10390 (SATT)III
Building
Address 55-855 Gait; Hill
4
P.O. BOX 1504
78-105 CALLE ESTADO.
LA QUINTA, CALIFORNIA 92253
0
Sunrise Desert Partners
Mailing
Address 42-600 Cook #200
City , Zip Tel.
P,�L3m Desert 92260 564-6716
Contractor
Same
Address
Tel.:
State Ljc. CitI23 .# 32$
& Classif. 2$$�3p Lic
Arch., Engr.,
Designer
Address Tel.
City I Zip I State
Lic. #
that I am'licensed'underlprovisioris,of Chapter 9 (commencing with
3 of the Business and'Professions_Code, andfmy license is in full h
bGNATURE- i DATE
" OWNER.BUILDEk DECLARATION
I hereby affirm that I am exempt from thAContractor'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 rile a signed statement that he is licensed pursuant to
the prdvisions or the Contractor's .License Law, Chapter 9 (commencing with Section 7000) or
'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 ownemployees,
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 1, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the projecL4(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
E] Copy 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., If, 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.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
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 Address
City, State, Zip
ILDING: TYPE CONST
'. Number
No. 10390
OCC: GRP.
Legal Description Tract 20717-1
Project Description FD
Sq! Ft. 1627 No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation .
'126,367.50
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
891.39
Const.
734.00
Mech.
55.50
Electrical
113.93
Plumbing
11%66.50
S.M.I.
12.00
Grading
20. 00
Driveway Enc.
? v A Q
Infrastructure
28 43.21
65.92
TOTAL
4922.51
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 5'
FINAL DATE INSPECTOR
Issued by: Date Permit
Validated by:
i
Validation:
a
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
2ND FL SQ. FT.
POR. SO. FT. ®
GAR. SQ. FT. ®
CARP. SQ. FT.
WALL SO. FT. ®
SQ FT ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN.
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEOUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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.
SO. FT. ®c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1+/a c
SEWAGE DISPOSAL
CZ- O�-e 6
v�
• SQ.FT.GAR ® 3/<c
HOUSE SEWER
VENTILATION
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PLCK.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
SEWER OR SEPTIC TANK
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.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
CZ- O�-e 6
v�
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION -
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINTTIALS
GARDEN WALL FINAL
` DESERT SAND& UNIFIED SCHOOL DISTRICT
' 82-879 Highway 111"
NOTICE: Indio,.CA !92201{..
Document Cannot Be Duplicated (619) 347=8631..
Date 12/17/91L Type of Permit::
No. 11060
Owner Name Sunrise Desert,
No.. ',55=855 Street.OakHill.. .
city La Quinta 3 Zip . 92253: _ Study Area 11
APN # Tract, # L:ot. # Square Footage 1
-71
Type of Development ,Single-:
At%
EARTH SYSTEMS CONSULTANTS S.C.
wr BUENA ENGINEERS DIV.
79-811 B Country Club Drive
Bermuda Dunes, CA 92201 • (619) 345-1588
Client Name
Client
Client Phone
DATE
TEST LOCATION
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JOB NO.
PROJECT
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LOCATION
CA
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CONTRACTOR
I MAXIMUM
DRY
DENSITY
%
OWNER
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WEATHER
CLE A
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TEMP. C at AM
0 a PM
PRESENT AT SITE
+ L I
1 S.
(03.$
q;�
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TEST
NUMBER
TEST LOCATION
c
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LOT
NO.
ELEVATION
FIELD TESTING
REFERENCE CURVE
MOISTURE
CONTENT
%
DRY
DENSITY
IbsJCu.It.
I MAXIMUM
DRY
DENSITY
%
MAXIMUM
DRY
DENSITY
Ibsicu. ft.
OPTIMUM
MOISTURE
CONTENT
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REMARKS: en%C-'4 C0 A 7 E —(S 2,) 711E PAd:) F— x= I (NJ
Air
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J�T�Tl a� '_ M cE E ob,�3
CLIENT REPRESENTATIVE SIGNATURE
71L[DD RT
TECHNICIANS SIGNATURE .�