15069 (PLBG)r
Qum&
P.O. BOX 1504
Address
54-217 Eisenhower Dr. 78'495 CALLE CALIFORNIATAMPIO
Address LA QUINTA, ORNIA 92253
Owner Mr. & Mrs. Charles wine
Mailing
Address Same
City Zip Tel.
La Quinta, CA 92253
Contractor
Denboer Engineering & Construction
Address
68-175 Berros Court
No. 15069
BUILDING: TYPE CONST. OCC. GRP.;
P. Number
Legal Description
Project Description Sewer Connect
Uthadrai City;`CA
92234
'327-2260
State Lic. A 684563
& Classif.
City 3577
Lic. #
Sq. Ft.
Size-
No. No. Dw.
Stories Units
Arch., Engr.,
Designer
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
City
Zip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chappter 9 (commencing with Section
7000) of Divisiori 3f of the Business Professions ,Cpde,s3nd my license is io�fu�ll f rce a_nd
effect. fi ', .�t/✓ _ l�F'Jia �� �
SIGNATUREDATE
7 .
BUILDER DECLARATION
ge exempt
I herebyaffirm that 1 exem t from the Contractors License Law for the following
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 statementthat he Is licensed pursuant to
the provisions of the Contractors 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).
❑ 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
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
Estimated Valuation
$1, 700.80
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal. )
Const.
Mech.
Electrical
Plumbing
30.00
i S.M.I.
Grading
Driveway Enc.
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 N��O.rr—y✓"~' Company
(VCispy is filed with the city. ❑ 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 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. d, 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.
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.
Signature of applicant —Date—
Mailing
ateMailing Address
City, State, ZIp
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 Cel Jr Line
Side Setback from Property it
Z
FINAL DATE INSPI
Issued by: Date yr Permit r
Validated by:
Validation: �j� /
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
IST FL. SO. FT. ® $
UNITS
COLL. AREA
o
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. SO. FT. ®
FORMS
SEW O I
•
DUCT WORK
MOBILEHOME SVC.
BAR SINK
FOUND. REINF.
POR. SO. FT. ®
METER LOOP
HEATING (FINAL)
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
TEMP. POLE
DRAINAGE PIPING
GROUT
CAR P. SO. FT. ®
SERVICE
FINAL INSP.
WALL SO. FT.
BOND BEAM
DRINKING FOUNTAIN
SO. FT. ®
=$
URINAL
a' 9 FINAL INSP.
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
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
SPARK ARRESTOR
LAUNDRY TRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
LATHING
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE,TEMIPERM
LAVATORY
INSULATION/SOUND
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
FINAL INSPECTION
CERT. OCC.
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 1'A c
SEWAGE DISPOSAL
INSPECTOR'S SIGNATURESIINITIALS
SO.FT.GAR ® 3/ac
HOUSE SEWER
GARDEN WALL FINAL
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 GOND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEW O I
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
yd.
$ plus x$
=$
LUMBER GR,cu.
a' 9 FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
�
L
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
i
f_Rom 0000000000++++++++
e
8U
JUN•21.95 8:47 AM P.003
i
June 15, 1995
TRI -STAR CONSTRUCTION
P.O. BOX 542
CATHEDRAL CITY, CA. 92235
ph. (619) 321-0898
fax. (619) 321-7798
TO; CITY OF LA QUINTA
RE: 54-217 EISENHOWER
PER MY AGREEMENT WITH TRT -STAR CONSTRUCTION I WILL RE -SEED OR
OTHERWISE COMPLETE MY YARD AFTER THE INSTALLATION OF THE SEWER.
i
THANK YOU,
sib bture
PI ease Ptint-, name -
y
HAMMER PUMPING INC. JOB INVOICE
.s `, P.O. Box 2448
CAT41nRAL CITY, CALIFORNIA 92235-2448
i&ld% -Owwe
wa�
(619) 321-7448
CUSTOMER'S ORDER NO.
DATF ORDERED
a" IFS
ORDER TAKEN BY
DATE PROMISED ❑ A.M.
❑ P.M.
BILL TO
V\
PHONE
I
ADDRESS
MECVIC
�- 1
CITY
HELPER
JOB NAME AQIq LQCATIflQN7 j""� ,
7 O r _ .P V
1.1,1 A
O -b -A -Y WORK
DESCRIPTION(ti �1K WORK
' r rl— Q�1 ! O N _
EXTRA
r
CONTRACT
❑
Se A -v e r- o 0
QUANT.
DESCRIPTION OF MATERIAL USED
PRICE
AMOUNT
166U
Gallons
06 0
Pumping Fee per 1000 gal.
Dumping Fee per 1000 gal.
S-0
S�
Out of Area Fee
Locating / Opening Fee (per hour)
Size System:
r C C-
_
A SERVICE CHARGE OF $20 WILL BE DUE
A
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 cQ
HELPERS Q
TOTAL
LABOR
1 hereby acknowledge the satisfactory TOTAL LABOR
completion of the above described work:
TAX
S, dNAT RE
DATE COMPLETED
TOTAL
�3��
C =•_ J
NOTICE TO OWNER
Under the California Mechanics Lien.LaW any, coptractor,, subcontractor, laborer, supplier
or -other person who helps to improve your property, biit 'is not paid for his/her work or
supplies, has a right to enforce a claim against yodr property. This means that after a court
hearing, your property could be sold by a court officer and the proceeds -of the sate 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. ks purpose is to
notify you of persons who.may have a right to file a lien against your propbrty 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 materiaf supplier`s through
a joint control. Any -joint control agreement'should include the addendum approved by,the
Registrar of Contractors.
f
2)X .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.