06516 (SFD)•4 "
P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address 54-447 Riviera LA QUINTA,,CALIFORNIA 92253
Sunrise Company
Mailing
Address -still Cook S 62001
City Zip Tel.
Pairs Desert 9226 568-2828
Contractor
National Mort ar
Address .
State Lic.I City
& Classif. 288134 Lic. # 328
Arch., Engr.,
Designer
Address Tel.
City IZip I State I
Lic. #
LICENSED CONTRACTOR'S DECLARATION.
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.
SIGNATURE DATE
OWNEWBUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sac. 7031.5,13usiness and Professions Cade: Any city or county which requires a
permit to construct, after, improve, demofsh, or repair any structure, prior to its issuance also
requires the applicant for such permit to lie 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, and the basis
for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit
subjects the applicant to a civilpenally 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 Contractors License Law does not appy 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 lot sale. If, however, the building
or improvement is sold within one year of completion, the owner -budder 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 appy to an owner of property who buikls or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursued to the Contractor's License Law.I
❑ 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, Later Code.)
Policy No. Company
❑ Copy is filed with the city. ❑ Certified copy is hereby fumished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the pemxt 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, 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 proviskms or the permit shag 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, CW Code.)
Lenders Name
Lenders Address
This is a building permit when property filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
1 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
5 — z --
No. 06516
LDING: TYPE CONST. OCC: GRP.;
P. Number PGA tllent — Tralet 744417--1.
egal Description
roject Description Phase 3IB, Plan 30H
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
10113189
Issued by: Date Permit.
Validated by:
Validation:
Sq. Ft. 2826
Size
.• No.
Stories
No. Dw.
Units
New ❑ Add ❑
Alter ❑
Repair ❑ Demolition ❑
Estimated Valuation
$194,692
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
$ 802.21
Const.
97240
Mech.
82.90
Electrical
142.41
Plumbing
204.00
S.M.I.
13.65
Grading
Driveway Enc.
Infrastructure
$4,380.57
2,199.29
Less Credit
2,190.29
TOTAL
$4,407.6
�%F•%C-�` (,(
REMARKS
r")lit�i" .4 A
Sf+IfS4. _ & i<A— 7.(
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
10113189
Issued by: Date Permit.
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES -
IST FL. SQ. FT. ® $
UNITS
B GRADE 2 -
2ND FL. SQ. FT.
BONDING
YARD SPKLR SYSTEM
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
UND. REINF.AS
(ROUGH) '�J / 0
•+ ` V
DRAINAGE PIPING
CAR P. SQ. FT.
OTHER APPJEOUIP.
REINF. STEE
WALL SQ. 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 FADE EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
f// �2
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
REMARKS:
LAUNDRY TRAY
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.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® V4c
HOUSE SEWER
MESH
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
SET ACK
OUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
B GRADE 2 -
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FRMS
ER OR SEPTIC Nyt
ROUGH WIRING.
DUCT WORK
ROCKSTORAGE
UND. REINF.AS
(ROUGH) '�J / 0
•+ ` V
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEE
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ —Plus—x$—=$
LUMBER GR.
W&NAL INSP. 00
RAMING —7– "r/,�
FINAL INSP.
&ROOFING U
f// �2
p� ��
' !/(J elg
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
I�ySULATION/SOON J 7v
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
'
GARDEN WALL FINAL