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15072 (PLBG)�y F T,i-tlt 4 4 Qum& P.O. BOX 1504 Building 78-495 CALLE TAMPICO Address 54255 Ave. 'Herrera LA QUINTA, CALIFORNIA 92253 Owner Mr. & Mrs. Bruce Pelletier Mailing Address ,'game City Zip Tel. La Quinta.. CA 92253 Contractor Denboer Engineering & Construction Address 6�3-37 grog court Cathedral City,IpCA 92234 Te327--2240 State Lic. A 604563 City 3577 & Classif. Lic. # Arch., Engr., Designer Address Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARAT-ON I hereby affirm thahl am licensed under provisions of Cha 000) (commencing with Section 70�) of Division 3'of the Business and'Professions Codec"arid my license is in full orce nd effect �� SIGNATURE .!°`-�.+�`-^'�"" ! DATE m WNEP BUILDER DECLARATION I hereby affirm that I exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Bustness 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 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 five hundred dollars ($500). ❑ 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 or 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.) O 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.) 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 No.. Company $.G py Is filed with the city.. ❑.Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed i1 the permit is for one hundred dollars ($100) valuation or less.) I certify that in the performance of thg 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. ff,. 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 certify that I have read this application and state that the above information is correct. 1 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 LDING: TYPE CONST P. Number No. 154?2 OCC. GRP. Legal Description Project Description Sewer Comiect Sq. Ft. No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ " Repair:❑ Demolition ❑ . Estimated Valuation $1,700.00 1 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing 30.00 S.M.I. Grading Driveway Enc. Infrastructure TOTAL 34.00 REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop.�Line� Side Street Setback from,Center Line fl,. Side Setback from Propetty. Ine<`,"l' FINAL DATE INSPECTOR 7,4 V �� Issued Validated by: I CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING; FEES 1 1ST FL. SO. FT. ® $ UNITS SLAB GRADE 2ND FL. SQ. FT. BONDING YARD SPKLR SYSTEM STORAGE TANK MOBILEHOME SVC. BAR SINK POR. SO. FT. ® DUCT WORK ROCK STORAGE GAR. SO. FT. ® POWER OUTLET ROOF DRAINS HEATING (FINAL) OTHER APPJEQUIP. DRAINAGE PIPING CARP. SO. FT. TEMP. POLE WALL SO. FT. ® GROUT DRINKING FOUNTAIN SO. FT. ® FINAL INSP. URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER SYSTEM WATER PIPING NOTE: Not to be used as property tax valuation =$ 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 LAUNDRY TRAY 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. SQ. FT. ® c BATH TUB GAR. FIREWALL SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR ® 3/ac HOUSE SEWER INSULATION/SOUND GAS PIPING PERMIT FEE FINISH GRADING PERMIT FEE PERMIT FEE DBL TOTAL FEES��FEE FINAL INSPECTION �S 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 EW R 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. c��/ y/�Q FINAL INSP . FRAMING FINAL INSP. ROOFING ' REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION �S CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL HAMMER PUMPING INC. JOB INVOICE P.O. Box 2448 CATHEDRAL CITY, CALIFORNIA .92235-2448 ray of 1An-7AAQ %v 1 — i — (619) 321-7448 QUANT. CUSTOMER'S ORDER NO. DAT ORDERED —a (- AMOUNT ORDER TAKEN BY Gallons DATE PROMISED ❑ A.M. 000 ❑ P.M. BILL TO 00 PHONE �t ADDRESS Dumping Fee per 1000 gal. k( S'�� MEN C /' 1` CITY t. HELPER JOB NAME A e CATION �� —ZJ P I%�� Gl AY WORK 1 J /� ✓� VLl DESCRIPTION (1 ^ ❑ CONTRACT ❑EXTRA L'W`OR�� , Locating / Opening Fee (per hour) o or - K - LAg I QUANT. DESCRIPTION OF MATERIAL USED PRICE AMOUNT '000 Gallons 000 Pumping Fee per 1000 gal. 00 Dumping Fee per 1000 gal. k( S'�� 5`Q oe t. Out of Area Fee Locating / Opening Fee (per hour) Size System: fCF r r t 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 HELPERS Q TOTAL LABOR I hereby acknowle e't"' s �Sfactory TOTAL LABOR completion of the�ab ve a fribed work: TAX SIGNATURE JTCOMPLETED a TOTAL 133 NOTICE TO OWNER . Under the California Mechanics Lien Law any contractor, subcontractor, Jaborer,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 A'� er a court hearing, your property could be sold by a court officer -and the proeeds 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 fife 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 nota 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) Days after completion of your project. 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 Jnclude 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 QPON 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.