13821 (BLCK)TA
4'4
P.O. BOX 1504 No. 1.
_Buiidirib 54-86.0 Ave. 0breg 78-105 CALLE ESTADO,
on
Address')- LA QUINTA, CALI FORNIA.92 253
,,,Owner
M a, It, t Mathe
Mailing BUILDING: TYPECONST. OCC: GRP. -
Address S ame
A.P..Number
City zip
-92253 115 Legal Description
'La Quinta.. 'CA
Contractor 150 of 314" hijh-r'etai_inkng._;
Project Description
_,Sunrose Corporation
Address
Sortera Road
city Zip Tel.'
palm Desert, 4 A 92260 34 -2840
State Lic. 8 533670 City 1137'
Classif. No.'
Lic. # Sq. Ft. No. Dw.
Size - Stories Units
Arch., Engr:-,
Designer New 0 Add El' _Alter 0 Repair 0 Demolition 0'
Address Tel.
p t State
Lic. #
City
4.
LICENSED C?NTRACTOR'S DECLARATION
-.1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
�000) L, ssand-Professions Code, and my license is in full force and
ifect
SIGNA DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contract6r's License Law for the following Estimated Valuation— .42,,250.00
reason: (Sec. '7031.5, Business and Professions Code: Any city or county which requires a
permit to construct, after, improve," demolish, or repair any structure, � prior to its issuance also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to PERMIT OUNT
the.provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of 'AM
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 Plan Chk. Dep.,
subjects the applicant to a civil penalty of not more than five hundred dollars ($ 5 00).
0 1, as owner of the propertyl or my employees with wages as their'sole compensation, will Plan Chk. Bal.
.do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. 00
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 Mech.
or improvement is sold within one year of completion, the owner -builder will have the burden Electrical
of proving that he did not build or improve for the purpose of sale.)
,b 1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing
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 S.M.I.
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
El I am exempt under Sec.—B. & P.C. for this reason Grading
Driveway Enc.
Date
Owner Infrastructure L
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of 6brisent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy 0. Company
Ljwzopy is i a th
I dwi a city. 0 Certified copy is hereby furnished.
TOTAL 54. OU
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE REMARKS
(This section need not be completed if the permit is for one hundred dollars (S100) valuation
or less.)
I certify that in the performance of thp 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. f .
Date wrier
NOTICE TO APPLICANT. if, after making this Certificate of—Exemption you - should become ZONE: BY:
-subject to the. Workers' Compensation provisions of the Labor Code, you must forthwith Minimum Setback Distances:
comply with such provisions or this permit shall be deemed revoked.
Front Setback from Center V- ine
Rear-Proo-6'
Rear Setback f �o��'. tne
CONSTRUCTION LENDING AGENCY
Side Street Setback from Gen, er Line -
I hereby affirm that there is a construction lending agency for the performance of the
w k
or for which this permit is issued. (Sec. 3097, Civil Code.) Side Setback from Prop,/e�rtlne -A
Lender's Name
Lender's Address 0
This is a building permit when properly filled out, signed and validated, and is subject I FINAL DATE INSPEr'. OR
0 V
expiration it work thereunder is suspended for 180 days. ;: . Ul
I car Illy that I have read this application and state that the above information is correct. Issued by:' Date -permil
I agree to comply with all city and county ordinances and state laws relating to building 0I
' construction, and hereby authorize representatives -of this city to enter the above-. �_Y_94
mentioned property for inspection purposes. Validated by:
Signature of applicant Date— 4:/y
Mailing Address Validation:
City, State, Zi
4
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. @ $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. SO. FT. @
FORMS
SEWER OR SEPTIC TANK
POR. SO. FT. @
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. @
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT. @
OTHER APPJEOUIP.
DRAINAGE PIPING
WALL SO. FT. @
TEMP. POLE
DRINKING FOUNTAIN
SO. FT. @
GROUT
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
WATER SYSTEM
FLOOR DRAIN
MECHANICAL FEES
$
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
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 @ 11/4 c
SEWAGE DISPOSAL
LATHING
SQ.FT.GAR @ 3/4c
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH!FEE PL.CK.FEE
CONST. FEE ELECT.FEE
SMIFEE PLUMB. FEE
STRUCTURE / PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.G. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCKSTORAGE
FOUND. REINF. V
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
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION 7-22
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL