001849 (SATT)Building
54-164 Oak Tree
Address
Owner
Sunrise many
Mailin
Address
75-005 Csimtrp Club. Drive
City Zip Tel.
. Palm Dessert 1 92260
contra . rNat'i Lemd ead Mortgage.
f
/ I
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
558-2828
City Sam IZip- G� ITel. Sam
State Lic. I City
& Classif. Lic. # 328
Arch:, Engr.,
Designer Robert Altevers Asame.
Address Tel.
2.915 Red AM Ave. (7.14) 5.60-5117
CityZip State
Costa �esst .. 92626 Lic- #
LICENSED CONTRACTOR'S DECLARATION f
I hereby affirm -that I am licensed under provisions of Chapter 9 (commencing,with Section
7000) of D.`ivision 3 of the Business and.Professions Code, and my license is in'full force and.
effect.,,.. • � �`.Or /p, ��� •`'i
SIGNATURE 1 -1 - .� / DATE
/OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Susiness 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 thathe 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 (8500).
O 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.)
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and Professions Coder TheContractor'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 Seca 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
O 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: It 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.
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 it work thereunder is suspended for 180 days.
I certify that I have read this applicationand 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 atiove-
mentioned property for inspection purposes. ,f r
P t
Signature of applicant--fie';-.'t` �''. Date
Mailing Address
City, State, Zip )
HARD COPY
No. 001849
BUILDING: TYPE CONST: M OCC. GRP.
P. Number
Legal Description
P" M 6QR
Project Description
Sq. Ft. .1918 No. No. Dw.
Size M 624 Stories- 1 Units 1
NewT97 Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT.
AMOUNT
Plan Chk: Dep.
Plan Chk. Bal.
395.613
Const.
485.513
Mech.
34.00
Electrical
74.69
Plumbing
87.50
S.M.1.
8.30
Grading
Driveway Enc.
Infrastructure
1,805.97
TOTAL
2,891.56
REMARKS
POOL AIM SPA UOT PART OF TECE8 PFS MT
VID BL= WALLS
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: Date11"12`85 Permit
idated by:
Validation:
A3212 11 13 2891.56 CK
CONSTRUCTION ESTIMATE
NO. ELECTRICAL EQ9k,
NO. PLUMBING FEES
1ST FL. SO. FT. ®
2ND FL. S0. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. I SO. FT.
WALL S0. FT.
SO. 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
COLL. AREA
FLOOR DRAIN
MECHANICAL FEES
'FCFORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
EWER OR SEPTI M
LAUNDRY TRAY
AIR HANDLING UNIT CFM
DUCT WORK
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
TEMP. POLE
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
FINAL INSP.
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 0710,
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
'FCFORMS
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
EWER OR SEPTI M
OUGH WIRING
7 /
v
DUCT WORK
ROCK STORAGE
r
OUND. REINF. %Z ��
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
/
GAS (FINAL) H 2
/
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
`FINAL INSP. , /
rJ
FRAMING
FINAL INSP.
I
ROOFING
1
VENTILATION
1
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND .�
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL