05021 (SFD)sv111, 44
u0l'�Gv
P.O. BOX 1504
7&105 CALLE ESTADO
Address 55-051 Riviera. LA QUINTA, CALIFORNIA 92253
Sunrise Company
Mailing
Address 42-600 Cook. Sid t»ei . qilato VIA
City Zip Tel.
FAI'm€ esar>r 1 92260 1 5fiA_2A2A.
Contractor
Address "
City Zip Tela
State Lic. City
B Classif. 28t- 130 Lic. # 328
Arch., Engr.,
Designer
Address Tel.
CityI Zip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
lot of Division 3 of the Business and Professions Code, and my license is in full force and
effec
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,Busimess and Professions Code: Any city or county which requires a
permit to construct, after, improve, demoksh, or repair any structure, prior to its issuance also
requires the applicant for such pemmir to Me a signed statement that he is licensed pursuant to
the provisions of the contractors License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professkm Code, or that. he is exempt therefrom, and the basis
for the alleged exemption. Any vkdatbn of Section 7031.5 by 'any applicant for a permit
subjects the applicant to a cidd penny 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 Coder -The Corihactevs License Law does not apply to an owner of property who
builds or improves thereon and who does such work hkrseff or through his own employees,
provided that such Improvements are not Wended or offered for safe. If, however, the building
or improvement Is sold within -one year of corrpletkm, the owner -builder will have the burden
of proving that he did not build of improve for the purpose of safe.)
O 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 builds or knproves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 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
Workers Compensation Insurance, ora 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
WORKED' COMPENSATION INSURANCE
(This section need not be completed If the permit is for one hundred dollars (5100) valuation
or less.)
I certify that in the performance of the 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 maift this Certificate of Exemption you should become
subject to the Workers' CorrpensaDon 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, Civil Code.)
Lenders Name
Lenders Address
This is a buitding permit when property 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 Date
Mailing Address
City, State, Zip
i
No. 05021
BUILDING: TYPE CONST.. OCC: GRP.
A.P. Number i►f'_dt Vo%^t _ I)U- ^ lv(r
Legal Description
Project Description P l a- . MA
Sq. Ft. 3038 No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT
BY:
AMOUNT
Plan Chk. Dep.
Front Setback from Center Line
Plan Chk. Bal.
Rear Setback from Rear Prop. Line
rj1,7f►
Const.
Side Setback from Property Line
Mech.
FINAL DATE
3 , nO
Electrical
12/22/88
16411,94
Plumbing
Validated by:
i in . 11C
S.M.I.
Validation:
15,76
Grading
Driveway Enc.
Infrastructure
$4,$$7,09
2,443.55
Lass Credit
2,443.55
TOTAL
$4,041,01
/A-
REMARKS
'SI1Fl3i a. t1, ttS^Z,l Int %V
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
12/22/88
Issued by:
Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
B GRADES ^
2ND FL. SO. FT.
BONDING
YARD SPKLR SYSTEM
POR. SD. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
U D. REINF.
GAS (ROUGH)
DRAINAGE PIPING
CAR P. I SO. FT.
OTHER APPJECU1P.
REINF. STEEL
WALL SD. FT.
T P. 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 FAN EVAP.COOL HOOD
SIGN
WASHER(AUTOXDISH)
APPLIANCE DRYER
ok lTILATION (�//!/
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.
SO. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/. c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ic
HOUSE SEWER
SH
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
ROUND PLUMBING! _
F UNDERGROUND
A.C. UNIT
COLL. AREA
B GRADES ^
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTI TA
ROUGH WIRING
DUCT WORK
ROCK STORAGE
U D. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJECU1P.
REINF. STEEL
S (FINAL) %/
T P. POLE
GROUT
WATER HEATER
4N6VICE 1V (
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ -plus-x$-=$
L ER GR.
FINAL INSP.
F ING
FINAL INSP.
OFING /
rVEN
ok lTILATION (�//!/
REMARKS:
FIRE ZONE ROOF164G
FIREPLACE
SPARK ARRESTOR
AR. FIREWALL
ING
SH
SULATION/SOUND
FINISH GRADING
�AL INSPECTION/`
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL