001873 (SATT)P.O. BOX 1504
Building 2454-e446 O Tree 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner Sunrise CcmllianY
AddreMailing ss 75-005 Ca�ntry Cl Drive
Cit-r=aim Desert Z"4226 . Tel. 568-2828
Contractor
ress.
BUILDING: TYPE CONST
A.P. Number
No. 001823
OCC. GRP.
Legal Description
Project DescriptionliQST FILM 10
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed i1 the permit is for one hundred dollars ($100) valuation .
or less.)
I certify that in the performance of the 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, 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 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 abbve-
mentioned property for inspection purposes. lJ'
Signature of applicant r Datef�<f
Mailing Address
City, State, Zip
HARD COPY
REMARKS
PWL. AM SPA WJT PAT 01? THTS P1=114TT
Nn KAWX VAT_ SS
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 11--12-85 Permit
,.Validated by:
Validation:
A3246
11 13 21)9,42 U
City Sam
Zip 63 -
Tela saw
State Lia
& Classif.
City
Lic. #328
MW 1930
Sq. Ft.�R, 424
Size
NewK Add ❑
No. 1 No. Dw.
Stories Units 1
Alter O Repair ❑ Demolition ❑
'Arch:, Engr.,
DesignerRobert E1itevers Ass=.
_ Address
2915 Red RIU Ave.
Tel.
(710-540-5117.
City
Cosa& mesa92616'
Zip
State
Lic. #
v
• LICENSED_CONTRACTOR'S DECLARATION %.
I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing w,itti Secti.6"
7000) of Division 3 of the Business and Professions Code, and my licenseis in full forrcce,and �,
effect...i' ,f %: .i-. ) . dpi'/
r
'SIGNATURE •"""� / '-I' DATE
' %OWNERBUILDER DECLARATION
y
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 anystructure, 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; andthe 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).
O 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
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
proving that he did not build or jmprove 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.)
O 1 am exempt under -Sec. -B. & P.C. for this reason
Estimated Valuation
-
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
. � �
Corlst.
391.00
Mech.
34.00
Electrical
59.99of
Plumbing. -
87.50
S.M.I.
-
- 5.99
Grading
Or Enc.
Date Owner
Infrastructure
1,276.00
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
❑. Copy is filed with the city. 0 Certified copy is hereby furnished. '
TOTAL
-0.179.42
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed i1 the permit is for one hundred dollars ($100) valuation .
or less.)
I certify that in the performance of the 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, 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 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 abbve-
mentioned property for inspection purposes. lJ'
Signature of applicant r Datef�<f
Mailing Address
City, State, Zip
HARD COPY
REMARKS
PWL. AM SPA WJT PAT 01? THTS P1=114TT
Nn KAWX VAT_ SS
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 11--12-85 Permit
,.Validated by:
Validation:
A3246
11 13 21)9,42 U
CONSTRUCTION ESTIMATENO.
ELECTRICAL FE.
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
COLL. AREA
2ND FL. SO. FT.
ROUGH PLUMB.
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO, FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT.
DUCT WORK
DRAINAGE PIPING
WALL SO. FT.
GAS (ROUGH)
DRINKING FOUNTAIN
SO FT ®
HEATING (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
-GAS (FINAL) LI
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER HEATER
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
WATER SYSTEM
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GRADING
cu. yd.
$ -plus-x$_=$
LAUNDRY TRAY
AIR HANDLING UNIT CFM
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
FIREPLACE
SO.FT.GAA ® 3/ac
HOUSE SEWER
SPARK ARRESTOR
GAS PIPING
PERMIT FEE
GAR. FIREWALL
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 3
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE l 6
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
`4 SEWER OR SPTC
ROUGH WIRING 3
o r
O G
DUCT WORK
ROCK STORAGE
r
FOUND. REINF. I / $r C�l /
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEGUIP.
kREINF. STEEL �1/ 7
-GAS (FINAL) LI
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ -plus-x$_=$
LUMBER GR.
OLKFJNAL INSP. S ,('
FRAMING 3 cL
l `
FINAL INSP.
ROOFING `3 Y6
Y
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
I LATHING 3
MESH
}INSULATION/SOUND 3 a,
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL