06507 (SATT)4 4 "
P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address 54-543 ftyiera LA QUINTA, CALIFORNIA 92253
Owner
Sunriee Company
Mailing
Address 42-600 Cook St., #200
City Zip Tel.
Palm Desert 922 ,
Contractor
Address
Tela
State Lic. City
& Classif. 288134 Lic. # 328
Arch., Engr.,
Designer
Address Tel.
City I
Zip I State
Lic. #
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
effect. in full force and
_ , ,
_SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,191usiress and Professions Code: Any city or county which requires a
permit to construct, after, erprove, demolish, or repair any structure, prior to its issuance also
requires the applicant for such pemdt to Me 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 civ9 penalty of not more than rive hundred dollars ($500).
O 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 Contractor's License Law does not apply to an owner of property who
builds or 6nproves 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
orImprovement is sold withinone year of completion, the owner -builder will have the burden
of proving that he did not build or kWove 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 births or frtrproves thereon, and who contracts for
such projects with a comractor(s) ficensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec_ R, g P.C. for this reason
Date Owner _
WORKERS' COMPENSATION DECLARATION
1 hereby affirm that 1 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.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed fl the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of lhp 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: fl, after makiing this Certificate of Exemption you should become
subject to the Workers' Conpensafion provisions of the Labor Code, you must forthwith
comply with such provisions or Oris 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, CM/ Code.)
Lender's Name—
Lender's
ame
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 above-.
mentioned property for inspection purposes.
Signature of applicant— Dale
Mailing Address
City, State, zip
-3,2 -
No. 05507
JILDING: TYPE CONST. 4 OCC: GRP.
P. Number PGA Wast Tract 24317"-1
Legal Description
Project Description Phase 311,. Pbw 20M
Sq. Ft.. 2596 No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
5timated Valuation
$179,18
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
$ 751.17
Const.
919,50
Mech.
Electrical
138.36
Plumbing
148.00
S.M.I.
12.60
Grading
Driveway Enc.
Infrastructure
$4,045.94
2,422.95
%ml Credit
2.322.95
d+�
TOTAL
$4.131.08
r 1—)/. 6) y
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
10113189
Issued by: Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
GRADE
2ND FL SO. FT.
BONDING
YARD SPKLR SYSTEM
POR SO FT ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
LIND. REINF.
GAS (ROUGH)�ilj•
DRAINAGE PIPING
CAR P. I SD. FT.
OTHER APPJEOUIP.
EINF. STEEL
WALL SO. FT.
TEMP. POLE
DRINKING FOUNTAIN.
SD 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
WASHER(AUTO)(DISH)
APPLIANCE DRYER
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, 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 a 1 Vi c
SEWAGE DISPOSAL
SO.FT.GAR ® V4c
HOUSE SEWER
MESH
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TO—AL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE _ PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SET CK
ROUND PLUMBING / , /�
UNDERGROUND
A.C. UNIT
COLL. AREA
GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SE/HC At �
ROUGH WIRING
DUCT WORK
ROCK STORAGE
LIND. REINF.
GAS (ROUGH)�ilj•
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
EINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
q&INAL INSPA _,�7 2
q19FRAMING ��
FINAL INSP.
OZOOFING//(
/�j `](/j/
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
THING
MESH
I ULATION/SOUND 5^-AZV ii
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL