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15064 (PLBG)Buildin Address 52-085 E.'i.seYliSg6+1'er Dr. Owner Profina V I Mailing Address same City Zip Tel. La Qulnta, CA 1. 92253 P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Contractor Deaboeg Engineering & Construction .. Address. . 68--175 Eerros Court Cit Cathedral City, Zip CA 92234 Tel.: 3272200 State sic. A 584563 & Classif. City 3577 Lic. # Arch., Engr., Designer Address Tel. City Zip State $1*700.00 PERMIT Lic. # LICENSED CONTRACTORS DECLARATION I hereby affirm that I am licensed under provisi ndof Chapter 9 (commencing with Section 7000) of Dlvi'slon 3 of the Bu mess and[['Profes/sions Code, and my license is ifn II fore and- effect. nd effect.�� . f i915- SIGNATURE -40- - �-� I � / 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 rite 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 acivil 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. It, 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 knprove 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 Company 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 N the permit is for one hundred dollars ($100) valuation or less.) I certify that in the performance of thF 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: N, alter 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 it 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 No. 15064 BUILDING: TYPE CONST. OCC. GRP. A.P. Number ,Legal Description Project Description Sewer Connect Sq. Ft. Size No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $1*700.00 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. = Electrical -� Plumbing 3.0.00 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 /P� • 4. Line Side Street Setback fr'om'l/,enter�Ltne> Side Setback from;Propert Line \ r �� V FINAL DATE INSPECTOF Issued by: Date N Permit Validated by: Validation: / CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBIW FEES 1ST FL. SQ. FT. ® $ UNITS COLL. AREA SLAB GRADE YARD SPKLR SYSTEM 2ND FL. SQ. FT. 0 HEATING (ROUGH) STORAGE TANK FORMS MOBILEHOME SVC. BAR SINK POR. SO. FT. ® DUCT WORK ROCK STORAGE GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS METER LOOP HEATING (FINAL) DRAINAGE PIPING CAR P. SO. FT. ® GAS (FINAL) WALL SQ. FT. ® DRINKING FOUNTAIN SO. FT. ® URINAL ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP. WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES GRADING cu. yd. $ plus x$ WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER ROOFING GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM 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 SPARK ARRESTOR SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1% c SEWAGE DISPOSAL LATHING SO.FT.GAR ® 3/ic 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 S"EWER R SE 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. W*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 SIONATURESJINITIALS GARDEN WALL FINAL HAMMER PUMPING INC. JOB INVOICE P.O. Box 2448 CATHEDRAL CITY, CALIFORNIA 92235-2448 ICInt QCA 7AA4 wig/ JVV-/ TTw (619) 321-7448 DESCRIPTION OF MATERIAL USED CUSTOMER'S ORDER NO. DAJ E ORDERED t - 7 �- �.5-- ORDER TAKEN BY DATE PROMISED ❑ A.M. ❑ P.M. BILL TO PHONE ADDRESS Pumping Fee per 1000 gal. %� MECI�IC t CITY Q� HELPER JOB JOB NAME AID 1}f��CATION v V f f / ✓� 0 hGH c,i B"6AY WORK ❑ CONTRACT DESCRIPTION WORK r ❑EXTRA .So S1Q a QUANT. DESCRIPTION OF MATERIAL USED PRICE AMOUNT 490 0 Gallons DO p Pumping Fee per 1000 gal. %� eo &S Q� "000 Dumping Fee per 1000 gal. 1 P .So S1Q a Out of Area Fee Locating / Opening Fee (per hour) Size System: A SERVICE CHARGE OF $20 WILL BE UE ON ALL RETURNED CHECKS. A FINANCE CHARGE OF 11/2% PER MONTH, 18% PER YEAR WILL BE CHARGED ON PAST DUE ACCOUNTS OVER 30 S.1 I HOURS LABOR AMOUNT TOTAL MATERIALS MECHANICS Q HELPERS Q TOTAL LABOR I hereby acknowledge the satisfactory TOTAL LABOR completion of the above described work: TAX SIGNATURE DATE COMPLETED � M NOTICE TO OWNER. Under the California {Mechanics Lien Law any cbntractor, subcontractor, laborer, supplier or other person Who helps to imJprove 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 entified "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 nirie_ty (90) pays after completion of your project. TO INSURE EXTRA PROTECTION FOR YOURSELF AND YOUR PROPERTY, YOU MAY MASH TO TAKE ONE OR MORE OF THE FOLLOWING STEPS: I) 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.