06513 (SATT)4 Z4-1
P.O. BOX 1504 No. 06513
Building 78-105 CALLE ESTADO
Address 54-511 'Riviera LA QUINTA, CALIFORNIA 92253
Owner
Mailing
Sunrise fiomtauy BUILDING: TYPE CONST. OCC: GRP.
Address 42-600 Cook St., MCIWest - Tract 24317--I
• A.P. Number
City Zip Tel.
Palm text 92260 Legal Description
Contractor Phaed 31B,, i lir 30M
Y�stttsaal�ort888@ Project Description
Address. .
Ste
City Zip Tel.'
State Lic. City
& Classif. 288.130 Lic. # 328 Sq. Ft. 2826 No. No. Dw.
Arch., Engr.,
Size Stories Units
Designer New ❑ Add ❑ Alter ❑ Repair ❑ -Demolition ❑
Address Tel.
City Zip State
Lic. If
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that 1 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
1 hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Busihess and Professions Code: Any city or county which requires a $194,692
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 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 exerrption. Any violation of Section 7031.5 by 'any applicant for a permit Plan Chk. Dep.
'subjects the applicant to a civilpenally 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 Plan Chk. Bal. $02.21
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and 97Z •.®
Professions Code: The Contractor's License Law does not apply to an owner of properly Const. y who 7
builds or improves thereon and who does such work himself or through his own employees. Mech. 82.
provided that such improvements are not intended or offered for sale. fl, however, the building I
or improvement is sold within one year of completion, Ne owner -builder will have the burden Electrical 142.41of proving that he did not build! or irprove for the purpose of sale.)
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 204.00
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law e
does not apply to an owner of property who builds or irtproves thereon, and who contracts for S.M.I. 13.63
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec. a_ g, P.C. for this reason Grading
Driveway Enc.
Date Owner Infrastructure14,384.57 2.170 29
Leas Credit 2 9 a 29
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. ❑ Certified copy is hereby furnished. -- r
TOTAL ,407.0 .+'d!/6 "t" U,^
CERTIFICATE OF EXEMPTION FROM
WORKERS'COMPENSATIONINSURANCE
(This section need not be completed if Me permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of Iwork 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: B, 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 perut 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, Cin? Code.)
Lender's Name
Lender's Address
This is a building permit when property filled out, signed and validated, and is subject to
expiration it 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
REMARKS
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 -
10/13189
Issued by: Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES"
IST FL. SQ. FT. ® $
UNITS
B GRADE
2ND FL. Sp. FT.
BONDING
YARD SPKLR SYSTEM
STORAGE TANK
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
DUCT WORK
ROCK STORAGE
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
OTHER APPJEQUIP.
DRAINAGE PIPING
CAR P. I SQ. FT.
TEMP. POLE
WALL SD. FT.
GROUT
DRINKING FOUNTAIN.
SQ FT ®
FINAL INSP.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
WATER PIPING
NOTE: Not to be used as property tax valuation
=$
FLOOR DRAIN
MECHANICAL FEES
/INAL
WIFFIAMING (� 6
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
REMARKS:
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1% c
SEWAGE DISPOSAL
MESH
SQ.FT.GAR ® 3/ic
HOUSE SEWER
4I SULATION/SOUND'?
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
ND PLUMBING j `b
UNDERGROUND
A.C. UNIT
COLL. AREA
B GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SE dC�fAl
ROUGH WIRING
DUCT WORK
ROCK STORAGE
U D. REINF.
YPISAS (ROUGH)'
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
EINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
INSP/%
/INAL
WIFFIAMING (� 6
FINAL INSP.
V—ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
FIREWALL
/GAR.
/ THING
MESH
4I SULATION/SOUND'?
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESJINITIALS
GARDEN WALL FINAL