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14393 (PLBG)Building Address Owner } P.O. BOX 1504 N o . 14393 9.3 51-860 Eisenhower Drive LA QUINTA, CALIFORNIA 92253 Mr. Mrs. Barajas Mailing" BUILDING: TYPE CONST. OCC. GRP - Address Sane . Cite Quinta., C zip92253 Tel. Contra for Ben�Mer Engineering & Construction AVEF-SS175- Berros Court ctathedral Cit'; CA 92234'Teri.619 j 327-2.200 State Lic. City & Classif.. A B 684563 Lic. # Arch.,•Engr., Designer Address Tel. City Zip State Lic. # - LICENSED CONTRACTOR'S DEbLARATION hereby affirm that I am licensed under Provisions�f,dhapter 9 (commencing with Section ,1�of Division 3 of the BusinAss and Profession Code, -and my license is)in fuit'force and . eTfect. RX L Ii*(er1 i �� F 3 /irr i -1/7, s OWNER -BUILDER DECLARATION I hereby affirm th t 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 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 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 dor such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) ❑ I 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�df Company W, opy is tiled with the city. ❑Certified copy is hereby furnished. 4. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE• (This section need not be completed I/ the permit is for one hundred dollars ($100) valuation Of less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any pornierson' in any manner so as to become subject to the Workers' Compensation Laws of Califa Date Owner _ NOTICE TO APPLICANT: ff, after making. this Certificate of, Exemption you should become i subject to the Workers' Compensation provisions o/ 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 ($100,0)0), IN ADDITION TO THE COST OF.COMP.ENSATION,- DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. - Ttiis 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 A.P. Number Legal Description Sewer Connect Project Description Sq. Ft. No. No. Dw. Size Stories Units New ❑ Add.❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation 41A30.00 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. .Const. Mech. Electrical ec Plumbing `r S.M.I. Grading Driveway Enc. Infrastructure TOTAL 30.00 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 Issued by: Date P• mit J Validated by: �I Validation:na CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBINU FEES 1ST FL. _�- o� SO. FT. ® $ UNITS SLAB GRADE ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL. SO. FT. @ FORMS EWE OR S 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 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, 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 a 11/4 c SEWAGE DISPOSAL SO.FT.GAR ® VAc HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE Ll 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 EWE OR S 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. AI- I J sdot"'l FINAL INSP. FRAMING FINAL INSP. 3 `J� 7 _ 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 SIGNATURES/INITIALS GARDEN WALL FINAL HAMMER PUMPING INC. JOB INVOICE P.O. Box 2448 CATHEDRAL CITY, CALIFORNIA 92235-2448 1c'1n'Icn -Fwwo ws�/ vvv-i �w (619) 321-7448 If DESCRIPTION OF MATERIAL USED CUSTOMER'S ORDER NO. DATE ORDERED -:L— 13 - 1? 5 - ORDER TAKEN BY DATE PROMISED ❑ A.M. ❑ P.M. BILL TO 04 PHONE ADDRESS Pumping Fee per 1000 gal. NIC CITY HELPER JOB NAMEr LOCV%O S� ((�� �/ /1 ❑ DAY WORK DESCRIPTION OF WORK �� /•1� 1 •_ WO O CONTRACT ❑EXTRA U� QUAINT. If DESCRIPTION OF MATERIAL USED PRICE AMOUNT Gallons 66V Pumping Fee per 1000 gal. WO Dumping Fee per 1000 gal. U� Out of Area Fee Locating / Opening Fee (per. hour) Size System: 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 ® HELPERS TOTAL LABOR I hereby acknowledge the satisfactory TOTAL LABOR completion of bove described work: TAX SIGNATU DATE COMPLETED r. 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 aright 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 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 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. 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. ;