06508 (SATT)" -1
P.O. BOX 1504 No. 06508
Building78-105 CALLE ESTADO
Address 54-495 Riviera LA QUINTA, CALIFORNIA 92253
Owner
Sunrise company
Mailing �.
BUILDING: TYPE CONST. OCC: GRP.
Address 42-600 Cook St.., #200 A.P. Number FGA West Tract 24317-'1
CityZip Tel.
Palm art 9226 . Legal Description
Contractor Phase 31B, Plan 2
Project Description .
National Nortimize
Address
City Zip Tela
State Lic. City
& Classif. 288130 Lic. # 328, Sq. Ft., 2596 No. No. Dw:,
Arch., Engr., Size . Stories Units
Designer New ❑ Add ❑ Alter ❑ Repair ❑ -Demolition ❑
Address TeL
City Zip State
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 Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following 179,818
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 rite a signed statement that he is licensed pursuant to PERMIT AMOUNT
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 Plan Chk. Dep.
subjects the applicant to a c" penalty of not more than rive hundred dollars ($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. $ 761.17
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. ��50Professions Code: The Contractors License Law does not apply to an owner of property who 7.
builds or improves thereon and who does such work himself or through his own employees, Mech. �I1 C
provided that such improvements are not intended or offered for sale. If, however, the building 82.50
or improvement is sold within one year of completion, the owner -builder will have the burden Electrical 1 'r�
of proving that he did not build or improve for the purpose of sale.) 1.. 6
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 1919.00
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. 12.60 _
such projects with a contractor(s) licensed pursuant to the Contractors License Law.)
Grading
❑ I am exempt under Sec. B. 8 P.C. for this reason
Driveway Enc.
Date Owner Infrastructure $4,045.90 2,022.95
Less Credit 2,022.95
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: lf, 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, Ciel Code.)
Lenders Name
Lenders Address
This is abuilding permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certity 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
TOTAL yg4ay1_4L*%ts I __`// 5 z/. f_- .s
REMARKS AAW.liP") AA CIA71 40—iA-419in
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 I NS6P€CT0R
13/89
Issued by: Date j Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES'
IST FL. SQ. FT. ® $
UNITS
ROUGH PLUMB.
2ND FL. SQ. FT.
HEATING (ROUGH)
YARD SPKLR SYSTEM
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. I SQ. FT.
HEATING (FINAL)
DRAINAGE PIPING
WALL SQ. FT.
GAS (FINAL)
DRINKING FOUNTAIN.
SQ FT ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
SERVICE
WATER PIPING
NOTE: Not to be used as property tax valuation
BOND BEAM
FLOOR DRAIN
MECHANICAL FEES
GRADING
cu. yd.
$ plus x$
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
CROOFING
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
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.
SQ. FT. RESID ® 1+/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
SETfACK
ND PLUMBING (l UNDERGROUND
A.C. UNIT
COLL. AREA
B GRADE J 6
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FOMS
ER OR Sii T ROUGH WIRING
DUCT WORK
ROCK STORAGE
OUND. REINF.
GAS (ROUGH)
v -_ ` METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
EINF. STEEL 7
42
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
-$
LUMBER GR.
INAL INSP.
RAMING
FINAL INSP.
CROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
fXLATHING
MESH
ft,NSULAT IONISO UND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINA'!