06340 (SATT)4
P.O. BOX 1504 No. 06340
Building 78-105 CALLE ESTADO
Address 54-673 Riviera LA QUINTA, CALIFORNIA 92253
Owner
Mailing
Sunrise copy BUILDING: TYPE CONST. OCC: GRP.
Address 75-005 Club Drive A.P. Number P" Test — Phz' " 30B
City Zip Tel.
Palm Desert 9236th 56072828 Legal Description
Contractor Project Description T=el 24317-1, Plan 300
S mr
Address
City Zip Tela
State Lic. City
& Classif. 2$$130 Lica# 328 Sq. Ft. 2826 A 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.
IDATE
OWNEWBUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following Estimated Valuation $1946692
reason: (Sec. 7031.5,Busrress and Professions Code: Any City or county which requires a
permit to construct, after, kprove, 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) o/
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 /or a permit Plan Chk. Dep:
subjects the applicant to a civil penalty of not more than five hundred dollars (5500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. $ 802.21
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Suisness and A?
Professions Code: The Contractors License Law does not apply to an owner o/ property who Const. 9 • ®
builds or improves thereon and who does such work himself or through his own employees, Mech. $,.
provided that such krps rovernerare not intended or offered for sale. If, however, the building
50
or improvement is said within are year of completion, the owner -builder will have the burden Electrical ' �(}'• �{�,
of proving that he did not build or rnierove for the purpose or sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con. Plumbing (`jQ. �D
struct the project (Sec. 7044, Business and Professions Code: The Contractors License Law
does not apply to an owner of properly who builds or improves thereon, and who contracts for S.M.I. 13.65 .
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
❑ I am exempt under Sec B. & P.C. for this reason
Driveway Enc.
Date owner Infrastructure $ .5 2,194.29
Lose Gredirc
WORKERS' COMPENSATION DECLARATION
I 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, a
TOTAL
CERTIFICATE OF EXEMPTION FROM REMARKS 1r651iAA12-. .,(}Q-
WORKERS' COMPENSATION INSURANCE
S. V is it,y rl 1 :.� s nx. r
(This section need nmol be carpeted it the permit is /or one hundred dollars ($100) valuation � y
or less.)
I certify that in the performance of the work for which this permit is issued, 1 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: ff after making this Certificate of Exemption you should become ZONE: BY:
subject to 'the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shag be deemed revoked. - Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued- (Sec. 3097, Civil Code.) Side Setback from Property Line
Lender's Name
Lenders Address S
C�1OR
This is a building permit when properly filled out, signed and validated, and is subject to FINAL DATE I yes
expiration it work thereunder is suspended for 180 days.
I certify that 1 have read this application and state that the above information is correct. Issued by: Date Permit
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. Validated by:
Signature of applicant Date
Mailing Address Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. a $
UNITS
RADE 1i
2ND FL SQ. 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. SQ. FT. ®
TEMP. POLE
WALL SO. 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
�J
(✓— f
FRAMING 21-1—f?)
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, TEMIPERM
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 ® 11/4 c
SEWAGE DISPOSAL
MESH
SQ.FT.GAR ® V4c
HOUSE SEWER
INSULATION/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
SET ACK
0,,06UND PLUMBING r
UNDERGROUND
A.C. UNIT
COLL. AREA
RADE 1i
LUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
R SE 6_fhU j0
kG
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
F D. R INF.
GH) �f.Of
✓
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
LlfiINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ —Plus—x$—=$
LUMBER GR.
/
NAL INSP. V 5—Ve
�J
(✓— f
FRAMING 21-1—f?)
FINAL INSP.
ROOFING U O
/� •
/dV/
— OfiC�
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
OCATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
'
GARDEN WALL FINAL
I