, `This will help to insure that all persons due payment are actually paid. 3) After UPON making payment on arty inpleted phase of the ;project, and before making any further payments, require your contraiao.- to provide you with unconditional lien releases signed -by each ntatersel suplali c .��itsr�,ctoa;artdlaboler Involvea in that portion of the s work for which payment was made. On projects involving improvements to.. a single family y 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 MATEAIAL_SUPPLIERS, SUBCONT'RACTOfiS'OR LABORERS HAVE SIGNED. ' i